Permit (93) 111 t
CITY OF TIGARD ELECTRICAL PERMIT
I.:'' COMMUNITY DEVELOPMENT Permit#: ELC2019 00087
Date Issued: 02/14/2019
TI 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S 102CC00500
Jurisdiction: Tigard
Site address: 13500 SW PACIFIC HWY
Project: Verizon Subdivision: None Lot: None
Project Description: Sign lighting for(3)wall signs.
Contractor: SALEM SIGN CO INC Owner: ROIC OREGON LLC
1825 FRONT ST NE 8905 TOWNE CENTRE DR, STE 108
SALEM, OR 97303 SAN DIEGO, CA 92122
PHONE: 503-371-6362 PHONE:
FAX: 503-371-0901
FEES
Quantity Description Date Amount
3 ea Sign or Outline Lighting 02/14/2019 $203.52
Specifics:
1 ea 12%State Surcharge- 02/14/2019 $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. 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 OAR 952-001-0090. You may obtain a copy oft - • - • •' -ct questions to OUNC by calling . .1987 or 1.800.332.2344.
Issued By: _ r- Ill-L_ _�<< •• i ittee Signature: l
---SL'---(C
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 FOR OFFICE USE ONEv
Received
City ofTigard Permit#:
D :
14 Ill 13125 SW Hall Blvd.,Tigard,OR 97223 '\r Et) Planate/ReviewB
Phone: 503.718.2439 Fax: 503.591EC� Y Date/B : Related Permit#:
Inspection Line: 503.639.4175 v Ready Date/By: Juris: Ei See Page 2 for
TIGARD Internet: www.tigard-or.govQ019 Notified/Method: Supplemental Information
TYPE OF WOR . 1 4 t- Ian PLAN REVIEW
®New construction 0 Addition/alteratit®riebl IG ` Please check all that apply(submit 2 sets of plans w/items checked):
�p�t �SION ❑Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition ❑Other: E3U1L[}(NUwhere the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION,i 0 Emergency system. larger separately derived
❑Addition
Job#: Job site address: 13500 SW PACIFIC HWY Hof new motor load of system.
100HP or more. ❑"A" "E" "1-2" "1-3"
City/State/ZIP:TIGARD,OR 97223 ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:VERIZON ❑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
Description I Qty. 1 Each C Total I *
New residential single-or multi-family dwelling unit.
Subdivision: 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
DESCRIPTION OF WORK.; Limited energy,residential 75.00 2
INSTALL(3)INTERNALLY ILLUMINATED WALL DISPLAYS (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
Ca PROPERTY OWNER D TENANT:.' Services or feeders installation,alteration,and/or relocation
Name:ROIC OREGON,LLC 200 amps or less 100.70 2
Address: 11250 EL CAMINO ROAD 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: SAN DIEGO,CA 92130 601 amps to 1,000 amps 301.04 2
Phone: (858)255-4917 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
-0 APPLICANT ®s CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: SALEM SIGN CO,.INC. above service or feeder fee, 7.42 2
each branch circuit
Contact name:OZZIE SPADY B.Fee for branch circuits without
Address: 1825 FRONT ST NEservice or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: SALEM,OR 97301 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)371-6362 Fax: :( ) Each manufactured or modular 67.84 2
Email:OZZIE@SALEMSIGN.COM Reconnect only
, onland/or feeder
y 67.84 2
ONFI2COR Pump or irrigation circle 67.84 2
Business name:SALEM SIGN CO,.INC. Sign or outline lighting 3 67.84 203.52 2
Signal circuit(s)or limited-energy
Address: 1825 FRONT ST NE 0 See Page 2 2
panel,alteration,or extension.
City/State/ZIP: SALEM,OR 97301 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)371-6362 Fax:( ) investigation(1 hr min) 90.00/hr
Email:OZZIE@SALEMSIGN.COM industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 65297 Electrical Lic.: 24-125CL Suprv.Lic.: 394-SIG specifically listed(Yzhrmin)
ELECTRICAL PERMIT FEES
/
Suprv.Electrician signature,required: �„ hLw: %87 Subtotal: 203.52
Print name: BRAD SPADY Date: 1- -1 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 12,
Authorized signature: �t�..�^ss TOTAL PERMIT FEE: � N
/ �J This permit application expires if a permit is not obtained within 1801
Print name: OZZIE SPADY Date: 1-31-19 days after it has been accepted as complete.
* Number of inspections allowed per permit.
L\Building\Permits\PLC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLYa FEE SCHEDULE
Description j Qty. I Each I Total I *
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
ri Vacuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(%2 hr min)
COMMERCIAL tRC WORK ONLY;
ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 alloweSubtod
perl peer on Page 1):
Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
E Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
E Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_PermitApp_ELR ERE.doc Rev 06/17/2015
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
13500 SW PACIFIC HWY, TIGARD, OR, 97223 March 28, 2019 at 9:41 :37 AM
Record Type: Record ID:
Commercial - Electrical ELC2019-00087
Inspection Type: Inspector:
199 Electrical final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor