Permit 11111 CITY OF TIGARD ELECTRICAL PERMIT
3 COMMUNITY DEVELOPMENT Permit#: ELC2015-00121
T(GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/17/2015
Parcel: 2S104BB07900
Jurisdiction: Tigard
Site address: 14300 SW BARROWS RD
Project: Haggen Subdivision: RUSSELL'S SCHOLLS FERRY Lot: 2,TRAC
Project Description: Sign lighting for(1)sign.
Contractor: E S&A SIGN&AWNING Owner: ABS OR-O LLC
89975 PRAIRIE RD 250 PARKCENTER BLVD
EUGENE, OR 97402 BOISE, ID 83706
PHONE: 541-485-5546 PHONE:
FAX: 541-485-5813
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 03/17/2015 $67.84
Specifics:
1 ea 12%State Surcharge- 03/17/2015 $8.14
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $75.98
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTEN • on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-00 •through OAR • :* 10 . You may obtain a copy of the rules or direct questions to OUNC by callin. -• . '.1987 or 1.800.332.2344.
/, � 1 I Il!/
Issued =y: , - Permittee Signal. _ _ • 2/
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
, Ekictrical Permit Application FOR OFFICE USE ONLY
City of Tigard Received Date/By: Permit No"CA , illi' 4s8
13125 SW Hall Blvd.,Tigard,OR 97223 <13 Plan Review
_
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: j luris: ® See Page 2 for
Internet: www.tigard-or.gov ') Notified/Method: 9 �S Y Supplemental Information
TYPE OF WOR%L J ' 1. PLAN REVIEW
Please check all that apply(submit 2 sets of plans w'items checked below).
❑New construction ❑Addition/alteration/replacement
n ['Service or feeder 400 amps or more El Building over three stories.
El Demolition ®Other:Sign l FP 9 4 7 015 where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1 and 2-family duelling ®C otnmcrcial/inJUStiial ❑ Ac .. ing amps for all other installations. buildings.
❑Multi-family ❑ Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
❑Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑Addition of new motor load of ❑"A","E","1-2","I-3",
100HP or more. occupancy.
Job no.: Job site address: 14300 Sw Barrows road 0 vehicle parks.
❑Six or more residential units. P
City/State/ZIP:Tigard,Oregon 97223 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: , Project name:Haggen ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site:SW Walnut street Description I Qt,. I Fee. I Total I
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 I
Tax map/parcel no.: Limited energy,residential
DESCRIPTION OF WORK (with above sq.ft.) 75.00 .,
Limited energy,multi-family 75 00
Install(1)internally illuminated wall sign residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER IS TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: Haggen Northwest Fresh 401 amps to 600 amps 200.34
Address: 14300 SW Barrows road 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP:Tigard,Oregon 97223 Temporary services or feeders installation,alteration,and/or
relocation
Phone:( ) Fm` ( ) 200 amps or less 59.36 I
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 3
Owner signature: _ Date: _- Branch circuits—new,alteration,or extension,per panel
® APPLICANT I ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee, 7.42 7
Business name: ES&A Signa and Awnings each branch circuit
B.Fee for branch circuits without
Contact name:Kaela Ouellette service or feeder fee,first 56.18 2
branch circuit
Address:89975 Prairie road Each add.'branch circuit 7.42 2
City/State/ZIP: Eugene,Oregon 97402 Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
Phone:(541)485-5546 Fax: :(541)485-5813 dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail: kuellette@esasigns.com _ —_ Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 1 67.84 6'7, $h 2
Business name: ES&A Signs and Awnings Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address:89975 Prairie road Each additional inspection over allowable in any of the above-
-- Additional inspection(I hr min) 66.25/hr
City/State/ZIP:Eugene,Oregon 97402 Investigation(I hr Irvin) 66.25/hr •
Phone:(541)485-5546 Fax:(541)485-5813 Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lie.: 163470 Electrical Lie.: 20534CLS Su rv. Lic.: 514 SIG specifically listed(%2 ht min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal• __
/ Plan review(25%of permit fee):
Print name: Gordy Roseboro Date: 2/6/2015 _.
,/ _ State surcharge(12%of permit fee):
Authorized signature: , TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within ISO
Print name: Kaela Ouellette Date: 2/6/2015 days after it has been accepted as complete.
Number of inspections allowed per permit.
1.\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description I Qty. I Fee I Tolxl-�_
Fee for all residential systems combined ... $75.00 Renewable electrical energy systems:
5 kva or less 100.70
Check Type of Work Involved: 133.56 5.01 to 15 kva
0 Audio and Stereo Systems* 15.01 to 25 kva 200.34 _ 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 55226 2
❑ Garage Door Opener* >100 kva fee in accordance with
( 552.26
OAR 918-309-0040)
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.4_2 3
❑ Vacuum Systems*
>100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr
charged at an hourly(I hr mm)
Inspections for which no fee is 90,00/hr
specifically listed('/:hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
$75.00 Subtotal:
Fee for each commercial system Plan review,if required(25%of permit fee):
(SEE OAR 918-309-0000) State surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within ISO
❑ Audio and Stereo Systems days after it has been accepted as complete.
* Number of inspections allowed per permit.
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ I-IVAC
❑ instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
t\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14300 SW BARROWS RD, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2015-00121
Chip Barnett
Violation Summary:
Inspector Contractor