Permit i` ELE CITY OF TIGARD
CTRICAL PERMIT
_ :` COMMUNITY DEVELOPMENT Permit#: ELC2010 -00073
Date Issued: 02/12/2010
SW Hall Blvd., Tigard OR 97223 503.639.4171
:TIGARD. 13125 Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9483 SW WASHINGTON SQUARE DR AO6B
Subdivision: Lot: 0
Project: Pac Sun
Project Description: Sign lighting inside mall.
Owner: FEES
PPR WASHINGTON SQUARE LLC Quantity Description Date Amount
2235 FARADAY AVE STE #O 1 ea Sign or Outline Lighting 02/12/2010 $67.84
CARLSBAD, CA 92008 1 ea 12% State Surcharge - 02/12/2010 $8.14
PHONE: Electrical
Contractor:
SECURITY SIGNS INC
2424 SE HOLGATE BLVD
PORTLAND, OR 97202
PHONE: 503 - 546 -7114
FAX: 503 - 230 -1861
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $75.98
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. /
Issued By: Permittee Signature: d 4./ d.i 7o
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
• Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Applicati&ECEIVED i,'Oit OFFICE Ilsr ONLY
City of Tigard Received
taste /By: a a //Q ; • Permit No,�( -'�0 00
/0 -0 7 _3
�F B 11 2 010
rt 13125 5W Hall Blvd. Tigard, OR 97 - -3 Plan Review
' ' - ' Phone; 703.639.4171 Fax: 503.598.1960 Date/By: Other Permit$u�ad(� 9 — OO�Oo1+
T!C A Inspection Line: 503,639 4175 CITY OF TIGARD Date Ready /By: !aria. ® See Page 2l'or
• DIVI S ION �I� Supplemental Information
Internet wwty •U ard of
g H^' OVh ILIA DI Notified/Method: PLAII IZE W
❑ New construction El Addition /alteration /replacement Please cheek all that apply (submit 2 sett of plan; w /items checked below);
❑ Service or feeder 400 amps or more ❑ Building over three stales.
❑ DeMolrtion ❑ Other: where the available fault current ❑ Marinas and boatyards .
r- w
7Y C OF ODN5TRIICr1';tOl� ..�, exceeds 10.000 amps at 150 volts or ❑ Float ng buildings.
less to ground, or exceeds 14,000 ❑ Cotnmercial -use agricultural
❑ 1 - and 2- family dwelling E] Commercial /industrial ❑ Accessory building amps for all other installations, buildin_;
❑ Multi - family ❑ Master builder Q Other: ❑ Fine pump. ❑ Installation of 75 KVA or
,., Emergency system. lamer separately derived syst ■ ' $11•' z ,
* 1 TIO1' S D L • '
_ ' ' � . "' ,' .u' ;. El Addition of new molar load of ❑ ' .4 .. ,. 1• .. ...1 ......1.3° ,
Job no.: Job site address`���g' 100Hp or more. occupancy,
[ A`lr� ❑ Six or more te'sidentlat units- ❑ Recreational vatic]; parks.
City /State/ZIP: 9 y f/ y ❑ Helth -care facilities. ED Su voltage for more than
/ v( �(�„ y- ❑ Hazerdaus iocatiore. 600 volt.; noauaal.
Suite /bldg. /apt, no Project name: (� Al S ui ❑ S ervice or rude 600 amps or more.
• .
Cross street /directions to Job site Docnption 1 QtyJ Fac. J Total 1 ,_4
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 1 143,15 4
Ea. add'1500 sq. ft. or portion ! 33.40 1 1
Tax map par
Cel no Limited energy, residential 75 0
' OI 47O1 K ; (with above so. ft.) 0
(, 1 Limited energy, multi - family 75.00 2
9) I' ctLI 1111 residential (with above sq. n.)
*mount t only* s Services or feeders installation alteration, and/or relocation
200 amps or less 80.30
0 PY2OPERT'Y O - EIZ , I ;' ,11'tTl�T, r ,; 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
A P
Address: Over 1,000 amps or volts 454.65 2
City /State/ZIP: Temporary services or feeder' i_ nstallation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 Amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 1 133.75 2
Owner signature: pate, Branch circuits – new, alteration, or extension. Per panel !
A. Fee for branch circuits fe e , .
A p P X Ct1�IT.; •; 98�,d QNT LOT: RS, abo ve service or feeder fee, 6.65 2
each branch circuit
Business name: Security Signs B. Fee for branch circuits
without service or feeder fee, 46,85 2
Contact name: Melissa Hayden first branch circuit
Address: 2424 SE Holgate Blvd Each add'I branch circuit 6.65 2
- miscellaneous (service or feeder not included)
City /State /ZIP: Portland, OR 97202 Each manufactured or modular 90.90 2
dwelling service and /or feeder
Phone: (503) 546 7114 Fax: : (503) 230 1861 Reconnect only _ 66.85 2
E -mail: melissa®Securitysigns.com I Pump or irrigation circle 53.40 2
,. t .: Sign or outline lighting I 53.40 2
Signal circuit(s) or limited-
Business name: Security Signs
energy panel, alteration, or
Address:
extension. Describe: Page 2 2
City/State/ZIP: Each additional inspection over allowable in any of the above
- Per inspection 62.50 1 ,
Phone: ( ) Fax; ( ) Investigation per hour (1 hr min) _ 62.30 _ 1
CCB Lie,: 122809 ✓ Electrical Lie.: 26560cis (/i Suprv. Lie.: 383sig ✓ Industrial plant per hour 73.75
IELEI✓TRIiCAL ! PTrIrh''IIT - PZLS i
Suprv, Electrician signature, required: Subtotal: (;-, 7, JP'y
Print name: Mark Linguist Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee): P
Authorized signature: — TOTAL PERMIT FEE: 15' , ,9P
This parent application expires if a permit is not obtained within 180
Print name: Melissa Hayden Date: days after it has been accepted as complete.
Number of inspections allowed per permit.
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