Permit rt CITY OF TIGARD ELECTRICAL PERMIT
11 • COMMUNITY DEVELOPMENT Permit#: ELC2015-00195
Date Issued: 04/06/2015
TFGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101 DA00104
Jurisdiction: TIGARD
Site address: 13333 SW 68TH PKWY
Project: I Heart Radio Subdivision: VARNS ACRES Lot: 9
Project Description: Sign lighting for(2)replacement signs.
Contractor: RAMSAY SIGNS INC Owner: TRIANGLE POINTE TWO LLC
9160 SE 74TH AVE 901 NE GLISAN ST, STE 100
PORTLAND, OR 97206 PORTLAND, OR 97232
PHONE: 503-777-4555 PHONE:
FAX: 503-777-0220
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 04/06/2015 $135.68
Specifics:
1 ea 12%State Surcharge- 04/06/2015 $16.28
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $151.96
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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a co• or direct questions to OUNC by calling 50. 32.1987 or 1.800.332.2 4.
Issued By: - � __ _ Permittee Signature: _' � _s ■.A/
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.
Electrical Permit Applicatiit
ECGj V 1 fl FOR OFFICE USE ONLY
City of Tigard Received
: Nt�� y J Permit No.: �h-„'/.. '
IN 13125 SW Hall Blvd.,Tigard,OR 97223 `� O 2015 Plan Review a
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit: cg,,(5,,R,
1 1 1 Inspection Line: 503.639.4175 i/ Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov p�,11 I OF il'1(TA�Hn1* Notified/Method: Supplemental Information
TYPE'IFA �)OIV SION PLAN REVIEW
New Construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: 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 dwelling Wommerciallindustrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.A
❑Addition of new motor load of ❑"A","E","1-2","1-3",
Job no.: Job site address: 1337,3 SW (j 8+'t'1 ,[ Vj2k j 100HPormore. occupancy.
r."JI ❑Six or more residential units. El Recreational vehicle parks.
City/State/ZIP I (�1 ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: \ ki tor- ..-qd l ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. 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 1
Tax map/parcel no.: Limited energy,residential
DESCRIPTION OF WORK (with above sq.ft.) 75.00 2
IhS 1 R1 touvimaved wan signs
Limited esietial( ithabfvesq 75.00 2
1 residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation
200 amps or less 59.36 1
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 2
Owner signature: Date: Branch circuits—new,alteration,or extension,per panel
❑ APPLICANT ' ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: each branch circuit
B.Fee for branch circuits without
Contact name: service or feeder fee,first 56.18 2
branch circuit _
Address: Each add'I branch circuit 7.42 2
City/State/ZIP: Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
Phone:( ) Fax: :( ) dwelling,service and/or feeder -
Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 C 3 5,(n,s' 2
Business name: t r l S a S('1 Ave Signal circuit(s)or limited energy See
panel,alteration,or extension. Page 2 2
Address:q I U S , H !f Each additional inspection over allowable in any of the above
ty PO 1 l�V\ IJ_. O 7 Ol.P
Additional inspection hrmi(1 hr min) 66.25/hr
City/State/ZIP:
Investigation(1 hr min) 66.25/hr
Phone:( ) Fax:( ) Industrial plant(1 hr min) 78.18/hr _
Inspections for which no fee is 90.00/hr
CCB Lie.: �3(,r ZZ Electrical Lie. 1 _ p�(J.S Suprv.Lic.: I v1� S) (-,-I specifically listed(%hr min) _
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required / r 1 Subtotal: !35 s cav
Print name:phi I f Il Cr Date: 3 l a Sl 5 Plan review(25%of permit fee):
7 l I((I State surcharge(12%of permit fee): I( .r'
Authorized signatu TOTAL PERMIT FEE. /5 L r
Print name:Jes co KAS IM a S Date:,?j/a 5 71 S This permit application expires if a permit is not o tained within 180
days after it has been accepted as complete.
' Number of inspections allowed per permit.
1:\Building\Permi ts\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(1I/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13333 SW 68TH PKWY, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2015-00195
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor