Permit :14,„ .4 : , l r o o 7 D r2 s 7
7
�
E LECTR A I L PER
:�1 T ®F TIGARD
PERMIT #: ELC2007 -00810
e ' COMMUNITY DEVELOPMENT DATE ISSUED: 11/30/2007
TIGARD; 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09504 SW WASHINGTON SQUARE RD J02 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
PROJECT: DQ /ORANGE JULIUS
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: SIGNAUPANEL:
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 MEYER SIGN CO OF OREGON
BY THE MACERICH COMPANY 15205 SW 74TH AVE
9585 SW WASHINGTON SQUARE RD TIGARD, OR 97223
TIGARD, OR 97223
Phone: Contact #: PRI 503 - 620 -8200
FAX 503 - 620 -7074
FEES
Description Date Amount Reg #: ELE 20- 190CLS
IELPRMTI ELC Permit 11/30/200' $53.40 LIC 64014
[TAX] 8% State Surcharge 11/30/200' $4.27 SUP 566S1G
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 180 days. ATTENTION: Oregon law requires you to follow 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 copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: (,w)-'ael -j3 Permittee Signature:
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.
r . Ekeettrical Permit Applic . � Mt il CEIVED FOR OFFICE USE ONLY
Rece ived I ` „ I d ' DO
Ci of Tigard Permit No . �(
tY g t 2 DateB
I ° 13125 SW Hall Blvd., Tigard, OR 9t1f ,3 t' Plan Review
' .. Phone: 503.639.4171 Fax: 50142446D DateB : Other Permit:
T l G A R D Inspection Line: 503.639 Lo l I O F TIGARL) Date Ready /By: El See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISION Notified Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ 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: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
Job no.: Job site address: 9504 SW Washington Sq. Rd. Six 100HP or more. occupancy.
❑ Six or more residential units. ❑ 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: DQ /Orange Julius ❑ Service or feeder600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Washington Square (next to AT &T) Description 1 Qty. 1 Fee. 1 Total 1
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'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi - family
Install (1) 75.00 2
() elee. wall sign residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ® TENANT 201 amps to 400 amps 106.85 2
Name: DQ /Orange Julius 401 amps to 600 amp 160.60 2
601 amps to 1,000 amps 240.60 2
Address: (same as above) Over 1,000 amps or volts 454.65 2
City/State /ZIP: Temporary services or feeders installation, 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 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
f■ APPLICANT 1 ® CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: (same as contractor) B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 1 53.40 53.40 2
Business name: Meyer Sign Co. of Oregon, Inc. Signal circuit(s) or limited -
energy panel, alteration, or
Address: 15202 SW 74 Ave. extension. Describe: Page 2 2
City /State /ZIP: Tigard, OR 97224 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 620 -8200 Fax: (503) 620 -7074
Investigation per hour (1 hr min) 62.50
CCB Lic.: 64014 Electrical Lic.: 20 - 190CLS Suprv. Lic.: 566S1G Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: w Subtotal: 53.40
Print name: Phil Reynolds Date: 11 -27 -07
Plan review (25 % of permit fee):
State surcharge (8% of permit fee): 4.27
Authorized signature: TOTAL PERMIT FEE: 57.67
This permit application expires if a permit is not obtained within 180
Print name: Steve Murphy Date: 11 days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 46t5T(II/05 /COM/WEB