Permit " ` :,,n: ; ; CITY OF TIGARD ELECTRICAL PERMIT
,
f 2 ; >• COMMUNITY DEVELOPMENT Permit #: ELC2010 -00266
T IGAR 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/02/2010
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9424 SW WASHINGTON SQUARE RD K05
Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project: Hot Topic
Project Description: Installing sign lighting.
Owner: FEES
PPR WASHINGTON SQUARE LLC Quantity Description Date Amount
2235 FARADAY AVE STE #O
CARLSBAD, CA 92008 1 ea Sign or Outline Lighting 06/02/2010 $67.84
PHONE: 1 ea 12% State Surcharge - 06/02/2010 $8.14
Electrical
Contractor:
RAMSAY SIGNS INC
9160 SE 74TH AVE
PORTLAND, OR 97206
PHONE: 503 - 777 -4555
FAX:
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 I w. 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 fo more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Thos rules are set orth in OAR
952 - 001 -0010 through OAR 952- 001 -0100. You a •• -.. direct questions to OUNC by calling 503.246.6699 or 1.800.c32.23•
Issued By: � / F � Permittee Signature:
Aar 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 Application , , °T ' ; t`� ,, �; PORro I ( Ic �x i>N'< ti 4 t �� .�� { �) \ L ,
t City of Tigard 0 Dare /By: ( �
r 10 i31 Perm No.: �GG�tJIU"Y.O��e
Date/By: Lo , /
13125 SW Hall Blvd., Tigard, OR 97223 6 Plan Review
0 P hone: 503.639.4171 Fax: 503.59 Other Permit:
O �Q Date /By:
T I G A inspection Line: 503.639.4175 1 Date Ready/By: Juris ® See Page 2 for
Internet: www.tigard O Notified /Method: 1'='Cp Supplemental Information
TYPE OF WORK O �`t ,G � - CAO PLAN . REVIEW
® New construction ❑ Addition/alteration/6f �'9 Please check all that apply (submit 2 sets of plans µ/items checked below):
❑ Demolition ❑ Other:
`` ❑ Service or feeder 400 amps or more ❑ Building over three stories.
µ where the available fault current ❑ Marinas and boatyards.
CATEGORY ::OF 'CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
Tess to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling IA Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family El Master builder ❑ Other: ❑ Fire pump. 0 Installation of 75 KVA or
JOB, SITE INFORMATION AND LOCATION ❑ Emergency system. larger E... - separately derived system.
- - ❑ Addition of new motor load of "A". ..E 13 ",
Job no.: Job site address: I00HP or more. occupancy.
�ga� a W • wrisH , %4I . ( .b r ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: T GeAR Q D. � ❑ Health -care facilities. ❑ Supply voltage for more than
1 1`.E�° ❑ Hazardous locations. 6(H) volts nominal.
�
�
Suite/bldgJaph I' 1 no.: Project name: tr i o - Q �_ ❑ Service or feeder 600 amps or more.
. FEE;:SCHEDULE:. . ' ..
Cross street/directions to job site: tN6tbi: W llsi1. % Description 1 Qt), 1 Fee. 1 Total 1
V W �T7i1 v - d►MM _ New residential single - or multi-family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1.000 sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 I
Tax map /parcel no.: Limited energy, residential
67.84
DESCRIPTION OF WORK , above sq. 0.)
•
Limited energy. multi - family 67.84 2
%l(ViTALL ELacr c.(10... t residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
•
❑ PROPERTY OWNER 1 ❑ TENANT r 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1.000 amps 301.04 2
Address: Over 1.000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City /State /ZIP: relocation
Phone: ( ) I Fax: ( ) 200 amps or Tess 59.36 I
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with • ❑ APPLICANT 1 above service or feeder fee
0 PERSON 7.42 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee. first 56.18 2
Contact name: branch circuit
Each add'! branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
Y dwelling. service and/or feeder
Phone: ( ) I Fax: : ( )
Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: i�1
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited - energy •
Business name: //�� panel, alteration, or extension. Page 2 2
1'eikq sA %.%,/\3 C.) Each additional inspection over allowable in any of the above
Address: oil 6 SSE' .yym owe . Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City /State /ZIP: P . f t V. 1. . critoLe Industrial plant (1 hr min) 78.18/ hr
Phone: ) y Fax: • Inspections for which no fee is
X Y �/ •ilSSS (� )'F �� 90.00/ hr
specifically listed ('h hr min)
CCB Lic.: 6 Electrical Lic • -.1' oVLSI prv. Lic.: 6 1903 S i C ELECTRICAL PERMIT FEES
7 Subtotal: �"jli
Suprv. Electrician signature, required: / -
Plan review (25% of permit fee):
Print names Lt. STE i & E D ate: /9.1.10 State surcharge (12% of permit fee): $ � g
�!. �s 4 S a.
TOTAL PERMIT FEE:
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: * Number of inspections allowed per permit.
1:\ Building \ Permit s \ELC -Perm it App.doc 10/01/09 4- 10-461 5T111 /05 /COM /wOB I SI t ` C?
sP-
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL ;WORK ONLY: • -
Fee for all residential systems combined $67.84
Check Type of Work Involved:
n Audio and Stereo Systems*
❑ Burglar Alarm
n Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
n Other:
I COMMERCIAL WORK ONLY:_
Fee for each commercial $67.84
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
❑ hire Alarm Installation
❑ HVAC
n Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other 0
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:\ Building \Permits \GLC- PermitApp.doc 10/01/09