Permit (266) CITY OF TIGARD ELECTRICAL PERMIT
Ili.' • COMMUNITY DEVELOPMENT Permit#: ELC2016-00904
Date Issued: 12/07/2016
T If.;A R.i 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S17/2016 100
Jurisdiction: Tigard
Site address: 11705 SW PACIFIC HWY E
Project: Baskin Robbins Subdivision: None Lot: None
Project Description: Sign lighting for(2)wall signs
Contractor: MEYER SIGN CO OF OREGON Owner: PACIFIC CROSSROADS PROPERTIES IN
15205 SW 74TH AVE BY WYSE INVESTMENT SERVICES CO
TIGARD, OR 97224 1501 SW TAYLOR ST STE 100
PORTLAND, OR 97205
PHONE:
PHONE: 503-620-8200
FAX: 503-620-7074
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 12/07/2016 $135.68
Specifics: 1 ea 12%State Surcharge- 12/07/2016 $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. ATTENT egon law requires you to follow the rules adopted by the Oregon Utility Notification -- ter. Those rules are set forth in OAR
952-001-0010 hrough O 952- 0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503 :87.r 1.800.2344.
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Issued By: Permittee Signature:
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 ApplicaplE CEIVED FOR OFFICE LSE("IA
City of Tigard Received Perm :
4 1111 13125 SW Hall Blvd.,Tigard.OR 9� ,2 8 2016 Date/B : J Q ib 06.-- it# G����- 9o4/Plan Review
. 0 Phone: 503.718.2439 Fax: 503.5_98.1960 Related Permit#: �ij/V—ire,3?�
Date/B
- Inspection Line: 503.639.4175 C x O l e r Read Date/B las:
T I G A R D
"' �/ to 1 1 Y Y' ® SeePage2for
Internet jwww Ugard or„gov81 �11 T� E e /41C!'
A l pi Notified/Method: Suppleml Information
❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
O Demolition 0 Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current ❑Marinas and boatyards.
a iz.zi :rr exceeds 10.000 amps at 150 volts or ❑Floating buildings.
❑ 1-and 2-family dwellingless to ground.or exceeds 14.000 ❑Commercial-use agricultural
®Commercial/industrial ❑Accessory building amps for all other installations, buildings.
❑Multi-family ❑Master builder 0 Other: 0 Fire pump. ❑Installation of Iso KVA or
nr� Zk � Z �� ,�rL i , : ,fi�' �,au:L ;�; "� �Iv ,, ❑Emergency sYstems
larger se arate] derived
P Y
❑Addition of new motor load of system.
Job#: Job site address:11705 SW Pacific Highway IOOHP or more. ❑"A","F". `1-2","1-3",
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: I Project name:Baskin Robbins ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more 600 volts nominal
Cross street/directions to job site: : 7 `' 7 x t:1t ::::2w
s
Description Qty. Fath Total
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
� �, ., ,� , Ea.add'l 500 sq.ft.or portion 33.92 1
� Limited energy,residential
75.00 2
(with above sq.ft.)
Connect 2 sets of Internally Illuminated Pan Channel letters on a raceway on
Limited energy,multi-family 75.00 2
tenants East and South elevations to existing electrical. residential(with above sq.ft.)
, ,, Renewable Energy 0 See Page 2
�� � ' �` -( a-uiuj Services or feeders installation,alteration,and/or relocation
Name:Pacific Crossroads Properties 200 amps or less 100.70 2
Address:810 SE Belmont St. 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,OR 97224 601 amps to 1,000 amps 301.04 2
Phone: ( ) I Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,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 ' 1
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 2
r '-v {_,> p - Branch circuits—::::,.'s alteration or extension per panel
�r�E ' �� �r � S` “'-f'.;.. 'z t f c � > >
....... .`r� ..-,.,'a`.r, !. .�,... - ,4.rz.?w^a ,., ..f�r ' -t:< vfi�..r>�i,. �,€":E,5:1. r"
�� � A.Fee for branch with
Business name:Meyer Sign Co.of Oregon above service or feeder fee, 7.42 2
each branch circuit
Contact name:Tony McCormick B.Fee for branch circuits wdthout
Address: 15205 SW 74th Ave. service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP:Tigard,OR 97224 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone: (971)232-5021 I Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:permits@meyersignco.com
Reconnect only 67.84 2
s.. $: ��� � � Pump or irrigation circle 67.84 2
Business name:Meyer Sign Co.of Oregon Sign or outline lighting 2 67.84 2
Address:15205 SW 74th Ave. Signal circuits)orlimited-energy ❑ See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Tiagrd,OR 97224 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(971)232-5021 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:permits@meyersignco.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 64014 Electrical Lie.: Sup4-rv.Lie.: 569SIG s,eclficall listed(�/z hr mm)
,ed,9 j%Q ii,s? ...2'a i. .+sem .g.�.n. a:
Suprv.Electrician signature,r-+wired: ry 6/ xvr Subtotal
Print name: Todd Barcl. , I Date: 11/21/16 ❑Plan Review Required(25%of permit fee):
//,� State surcharge(12%of permit fee):
Authorized signature a, n (1 TOTAL PERMIT FEB: 57
This permit application expires if a permit is not obtained within 180
Print name: Anthony G McCor ' Date: 11/21/16 days after it has been accepted as complete.
Number of inspections allowed per permit.
I:ABuilding\Permits\ELC_PermitApp_I:l R_ERE.doc Res 06/17/2015 440-4615T(11/05/COM/WEB