Permit CITY OF TIGARD ELECTRICAL PERMIT
D " PERMIT #: ELC2007 -00313
COMMUNITY DEVELOPMENT
DATE ISSUED: 5/7/2007
Tf GARD: 13125 SW Hall Blvd Tigard, OR 97223 503.639.4171
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!"" g PARCEL: 1S12600-00300
SITE ADDRESS: 09414 SW WASHINGTON SQUARE RD K -9 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
PROJECT: GAMESTOP
Project Description: (1) sign lighting.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: 1
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
WASHINGTON SQUARE LLC VANCOUVER SIGN COMPANY, INC
BY THE MACERICH COMPANY 6615 SW HWY 99
9585 SW WASHINGTON SQUARE RD VANCOUVER, WA 98665
TIGARD, OR 97223
Phone: Contact #: PRI 360 693 - 4773
FAX 360- 693 -2747
FEES
Description Date Amount Reg #: ELE 37 -46CLS
[ELPRMT] ELC Permit 5/7/2007 $53.40 LIC 63951
[TAX] 8% State Surcharge 5/7/2007 $4.27 SUP 525SIG
Total $57.67 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than ; e : - • TTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OA' • 2- 001 -0010 throu• • O; 9 -001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
1
I - ued By: ' . - �► ���� Permittee Signature: 11 1 ► 1 4
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'N: 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 A licat cor,..„,,Al'e ° '011 FOR OFFICE USE ONLY
1 Received
City of Tigard , { O) Date/By: 7 d 7 m
Perit No.: Ez_C ( -5/3
:
B 13125 SW Hall Blvd., Tigard, OR 97223' . ,A `,
Plan Review
\� C ^ S Other Permit:
Phone: 503.639.4171 Fax: 503.598.19,�f ``�V ei � , �kV, DateBy:
T (G A l: D Inspection Line: 503.639.4175 , `` * Q OM Date Ready/By: 1 / H See Page 2 for
Internet: www.tigard- or.gov a Notified/Method: (P. Supplemental Information
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction ❑ Addition/alteration/replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: sign where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: sign ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
El Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ",
100HP or more. occupancy.
Job no.: Job site address: 9414 Washington Square Road
0 Six or more residential units. 0 Recreational vehicle parks.
City /State /ZIP: Tigard OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: Game Shop ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street /directions to job site: South on Schools Ferry , left Wash Sq Rd Description I Qty 1 Fee. 1 Total I_
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft)
Limited energy, multi- family 75.00 2
Installation of one illuminated fascia sign residential (with above sq. fl..)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ® TENANT 201 amps to 400 amps 106.85 2
Name: Game Shop 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 9414 Washington Square Road Over 1,000 amps or volts 454.65 2
City /State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)620 3338 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 _ 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel _
A. Fee for branch circuits with
® APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: Vancouver Sign Company B. Fee for branch circuits
Contact name: Isaiah Wyckoff wi service or feeder fee, 46.85 2
Y first branch circuit
Address: 6615 NE Hwy 99 Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Vancouver, WA 98665 Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (360) 693 -4773 Fax: : (360) 693 -2747 Reconnect only 66.85 2
E -mail: isaiah @vansignco.com Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 1 53.40 53.40 2
Business name: Vancouver Sign Co
Signal p a ne l, alteration, or t itnite
energy panel alteration, or r
Address: Same
extension. Describe: Page 2 2
City/State /Z1P: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lic.: 63951 Electrical Lic.: 37 -46CLS uprv. Lic.:•e c"9 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, requir : . Subtotal: ( 3, La)
Print nanme:CB ,4, f L, Date:3 /5/07 Plan review (25% of permit fee):
/ State surcharge (8% of permit fee): �` ,r9 7
Authorized signature: �l..e t TOTAL PERMIT FEE: 7• (0 7
Print name: Isaiah Wyckoff v ((( Date 3/5/2007 This permit application expires if a permit is not obt ned within 180
Y days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\ 3uilding \Permits\ELC- PermitApp.doc 05/23/06 440 -4615T(11 /05 /COM /WEB