Permit (93) CITY OF TIGARD ELECTRICAL PERMIT
1111� COMMUNITY DEVELOPMENT
Permit#: ELC2018-00537
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/14/2018
T t Ca tIt•L�i Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 15575 SW SEQUOIA PKWY 180
Project: Bfit Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Sign lighting for(1)sign.
Contractor: VANCOUVER SIGN COMPANY INC Owner: PACIFIC REALTY ASSOCIATES
2600 NE ANDRESEN RD#50 ATTN: N PIVEN
VANCOUVER,WA 98661 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 360-693-4773 PHONE:
FAX: 360-693-2747
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 08/14/2018 $67.84
Specifics:
1 ea 12%State Surcharge- 08/14/2018 $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 sus•ended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those - are set forth in OAR
952-001-0010 through 2-001-0090. in a c s or direct questions to OUNC by calling 50 .212. 87 or 1.800.3 ' 4.
Issued By: ����( Permittee Signature: _�L`>��� 4.--
r
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.
Electrical Permit Application. i.---;‘• FOR OFFICE t'SF ONL1
= i ., �A 'fit tv i .
City of Tigard Received
- e Plan R
III . 13125 SW Hall Blvd.,Tigard,OR 9722 ��i '� '
1 4 [s41 Plan Review
Phone: 503.718.2439 Fax: 503.598.1 �< Date/13 : Related Permit#:
T 1 GARD Inspection Line: 503.639.4175 Ready Date/By: El See Page 2 for
Internet: www.tigard-or.gov 'yes '..2"- `i f - Notified/Method: IMIll Supplemental Information
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❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
f " t''° '77:a ;a:,;,:i2:.:rvaitZpiiiiregt, exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑Multi-family 0 Master builder 0 Other:Sign ❑Firs um
. ocher installations. tdings.
p p. 0 Installation of 150 KVA or
f t '" t ❑Emergency system•
larger separately derived
3r� t ❑Addition of new motor load of system.
Job#: Job site addre `: % 1 SW Sequoia Pkwy 100HP or more. ❑"A","E","t-2","1-3",
City/State/ZIP:Portlan OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt; •• i I Project name:Bfit ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: t4
Description Qty. Each Total *
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
Tax map/parcel#:
1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
, t' t' t Limited energy,residential
Install(1)sign circuit. (with above sq.ft.)
75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
t Services or feeders installation,alteration,and/or relocation
Name:Bfit 200 amps or less 100.70 2
Address: 15350 SW Sequoia 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Portland 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
: T's , t, Branch circuits-new,alteration,or extension, .er panel
A.Fee for branch circuits with
Business name:Vancouver Sign Group above service or feeder fee, 7.42 2
each branch circuit
Contact name:Chris Brown B.Fee for branch circuits without
Address:2600 NE Andresen Rd Ste 50 service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP:Vancouver WA 98661 Each add'1 branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone: (360)693-4773 I Fax: :(360)693-2747 Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Cbrown@vansignco.com Reconnect only 67.84 2
giatINPijeankreESZI T317:71 Pump or irrigation circle 67.84 2
Business name:Vancouver Sign Group Sign or outline lighting 1 67.84 2
Signal circuit(s)or limited-energy
Address:2600 NE Andresen Rd Ste 50 0 See Page 2 2panel,alteration,or extension.
City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(360)693-4773 I Fax: (360)693-2747 Investigation(1 hr min) 90.00/hr
Email:Cbrown@vansignco.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 63951 1 Electrical Li. : 37-46CLS I Suprv.Lic.: 648SIG s secifccall listed(v2 hr 0
min) 9 .00/hr
j
Suprv.Electrician signature,required: _�_4 .- Subtotal:
Print name: Adam Wallis Date: l\ 1 l LI ❑Plan Review Required(25%of permit fee):
N0cAA, State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Chris Brown Date: v I(1.1 days after it has been accepted as complete.
* Number of inspections allowed per permit.
L\Building\Permits\ELC_PermitApp_ELR_['RE.doc Rev 06/17/2015 440.4 15TQ l/OS/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15575 SW SEQUOIA PKWY 180, TIGARD,
OR, 97224
Record Type: Record ID:
Residential - Electrical ELC2018-00537
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor