Permit (94) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT111
Permit#: ELC2017-00841
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/09/2017
( �' Parcel: 1S134BC00300
Jurisdiction: Tigard
Site address: 12280 SW SCHOLLS FERRY RD
Project: Firenza Pizza Subdivision: None Lot: None
Project Description: (1)circuit for sign lighting.
Contractor: RAMSAY SIGNS INC Owner: FW OR-GREENWAY TOWN CENTER LLC
9160 SE 74TH AVE PO BOX 790830
PORTLAND, OR 97206 SAN ANTONIO, TX 78279
PHONE: 503-777-4555 PHONE:
FAX: 503-777-0220
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 11/09/2017 $67.84
Specifics:
1 ea 12%State Surcharge- 11/09/2017 $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 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 OA 52-001-0090. •i may obtain-copy of a rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: F 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 603.639.4175 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.
,..... • • ,.... RECEIVE ', '
Electrical Permit Application FOR OFFI( F E sE ov 1.1
Received / Permit No.:
City of Tigard N n v 2 n y DeeB �/ L ip r/_0 7 /
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1 161 p . p. Date/By: Other Permit:
Inspection Line: 503.639.4175 lTY O ' I>(51 iii Date Ready/By: tans: See Page 2 for
I 1 C,:1 K I) NotiSed/Method: Supplemental Information
Internet: www.tigard-or.gov BUI1 DING gt(VISI I
TYPE OF WORK i PLAN REVIEW
Please check all that apply(submit 2 sets of plans w/items checked below):
❑New construction Addition/alteration/replacement 0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
❑Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION 0 Addition of new motor load of ❑"A" E", 1-2 ,"t-3
100IIP or more. occupancy.
Job no.: Job site address. ...&„ lS ce:e�,lVn ❑Six or more residential units. ❑Recreational vehicle paries.
0 Health-care facilities. 0 Supply voltage for more than
City/State/ZIP:Tigard,OR 97223 ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name:Re 2_ P j-ruck ❑Service or feeder 600 a�or
more.
FEESCHEDULE
Cross street/directions to job site: C) 1\Ct1� U ) Description I Qty. i Fee. I Total 1 *
New residential single-or multi-family dwelling unit.
e.. ��
i) / 1 .-A 'l' Includes attached garage.
\ Lot no.: 1,000 sq.ft.or less 168.54 4
Subdivision �` _��� l
Ea.add'1500 sq.ft.or portion 33.92 1
Tax map/parcel no.: f 45 I.34 (13$C) Limited energy,residential 75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family 75.00 2
Instal 1 circuit residential(with above sq.ft.)
Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
0 PROPERTY OWNER F.-- ) TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:See Attached 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
City/State/ZIP: relocation
Phone:( ) Fax:( ) 200 amps or less 125.0859.36 1
2
201 amps to 400 amps
Owner installation:This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. Branch circuits—new,alteration,or extension,per panel
Owner signature: Date: A.Fee for branch circuits with
2APPLICANT ❑ CONTACT PERSON above service m feeder fee, 7.42 2
each branch circuit
Business name:Ramsay Signs Inc B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Contact name:Garrett Gibson branch circuit
Each add'l branch circuit 7.42 2
Address:9160 SE 74th Ave Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
City/State/ZIP:Portland,OR 97206 dwelling,service and/or feeder
Fax::(503)777-0220 Reconnect only 67.84 2
Phone:(503)777-4555 Pump or irrigation circle 67.84 2
E-mail:GarrettG@RamsaySigns.com Sign or outline lighting i 67.84 2
CONTRACTOR Signal circuit(s)or limited-energy
Business name:Ramsay Signs Inc panel,alteration,or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address:9160 SE 74th Ave Additional inspection(1 hr min) 66.25/hr
Investigation(1 hr min) 66.25/hr
City/State/ZIP:Portland,OR 97206 Industrial plant(I hr min) 78.18/hr
Phone:(503)777-4555 Fax:(503)777-0220 Inspections for which no fee is 90.00/hr
specifically listed(%z hr min)
CCB Lic.: 63422 Electrical Lic.: 26106CLS Suprv.Lie.: 493Sig ELECTRICAL PERMIT FEES
Subtotal:
Suprv.Electrician signature,required: Plan review(25%ofpermit fee):
Print name: Phil Steiger Date: /1--7—17 State surcharge(12%of permit fee):
( / TOTAL PERMIT FEE:
Authorized sign This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Garrett Gibson Date: 'f * Number of inspections allowed per permit.
L\Building\Permits4ELC-PeneitAPP.dac 07/01/10 440-4615T(11/05/COM/WEB
Electrical Permit Application - City of Tigard
Page 2-Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for All residential systems combined........ $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
O Burglar Alarm
❑ Garage Door Opener*
• Heating,Ventilation and Air Conditioning System*
O Vacuum Systems*
❑ Other
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
O Data Telecommunication Installation
❑ Fire Alarm Installation
• HVAC
O Instrumentation
❑ Intercom and Paging Systems
O Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
g Other
Total number of commercial systems: —
*No licenses are required. Licenses are required
for all other installations
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