Permit 111 CITY OF TIGARD ELECTRICAL PERMIT
�' COMMUNITY DEVELOPMENT Per
CITY
ELC2015-00588
TIGARD 13125 SW Hall Blvd..Tigard OR 97223 503.718.2439 Date Issued: 07/30/2015
Parcel: SEG3436
Jurisdiction: Tigard
Site address:
Project: City of Tigard Subdivision: Lot:
Project Description: (2)branch circuits for ground lighting for new signs and artwork located at the North and South intersections of
Main St.and Pacific Highway.
Contractor: UNITED ELECTRIC LLC Owner:
PO BOX 829
BATTLE GROUND,WA 98604
PHONE: 360-953-3599 PHONE:
FAX:
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo/Purchase 07/29/2015 $63.60
Specifics: Service or Feeder
1 ea 12%State Surcharge- 07/29/2015 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 c••y of t1tewtps or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ;i . �.i— Permittee Signature: . i�� -
.070/ _ j/
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.
Jul 28 15 04:52p p.1
RECEIVED
Electrical Permit Application FuR ()1 I 1( t. 1 sl ().l ,
City of Tigard JUL 2 9 2015 Received � ► Mi
■ 13125 SW Hall Blvd.,Tigard,OR 9,T42 �� P Plan Review
o Phone: 503.7182439 Fax: 503.598.1960 JF-i.IGARD Dmay. Relined Permit 4:
InspeelionLine: 503.639.4175 BUILDING DIVISION ReadyDate/By :uric. 81 See I'age2 for
TI i,.1 1,n Internet: wwtw.tigard-or.gov Notified/Method: 777-6 Supplemental Information
TYPE OF WORK PLAN REVIEW
®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/terns checked):
❑Service or feeder 400 amps or more ❑Building over three stones.
❑Demolition ❑Other where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating bwldiogs.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building
amps for allottkr itutailalions. buildings,
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
7 ❑Addition of new motor load of system.
Job#: Job site address:Main&99W 31 j (p -L / _ I00HPormore ❑'q E "t_2 y_3"• ❑Six or more residential wits occupancy.
City/State/ZIP: fY 77 e, J 'I ❑Health-care facilities. ❑Recreational vehicle perks
Suite/bldg./apt.4: Project name: / r ✓ '� 0 Hazardous locations. ❑Supply voltage for more than
C f 0 I (a�iv� ❑Se vice or feeder 600 amps or more. 600 volts nomina'.
' Cross street/directions to job site:N&S intersections of ain and 99`V FEE SCHEDULE
Description I Qtv. I Earl' I Total I "
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: includes attached garage
1,000 sq.ft.or less 168.54 4
Tax map/parcel 4: Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
Add Ground lighting for new signs and artwork. (with above s4 ft)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
® PROPERTY OWNER { ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name:City of Tigard 200 amps or less I 100.70 2
201 amps to 400 amps i 133.56 2
Address: 401.amps to 600 amps 200.34 2
City,StateiZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Far:( )
Over 1000 amps or volts 552.26 2
Temporary services or feeders installation,alteestior,and/or
Email: relocation
' Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange.according to ORS 4.47,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
Branch circuits-new,alteration,or extension, r panel
® APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with
Business name:United Electric LLC above service or feeder fee, 7.42 2
each branch circuit
Contact name:Troy dolma B.Fee for branch circuits with ut
service or feeder fee,first I 56.18 56.18 2
Address:PO Box 829 branch circuit
Each add'I branch circuit 1 7.42 742 2
City!StaterZlP:Battle Ground,WA 98604
Ntiacellaneous(service or feeder not included)
Phone:(360)984-3589 1 I ax::( ) Each manufactured or modular
67.84 2
dwelling,service and%or feeder
Email:troyjaunitedeleet.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP: Additional inspection(I hr min) 66.25/hr
Fax:( ) Investigation(1 hi-min) 90.00/hr
Phone:( ) Industrial plant(1 hr min) 78.18i hr
Entail: Inspections for which no fee is 90.00/hr
CCB Lic.: 199299 Electrical Lic.: C436 Suprv.Lic.: 5984S specifically listed(14 hr min) ,
ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: �y,� Subtotal: 63.60
Print name: Ben Lipe � ° Date: 7-28-15 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 7.63
'—� TOTAL PERMIT FEE: 71.23
Authorized signature:
This permit application expires if a permit is oat obtained within 180
Print name: Troy Jo12na Date: 7-28-15 days after it has been accepted es complete.
• Number of inspections allowed per permit.
I^Buildirpv°ermita.tc renn4App_t:r•R_ERE.doc Rev C6/117/2015 '140-46155(11e51COMME6
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
SW NO ADDRESS
Commercial - Electrical
105 Underground/slab cover
PASS
ELC2015-00588
Jeff Grove
Violation Summary:
Inspector Contractor
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
SW NO ADDRESS
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2015-00588
Jeff Grove
Violation Summary:
Inspector Contractor