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Permit (129) q TIGARD City of Tigard January 28, 2020 Tube Art Group 4243-A SE International Way Milwaukie, OR 97222 Re: Permit No. FT.C2019-00641 Dear Applicant: The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the following: Site Address: 7600 SW Atlanta St Project Name: Public Storage Job No.: N/A Refund Method: ® Check#234523 in the amount of$243.14. ❑ Credit card "return" receipt in the amount of$ Note: Please allow 2-5 days for this refund transaction to be credited to your account by the company that issued your card. ❑ Trust account"deposit"receipt in the amount of$ Comment(s): Per applicant's request as job was cancelled. Refund 80% of permit fees. If you have any questions please contact me at 503.718.2430. Sincerely, 4 Dianna Howse Building Division Services Supervisor Enc. 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov II IN : City of Tigard r►c,��z 1) Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE TO: Tube Art Group DATE: 1/17/2020 4243-A SE International Way Milwaukie, OR 97222 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt#: 426036 Case#: ELC2019-00641 Date: 9/25/2019 Address/Parcel: 7600 SW Atlanta St Pay Method: Check Project Name: Public Storage EXPLANATION: Per applicant's request and job was cancelled. Refund 80% of permit fees. REFUND INFORMATION: Fee Description From Receipt Revenue Account No. Refund Example: Building Permit Fee Example: 2300000-43104 $Amount Electrical Permit 220-0000-43103 $217.09 12%State Surchage 100-0000-24001 26.05 TOTAL REFUND: $243.14 APPROVALS: SIGNATURES/DATE: If under$5,000 Professional Staff / d24iS7ikaY-1-C.--- If under$12,500 Division Manager If under$25,000 Department Manager If under$100,000 City Manager If over$50,000 Local Contract Review Board FOR ACCELA SYSTEM ADMINISTRATION USE ONLY Case Refund Processed: Date: 4f/g/;',-7 By: ��%J? l I:\Building\Refunds\RefundRequest.doc x 09/01/2010 CITY OF TIGARD RECEIPT 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Project Name: Public Storage Site Address: 7600 SW ATLANTA ST Receipt Number: 436196 - 09/03/2021 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID ELC2019-00641 $-243.14 Total: $-243.14 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 234523 DHOWSE 09/03/2021 $-243.14 Payor: Tube Art Group Total Payments: $-243.14 Balance Due: $243.14 Page 1 of 1 u : W liffq CITY OF TIG RD RECEIPT Et 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 T.f GG MW Project Name: Public Storage Site Address: 7600 SW ATLANTA ST /9 fill /AM-L. Receipt Number: 426036 - 09/25/2019 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID ELC2019-00641 Sign or Outline Lighting 220-0000-43103 k0 `i'e $271.36 E ELC2019-00641 12% State Surcharge- Electrical 100-0000-24001 1° 90 $32.56 Total: $303.92 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 4229 BTAGGART 09/25/2019 $303.92 Payor: Tube Art Displays, Inc. Total Payments: $303.92 Balance Due: $0.00 Page 1 of 1 RECEIVED DEC 10 2019 CITY OF TIGARD City of Tigard • coninluNri'�- DI:vI�a.OPnu�.N�r l�r.l>,�R�rnnv'r LDI DIVISION �► 11 Request for P °/ermi q t Action ,/-7 zoo TIGARD 13125 S\V Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPertnits@tigard-or.gov FROM: ❑ Owner ❑ Applicant ni Contractor ❑ City Staff Check(V)one REFUND OR Name: INVOICE TO: (Business or Individual) Tube Art Group / lfaley Arnell Mailing Address: 4243-A SF. International Way City/State/Zip: Mihvaukie OR 97722 Phone No.: 503.653.1133 / 917.205.7780 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓): ►:4 CANCEL/VOID PERMIT APPLICATION. va,4 REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). MI INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). Permit#: ].0.1019-00641 i, 3t,h�Hi�>-tiri9f,t`s� Site Address or Parcel #: 7600 S\V Atlanta St. #1S136CD01501 Project Name: Public Storage Subdivision Name: Lot#: EXPLANATION: Ptb1;'t, s ra.gt C/i en f ea me//ed a// 5ifr1apt , 7,6 6;9174 Ge 1i .Ci 7ee✓ Gt.; t412 �hZs /isoo." prefrzt h�!.S been [icyr'ee//te/, Signature: Date: 4?-;i.-1 Print Name: kick \ .tell Refund Policy 1. The city's Community Development Director,Building Official or City Iingineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal ser�iee. 3. Please allow 3-4 weeks for processing refund requests. ..2.7/ .( / 7.4 J = 5 .�� • Jo . 12:/y od . 71 FOR OFFICE USE ONLY Route to Sys Admin: Date By Route to Records: Date ?/3 /_jr B / u.. CITY OF TIGARD ELECTRICAL PERMIT 1911 COMMUNITY DEVELOPMENT Permit#: ELC2019-00641 Date Issued: 09/25/2019 TfGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S 136C D01501 Jurisdiction: Tigard Site address: 7600 SW ATLANTA ST Project: Public Storage Subdivision: None Lot: None Project Description: Sign lighting. Contractor: TUBE ART SIGNS &SPORTS DISPLAYS Owner: TRAILBLAZER DEVELOPMENT LLC 4243-A SE INTERNATIONAL WAY BY CPS ASSET MANAGEMENT LLC MILWAUKIE, OR 97222 333 S STATE ST STE V-144 LAKE OSWEGO, OR 97034 PHONE: PHONE: 503-653-1133 FAX: 503-659-9191 FEES Quantity Description Date Amount 4 ea Sign or Outline Lighting 09/25/2019 $271.36 Specifics: 1 ea 12%State Surcharge- 09/25/2019 $32.56 Electrical Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $303.92 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 of e ru- • direct questions to OUNC by calling 503 232.1987 or 1.800. 2.2344. 1) Issued By: - i —� •ermittee Signature: Q Ety 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 ONLY City of Tigard ECEIV i Bed I GG�� : a 114 "I 13125 SW Hall Blvd.,Tigard,OR 97223 y g Plan Review i9 Phone: 503.718.2439 Fax: 503.598.1960 r Date/By: R P �f�2.G Inspection Line: 503.639.4175 SEP 17 201• Ready Date/By: Juris: Or See Page 2 for TIGARD Internet: www.tigard-or.gov otified/Method: Supplemental Information CITY 9F TIGA i- k tf. s ur s s2. :i as} TY `5, PE•OF,WORK 4 tAVI; "',;.t. . .-1n`..'.r ._...PLAN REVIEW. `. I ®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 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. 0 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations, buildings. ❑ Multi-family 0 Master builder 0 Other: 0 Fire pump. ❑Installation of 150 KVA or :JOB+SITE.INFORMATION AND-LOCATION _ 0 Emergency system. larger separately derived ❑Addition Job#: Job site address:7600 SW Atlana St. 100HPHof new motor load of system. or more. ❑"A" "E» "1-2" "I-3" City/State/ZIP:Tigard,OR 97223 ❑Six or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name:Public Storage 0 Hazardous locations, 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site:Dartmouth St ,FEE,.•SCHEDULE £. , Description I Qty. I Each I 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#:R0284285 Ea.add'I 500 sq.ft.or portion 33.92 l ;,,,,,. , ,. ;, a , ,p,„I SCRIPtTION,OF, WORK 44 „„- ,;;& a1- Limited energy,residential Connect Four(4)illuminated Wall Signs (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 -;V;:';'....]0,1,4::]'PROPERTYs;OWNER , ,,,I„„1, }.t ,,, „rt, .';: l iTENANT z ti " ' ' Services or feeders installation,alteration,and/or relocation Name:Public Storage 200 amps or less 100.70 2 Address:7600 SW Atlana St. 201 amps to 400 amps 133.56 . 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Tigard,OR 97223 601 amps to 1,000 amps 301.04 i 2 Phone:( ) 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 l Ft.tI '� ,V;t '+' ►�rCONTAC'T;'PERSONi w .i Branch circuits-c new,alteration,or extension,per panel ,, , ;. v ®.APPLICANT x.,y. 1„�, u,,y,, , A.Fee for branch circuits with Business name:Tube Art Group above service or feeder fee, 7.42 2 each branch circuit Contact name:Haley Arnell B.Fee for branch circuits without Address:4243-A SE International Wayervice or feeder fee,first 56.18 2 bbranch circuit City/State/ZIP:Milwaukie,OR 97222 Each add'l branch circuit 7.42 . 2 - Miscellaneous(service or feeder not included) Phone:(971)205.7780 Fax: :(503)659.9191 Each manufactured or modular 67.84 2 Email:harnell@tubeart.com dwelling,service and/or feeder Reconnect only 67.84 2 .- _ 4 .81 'Business name:Tube Art Group Sign or outline lighting 4 67.84 2 Address:4243-A SE International WaySignal circuit(s)or limited-energy 0 See Page 2 2 panel,alteration,or extension. City/State/ZIP:Milwaukie,OR 97222 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)653.1133 Fax:(503)659.9191 Investigation(1 hr min) 90.00/hr Email:harnell@tubeart.com Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 70956 Electric Lic.: 37554CLS Suprv.Lic.: SIG 761 specifically listed(%z hr min) .ELECTRICAL`:PERMIT FEES Suprv.Electrician signature,require // Subtotal: Print name: Jesse Yankee ate: 91/6// 1 0 Plan Review Required(25%of permit fee): !/' / / State surcharge(12%of permit fee): Authorized signature: ),_________-- 4 TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Haley Arnell Date: 9 , ) . 19 days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB