Permit (68) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2016-00397
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/06/2016
Parcel: 2310461307900
Jurisdiction: Tigard
Site address: 14300 SW BARROWS RD
Project: Albertsons Subdivision: RUSSELL'S SCHOLLS FERRY Lot: A
Project Description: Sign lighting for(3)wall signs.
Contractor: VANCOUVER SIGN COMPANY INC Owner: SPIRIT SPE HG 2015-1 LLC
2600 NE ANDRESEN RD#50 BY HAGGEN OPCO SOUTH LLC
VANCOUVER, WA 98661 2211 RIMLAND DR, STE 300
BELLINGHAM,WA 98226
PHONE: 360-693-4773 PHONE:
FAX: 360-693-2747
FEES
Quantity Description Date Amount
3 ea Sign or Outline Lighting 05/16/2016 $203.52
Specifics:
1 ea 12%State Surcharge- 05/16/2016 $24.42
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $227.94
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. ATTENTI . on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are s- forth in OAR
952-001-0010 t rough OAR 52-001 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.19=7 or .;00.x,.23'4. •
- '♦
Issued By: Permittee Signature: /t1
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 Application
Cityo Ti and `+ Receives )/�
f g .J l)al'iiy, �#4'r .Permit t!. l—/ C..��/,_[ -y
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review IJ Y!
I
Phone: 503.718.2439 Fax: 503.598.1960iii ')C)1� Date/By: Related Penni(N:/i"/,P ,y 0 XX)/t.,"/
Inspection Line: 503.639.4175 +�( ' ady Date/By: Ju 0 See Page 2 for
I It.A it I 1 Internet: www.tigard-or.gov MP � Ir 6lifwd/Mcttaxi: Supplemental Information
TYPE OF WORK 11.1 ,. 11 i'tj�t°1[ PLAN REVIEW
ili'New construction 0Additian./alteration/repTit` f Please check all that apply(submit 1 sets of plans Wilms checked):
)
,,g \SV 0 Service or feeder 400 amps or more 0 Building over three stories
El Demolition ❑Other;
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. i
0 1-and 2-family dwelling Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations, buildings.
El Multi-family 0 Master builder
❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system larger separately derived
Job#: Job site address: 2-(zj / " 0 Addition of new motor load of system,
�c'U �Ct sx.0t.j, c1� in HP or more. ❑"A""E" "1-2""1-3"
City/State/ZIP:""/ t ( ❑Six or more residential units. occupancy,
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: 4 t .,,i-sons 1 .j!..(z ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
oescrtptlon j Qty. j Path I Total I '
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#:
1,000 sq.ft.or less 168.54 4
Ea.add'I 500 sq ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
y (with above sq.ft.) 75.00 2
V Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
0 PROPERTY OWNER f( ENANT Renewable Energy El See Page 2 '
tei4 , Services or feeders installation,alteration,and/or relocation
Name: c y// t i ,yi.x 1 1�r 5 200 amps or less 100.70 2
Address' l 201 amps to 400 amps 133.56 2
(41 10 �� `L c'r, � F 6 401 amps to 600 amps 200.34 2
City/State/ZIP:
4
v1 {{ C 601 amps to 1,000 amps 301,04 2
"• Phone: 0420) cz.ct) _.[J --2 7-i Fax:(2.Zod • (2,Ci — Z Over 1,000 amps or volts 552.26
Temporary services or feeders installation,alteration,and/or 2
l
Email: '"��� o�- Q.( c ," til (C). cC)lit�
relocation
Owner installation:This installation is being a on property that I own which is not 200 amps or less 59.36 I
44 intended for sale, lease,rent,or exchange,according to ORS 447,449,670,and 701, 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 r 2
/APPLICANTGONTACT PERSON Branch circuits-new,alteration,or extension,ear panel
A.Fee for branch circuits with
Business name: V�� CO� vim. C)iyp / above service or feeder fee,
7.42 2
?U{ W each branch circuit
�. Contact name: -^'�"-,'a CLQ" la B.Fee fur branch circuits without
I
service or feeder fee,first 56.18 2
Address: ( , � � p �-I �� SG branch circuit
City/State/ZIP: C� Each add'I branch circuit 7.42 2
Phone:( 62 Ct 'S ,- t+ '7 7 3 Fax: :(, (C(3- �-7 t ' Each manufacturedianeous(seoricedu feeder not included)
3 i l Each or modular
67.84 2
N j. Email: 'ck (Q c'("`+ VPS�'L..i C)
dwelling,service and/or feeder
,, � C f S b'1 C (,f..J1r�..-� Reconnect only 67.84 2
i ONTRACR Pump or irrigation circle /// 67,84 2
Business name: �rr(�� � ,, i �,` C'C� Sign or outline lighting � � 67.84 2
Address: �' r Signal circuit(s)or limited-energy
0 See Page 2 2
l�iy
u, ,4 t,, C't- 1—e- -1 z d •.,'T'"`e' C-Cs-) panel,alteration,or extension
`1 Each additional inspection over allowable in any of the above
City/State/ZIP: \tottA.Co u....u. LA-Ji—
( D /:,/ Additional inspection(I hr min) 66.25/hr
Phone:(3a.)} Gpil..7 'L( k—Fe) Fax:( ) (c)( :7S.-j?�("' Investigation(I hr min) 90.00/hr
Email: -Incr� t Industrial plant(I hr min) 78.18/hr
J)' L I. r LA.(Q. (.kn.-,\---'- Inspections Ibr which no fee is 90.00/hr
/
CCB Lic.: Ct 5 Electrical Lie.: Suprv. Lie.: 1— slwcifically listuxi('ii hr titin)
Cs;-"S
¢i ( r� t I p 3 Z� ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: teL
Subtotal: 036,q
Print name: c afee):
�� �CI 11 t Date: � � 0Plan Review Required(25%of permit
Stale surcharge(12%of permit fee):
Authorized signature ' �• .� TOTAL PERMIT FEE• r r{ c,t
/.4416.
This permit application expires If a permit is na ed within 1811
Print name: '-1 k,Q f �� _L ib. Date: 5 /j_J fee days after it has been accepted as complete,
'L t L e f ' Number of inspections allowed per permit.
1 Molding Permitafit.<'I' A It.R FRF doc Rev 06'17 201 7ati• I ST(11:05,COM,WEB
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
ELC2016-00397
Jeff Grove
Violation Summary:
Inspector Contractor