Permit (72) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2019-00406
Z I
c,A R f7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/13/2019
Parcel: 2S115BA00102
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY P
Project: McDonalds Subdivision: None Lot: None
Project Description: Sign lighting.
Contractor: STEIN SIGN COMPANY, Owner: ARCHLAND PROPERTY I LLC
39810 CROWN POINT HWY BY DOUBLE K VENTURES INC
CORBETT, OR 97019 8255 SW HUNZIKER ST#101
TIGARD, OR 97223
PHONE: 695-3220 PHONE: 503-695-3220
FAX:
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 06/13/2019 $135.68
Specifics:
1 ea 12%State Surcharge- 06/13/2019 $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. ATTENTION: Oregon law requires you to follow e r adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through 0 9 -001-0090. You obtain opy o e rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ij Permittee Signature: �c7
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 Applicatio r ��,- ' r FOR OFFICE USE OyLv
City of Tigard Received
JU n 2019Date/By: G jai - /
,
,1 . 13125 SW Hall Blvd.,Tigard,OR 97223 e
a Plan Review
Phone: 503.718.2439 Fax: 503.5981960Related Permit#:
I Date/B
Inspection Line: 503.639.4175 Ready Date/By: funs: la See Page 2 for
TIGARD Internet: www.tigard-or.gov :i;..;.:,.;
.L'N Notified/Method: Supplemental Information
❑New construction a Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Demolition 0 Other: ❑Service or Feeder 400 amps or more ❑Building over three stories.
where the available fault current 0 Marinas and boatyards.
th y o.. . . ,I; ' .; r ;,r A exceeds 10,000 amps at 150 volts or ❑Floating buildings.
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑Multi family 0 Master builder 0 Other: Fire pumPll other installations. Installation
buildings.
� � ❑Installation of 150 KVA or
'i z , R,�I . ,q ¢`, .' 5::'' " - , ❑Emergency system. larger separately derived
Job#: ioq i8 Job site address: /6200 LW p4 :4 ti c ❑Additioo of ore motor load of system.
}�uf� 100HP or more. ❑"A","E","1-2","1-3", i
City/State/ZIP: 77 6 Die_ ❑Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: / Project name: NC.4:2,1MOSS 0 Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: 04/1044.4444, to -IteNie',
A e „
} :iriii_.fO7* '. _,
Description 1 Qty. Each I Total j " '
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel# 1,000 sq.ftor less 168.54 4
1r ., Ea.add'l 500 sq.ft.or portion 33.92 i I
,�,f� ,.; Limited energy,residential 75.00 1 2
2 A�iL tit t9,40e ' 0n i . !e.,p / C (with above sq. lti I
x+.17 �V �V Gvl! [.'rJ I
Limited energy,multi-family 75.00 2
4Ap Z P/2,�� ArRog z ell,cur'r'5 j� t--- residential(with above sq.ft.)
Renewable Energy ❑ See Page 2 1
" � �.' may. Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 I[I2 1i
Address: t
201 amps to 400 amps 133.56 i 2 I
401 amps to 600 amps 200.34 12
City/State/ZIP: 601 amps to 1,000 amps 301.04 1 2 1
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 — 12 i
Email: Temporary services or feeders installation,alteration,and/or
L.
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 [T]
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08
Owner signature: Date: 401 amps to 599 amps 168.54 L I
az
,,
;!§,;c7•,
q,,,r,,,,;,r,,,q ; ,? /1 ik :,,,,,!,,,,,,,;,,:74
r :�i Branch
for bcircuits new,alteration,or extension,per panel
�` - �� � A.Fee ranch—ircuits with �
Business name: ,57' 6Z above service or feeder fee,
I each branch circuit 7.42 1,
Contact name: B. —Fee for branch circuits without --1
/�
service or feeder fee,first
Address;
P013 `E le) branch circuit 56.18 2
.e
City/State/ZIP: CC,42G XVtii Each add'I branch circuit 7.42 2 1
Miscellaneous(service or feeder not included)
I Phone:(
3) et -- g Fax: :( ) Each manufactured or modular
Email: dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
S -`}-� �.H, -� '���-�'�',���, � �mF,.� ,._ osm�, �� Pump or irrigation circle 67.84 2
Business name:S"'r(� S/6'v Sign or outline lighting 2.. 67.84
Address: PP& 40Signal circuit(s)or limited-energy 2 I
panel,alteration,or extension.
0 See Page 2 2
City/State/ZIP: �� C17
Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(03 ) L15 3 Fax:( ) Investigation(1 hr min
Z� ) 90.00/hr
i Email: 67Ein2.0, g Emit i Industrial plant(1 hr min) 78.18/hr
.� _ .�'��.,�— ' Inspections for which no fee is
CC: Lie.: 643 4 Electrical Lie.:20— ,J uprv.Lic.: /4 �ec9fically li %h
sted r min) 90.00/hr
Suprv. e trician signature,required: -
Subtotal:
[Print name: e,` ‘rf/ Date: i >3 /d ❑Plan Review Required(25%of permit fee): _—;
li `� State surcharge(12%of permit fee): _�
TOTAL PERMIT FEE:
A uthorized signature: ....10.001 I
Print name: ))1-t, � G Data. 7/1/e?
c
G_,, This permit application expires if a permit is not obtained within 180
,, u J r //1 dais after ittig3l�cen nccepteA as complete.
/ *
Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015 440-46.5T(11/05/COM/WEB
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
16200 SW PACIFIC HWY P, TIGARD, OR, 97224 June 20, 2019 at 3:38:10 PM
Record Type: Record ID:
Commercial - Electrical ELC2019-00406
Inspection Type: Inspector:
140 Sign installation Chip Barnett
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
16200 SW PACIFIC HWY P, TIGARD, OR, 97224 June 20, 2019 at 3:37:49 PM
Record Type: Record ID:
Commercial - Electrical ELC2019-00406
Inspection Type: Inspector:
199 Electrical final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor