Permit UPI CITY O F TIGARD
ELECTRICAL PERMIT
° PERMIT #: ELC2009 -00068
° COMMUNITY DEVELOPMENT DATE ISSUED: 2/19/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09508 SW WASHIN.GTON_SQUARE_RD_J01 ZONING: MUC
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
PROJECT: CLEARWIRE
Project Description: Install (2) sign lightings.
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: 2
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 RAMSAY SIGNS
BY THE MACERICH COMPANY 9160 SE 74TH AVE
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97206 -9345
TIGARD, OR 97223
Phone: Contact #: PRI 503 - 777 -4555
FAX 503 - 777 -0220
FEES
Description Date Amount Reg #: ELE 26- 106CLS
[ELPRMT] ELC Permit 2/19/2009 $106.80 LIC 63422
[TAX] 12% State Surchar 2/19/2009 $12.81 SUP 493SIG
Total $119.61 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 181 : -' . - • NTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 -• -0010 through c • R • 2 -061 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246 6699 or 1.800.332.2344.
Issued By: . 1. A , .11 Permittee Signature: / ;e7.7 7-c /` -
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 Application FOR OFFICE USE ONLY
City of Tigard Received DateB �j �� Permit No £ „,,....,,,,,„
511
q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C ! ' Phone 503.639.4171 Fax• 503.598.1960 Date/B Other Permit
f I G A R D Inspection Line 503.639.4175 Date Ready/By. ® See Page 2 for
Internet: www.tigard - gov Notified/Method Supplemental Information
E OF WORK PLAN REVIEW
El 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 stones
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards
CATEGOQY 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
❑ Emer system larger separately derived system
JOB, SITE INFORMAT ON A I LOCATION
t • CI Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
(� • !r • 1/041- I OOHP or more occupancy
Job no.: Job site address: >.�
t no n n ❑Six or more resid units ❑ Recreational vehicle parks
City/State /"LIP: T 't l Y t� 1 O ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no. r i 1 Project name: ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: R 5/ S t / k 1 1 Description I Qty. I Fee. I Total I•
l/ � I New residential single- or multi - family dwelling unit.
,' — 0 1 Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft or less 145.15 4
Ea. add] 500 sq ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75 00 2
DESCRIPTION OF WORK (with above sq ft )
Limited energy, multi - family
L–& "
Y �G -e i, C∎ . residential (with above sq ft ) 75.00 2
��` 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: /� GvA S_ L L 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 I
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 :, .PN Date: A. Fee for branch circuits with
APPLICANT I C ONTACT PERSON above service or feeder fee, 6 65 2
FR each branch circuit
Business name: a , m S Q l.1i 1 , R S B. Fee for branch circuits
Contact name: I , � ( r! ,/ " �yJI without service or feeder fee, 46.85 2
S`� e VV I r\ 1 first branch circuit
Address: 91 / _ 0 SE `7 Lf L. il v E Each add'l branch circuit 6.65 2
l(� 1 Miscellaneous (service or feeder not included)
City/State /ZIP: F t-- , --r� A 9'7
-- ^) Z2 ( Each manufactured or modular 90 90 2
1 dwelling, service and/or feeder
Phone: (Sp� -7 7 7._ tic Fax: : ( ) Reconnect only 66 85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting Z 53 40 100 01
3
I 1, Signal circuit(s) or limited-
Business name: 0, n/)/ . ` �7 , — t �7 i n ' j energy panel, alteration, or
Address: j/l � -- u e V extension Describe. Page 2 2
City/State /ZIP: / Each additional inspection over allowable in any of the above
Phone: ( ) 1, iy1 11 I Fax: ( ) Per inspection 62 50
Investigation per hour (I hr mm) 62 50
CCB Lie.: 4 3L/ Z I Electrical Lic.: 26_10 I Suprv. Lic.: C13 S _ Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: C...4--;. /
_ Subtotal: i IJCt
. � �j Plan review (25% of permit fee):
Print name: ?/ t / i �_ � P, ! Date 2 19 ( 0Q (12% 1 0 e – ( State surcharge (12 /a of permit fee): t ,E 1
Authorized signature: �_O ��� TOTAL PERMIT FEF I )
J � This permit application expires if a permit is not - ...rimed wit in 180
Print name: � -f- vv _.__ ,,k),,,. I K Date: Z._ I 1000 0 CI days after it has been accepted as complete.
• Number of inspections allowed per permit
I \Budding\Permits\ELC- PermitApp doc 05/23/06 440- 4615T(11/05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2009-00050
13125 SW Hall Blvd., Tigard, OR 97223
.14%:;1(itib' DATE ISSUED: 20912009
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 2/26/2009 TIME: 7:00Atvl PAGE: I
SITE ADDRESS: 09608 SW WASHINGTON SQUARE RD J01 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: CLEARWIRE
DESCRIPTION: ifisiall pi OWNER: WASHINGTON WASHINGTON SQUARE Lie., PHONE #:
CONTRACTOR: RAMSAY SIGNS PHONE #: .03-777-45'55
Inspection Request Scheduled For: Date: 2/26/2009 Pour Time:
Code # Inspection Description -onfirm # Contact # Message
199 Electrical final 080844-01 603-777-4555 N
Corrections/Comments/ Instructions:
\ .
4Z PASS 0 PARTIAL APPROVAL 0 CANCEL P1 NO ACCESS
FAIL Ei CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: G N 08 Date: 1-1,4 Phone #: (503) 718- 244