Permit (7) ill CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2019-00731
Date Issued: 10/23/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1S136DD02300
Jurisdiction: TIG
Site address: 11799 SW 69TH AVE
Project: HAMPTON INN&SUITES Subdivision: Lot:
Project Description: New 87,872 sq.ft.five-story, 152 room hotel with parking structure. 12/31/2018: REPRINT permit to change
contractor.
Contractor: RAMSAY SIGNS INC Owner: DVKOCR TIGARD, LLC
9160 SE 74TH AVE 1419 W MAIN STREET, SUITE 110
PORTLAND, OR 97206 BATTLEGROUND,WA 98604
PHONE: 503-777-4555 PHONE: 360-723-0024
FAX: 503-777-0220
FEES
Quantity Description Date Amount
7 ea Sign or Outline Lighting 10/23/2019 $474.88
Specifics:
1 ea 12%State Surcharge- 10/23/2019 $56.99
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $531.87
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 Notific. n Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a co.,, • e rules< direct questions to OUNC by calling '1 '.1987 ora.:• 2.2344.
Issued By: fid Permittee Signature: A A LA6.1111/
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 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 Received
� c. Date/B l6 � � 0 1l� � _ dlI �
13125 SW Hall Blvd.,Tigard,OR 97111'1-7— v Plan Review
' la Phone: 503.718.2439 Fax: 503.5984 -�'aac� r"-^ Date/B _
f i .
['GAR!), Inspection Line: 503.639.4175 ry Ready Date/By: Juris: E1 See Page 2 for
Internet: www.tigard-or.gov CI("T ? ..01 l Notified Method: Supplemental Information
,_, .. TYPE OF WORK PLAN W ,t? .
❑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 ❑ Other: where the available fault current ❑Marinas and boatyards.
TEGORY OF CONSTRUCTION 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 El Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION ASD.LOCATION 0 Emergency system. larger separately derived
Job#: Job site address: 1179°SW 69th Ave 0 Additioo of newmotor load of " tem.
IOO1001-1P or more. ❑"AA","E","1-2","1-3",
City/State/ZIP: Tigard OR 97223 0 Six or more residential units. occupancy.
0 Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Hampton Inn ❑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 Qly. I Each 1 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
with above s ft 75.00 2
Install(7)sign circuits ( q )
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
w Renewable Energy 0 See Page 2
❑ PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name:Hampton Inn 200 amps or less 100.70 2
Address: 11795 SW 69th 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:97223 601 amps to 1,000 amps 301.04 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
p° Branch circuits—new,alteration,or extension,per panel
'm.. -. :--fi: i. �.',---'''"® CONTACT PERSON
A.Fee for branch circuits with
Business name:Ramsay Signs above service or feeder fee, 7A2 2
each branch circuit
Contact name: Chris Brown B.Fee for branch circuits without
service or feeder fee,first
Address: 9160 SE 74th Ave branch circuit 56.18 2
City/State/ZIP:Portland OR 97206 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)777-4555 Fax: :(503)777-0220 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: CBrown@ramsaysigns.com
>; _ Reconnect only 67.84 2
i . , .14. 4CTO:
";s ,:. .. � =.f x_: ..«L' kPump or irrigation circle 67.84 2
Business name:Ramsay Signs Sign or outline lighting 7 67.84 /471/-S12
Address: 9160 SE 74th Ave Signal circuit(s)or limited-energy ❑ See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Portland OR 97206 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)777-4555 Fax: (503)777-0220 Investigation(1 hr min) 90.00/hr
Email: Cbrown@ramsaysigns.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 63422 Electrica Lic.: 26-106C15 Suprv.Lic.: 493SIG specifically listed(1/2 hr min)
Suprv.Electrician signature,required:
`,+ Subtotal: l/(7 ty.• r
Print name: Phill Steiger Date: ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): , .`t t
TOTAL PERMIT FEE:
Authorized signature: . cb
V...) 5-3 j I.
This permit application expires if a permit is not obtained within 180
Print name: Chris Brown Date: days after it has been accepted as complete.
r Number of inspections allowed per permit
I:\Building\Pemrits\ELC_PemritApp_ELR_ERE.doc Rev 06/17/2015 440-46151(11/05/COM/WEB