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Permit (33) 111 CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2017-00328 T(G r�R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/31/2017 Parcel: 1 S 136DB00201 Jurisdiction: Tigard Site address: 11571 SW PACIFIC HWY Project: T-Mobile Subdivision: None Lot: None Project Description: Sign lighting for(1)new 16.75-square-foot wall sign on east-facing wall. Contractor: HANNAH SIGN SYSTEMS INC Owner: FRED MEYER STORES INC 1660 SW BERTHA BLVD STORE#375 PORTLAND, OR 97219 1014 VINE ST PROPERTY TAX 7TH FLOOR CINCINNATI, OH 45202 PHONE: 503-946-8373 PHONE: FAX: 503-206-4900 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 05/31/2017 $67.84 Specifics: 1 ea 12%State Surcharge- 05/31/2017 $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 -pplicable 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 ' suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. T •se rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a c rules or direct questions to OUNC by calling 503.2 .1987 or 1.7.0.332.2344. Issued By:a;4 ,..---‘--:-.-•-? ermittee 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 Applic FOR OFFICE I SE ONLY City of Tigard � �'�� ReceivedPermitNo.: C / P Date/B,74 ©��`� ati 7 • 13125 SW Hall Blvd.,Tigard,OR 9 Plan Review 2 Phone: 503.718.2439 Fax: 503.59x) 8 2017 Date/B : Other Permit: - P,ot, A11 1 i c, tt1 Inspection Line: 503.639.4175 Date Ready/By: .loris: @I See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information , j� i -',- !G/ , jj0%/j� �2j��� / /O �� ea A Please check all that apply(submit 2 sets of plans w/items checked below): ix New construction ❑Addition/alteration/replacement ❑Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition ❑Other: where the available fault current ❑Marinas and boatyards. %,'7 re ,.y " i/a y /<('0 ','i 0 ,// exceeds 10,000 amps at 150 volts or j�y ;IS. 7,i ,X " , w/"% a 2» j /i ❑Floating buildings. �� �� / �� � less to ground,or exceeds 14,000 ❑Commercial-use agricultural 0 1-and 2-family dwelling ®.Commercial/industrial ❑Accessory building amps for all other installations. buildings. 0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or �� ;„ �/ �/�/o� lff£y 0 Emergency system, larger separately derived system. j U //i/� ///Oi,. 1 '�t//J // %%///J%%///////%�9�i///® // ,:`V���///� /4 ❑Addition of new motor load of ❑"A","E","1-2","1-3", Job no.: Job site address://,s-7/ f6.) ?ASG hy 1 or more. occupancy. ❑Six oor r more residential amts. ❑Recreational vehicle parks. ❑Health-care facilities. 0 Supply voltage for more than City/State/ZIP: 7-26A4 0,z_ 9 722-3 0 Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: name: 0 Service or feeder 600 amps or more. Project7/!'IDC!/t c / %// /;✓� Cross street/directions to job site: , /��� '"'/"' //'/"'Q' " Description Qty. Fee. Total 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'l 500 sq.ft.or portion 33.92 1 Tax map/parcel no.: Limited energy,residential %/ // %/�%% , < aipa O//Oag // 75.00 2 y„ 4 � > : y,.,,,,,,:,,,.3,/ ` o ,///Di% ''//'" ,,,37/77 /' (with above sq.ft.) - Limited energy,multi-family 75.00 2 f,,tn/ Y- 0,o residential(with above sq.ft.) Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation �� ! 200 amps or less 100.70 2 �/ /,,,;..4%0i,.GOD/ i///%,,,. f �% %i%%//ems" j% 201 amps to 400 amps 133.56 2 Name: r f /Dan_F 401 amps to 600 amps 200.34 2 Address: //.r7/ fuJ /24-uFr� /74,-- / 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP: n17 ' 0,2_ 97ZZS Temporary services or feeders installation,alteration,and/or Phone:( ) I Fan:( ) 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 i,, o3 ,f,,,,!„,,,;,, A.Fee for branch circuits with ' ''4"1 ^,,,.,,,e,,,4 i r, y /i%i/ii//ce/ii%i i/ ilt Gia%/iiiiDii/% / above service or feeder fee, 7.42 2 Business name: Hannah Sign Systems, Inc. each branch circuit B.Fee for branch circuits without Contact name: David P Lanphere service or feeder fee,first 56.18 2 branch circuit Address: 1660 SW Bertha Blvd. Each add'l branch circuit 7.42 2 City/State/ZIP: Portland,OR 97219 Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 2 Phone:( 503)946 8373 Fax::(503 )206 4900 dwelling,service and/or feeder Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 0 ,4 //ti / A Sign or outline lighting I 67.84 Cerpg 2 Business name: Hannah Sign Systems, Inc. Signal circuit(s)or limited-energy See panel,alteration,or extension. Page 2 2 Address: 1660 SW Bertha Blvd. Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr City/State/ZIP: Portland,OR 97219 Investigation(1 hr min) 66.25/hr Phone:(503 )946 8373 Fax:( 503 )206 4900 Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 203638 Electrical Lic.: CLS34 Suprv.Lie.: SIG676 s.ecificall listed('/z hr min) Suprv.Electrician signature,required: ` s R 4,,. Subtotal: 1- Print name: Plan review(25%of permit fee): David P Demuth Date: J--8-1'7 State surcharge(12%of permit fee): ' / Authorized signature: X TOTAL PERMIT FEE: 7 5. 7 5 Print name: David P Lanphere I Date: 6 -( 7 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Buitding\Permits\ELCPermitApp_ELRERE.doc Rev 05/21/2013 440-4615T(11/05/COM/WEB City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 11571 SW PACIFIC HWY, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Electrical ELC2017-00328 Inspection Type: Inspector: 199 Electrical final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor