Permit 1// addialt Ca) yh17 .7'
CITY CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC201000486
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/09/2010
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9669 SW WASHINGTON SQUARE DR CO3
Project: Express Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project Description: (1) sign lighting. 11/09/10 added (2) sign lighting. BT.
Contractor: RAMSAY SIGNS INC Owner: PPR WASHINGTON SQUARE LLC
9160 SE 74TH AVE 2235 FARADAY AVE STE #O
PORTLAND, OR 97206 CARLSBAD, CA 92008
PHONE: 503 - 777 -4555 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 09/09/2010 $67.84
Specifics: 1 ea 12% State Surcharge - 09/09/2010 $8.14
Electrical
Type of Use: COM 2 ea Sign or Outline Lighting 11/09/2010 $135.68
Class of Work: ALT 16 12% State Surcharge - 11/09/2010 $16.28
Type of Const: Electrical
Occupancy Grp:
Total $227.94
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 . ork is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those ru e - - set forth in OAR
952 - 001 -0010 through • r • -2- 001 -0090. You - • • - • - - - • of t --r direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: —�/ - = Permittee Signature: AM,
/W' 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.
Cali 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
CITY OF TIGARD ELECTRICAL PERMIT
11 • • COMMUNITY DEVELOPMENT Permit #: ELC2010 -00486
T 1 G A R O 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/09/2010
Parcel: 1 S 1260000300
Jurisdiction: TIGARD
Site address: 9669 SW WASHINGTON SQUARE DR CO3
Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project: Express
Project Description: (1) 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 09/09/2010 $67.84
PHONE: 1 ea 12% State Surcharge - 09/09/2010 $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 law. All work will
be done •• - cor•ance • ..proved p = • This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. •TTENTION: Oregon la • re. • ires you • follow the rules adopted by the Oregon Utility Notification Center. Those s are set forth in OAR
95 r 01 -0010 thro gh OAR 952 -001- 00. j • stain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2 44.
f \
sued By: — d 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' 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
day
City of Tigard Dateiv d 7 9 �d Permit No.: £'��
Date/By: :DID ...7 6%,
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit: Azdolo /D- 100/5'7
T 1 G A R D Inspection Line: 503.639.4175 Date Ready/By: luris: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
. , TYPE OF WORK • • PLAN REVIEW. .
INew 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: 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 g Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
`. JOB SITE INFORMA�',19N D LOCATION ❑Emergency system. larger separately derived system.
7 0 6LJ ❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "I - ",
100HP or more. occupancy.
Job no.: Job site address:
Si,..) WA SL: i..54 St 0 Six or more residential units. 0 Recreational vehicle parks.
City /State /ZIP: O� .^, 9 7oZ 3 ❑ Health -care facilities.
El Supply voltage for more than
D /L 1 1 /3�v
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: C K�s_s ❑Service or feeder 600 amps or more.
1_ FEE. SCHEDULE . •
Cross street/directions to job site: . Description 1 Qty. I Fee. 1 Total 1 •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
.. - DESCRIPTION OF WORK • . • (with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
')iN GIRL "-'k'. residential (with above sq. ft.)
J Services or feeders installation, alteration, and/or relocation
200 amps or Tess 100.70 2
❑ PROPERTY OWNER - ❑ TENANT , ., 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: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that 1 own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT - , . ❑ CONTACT PERSON above service or feeder fee 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'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
tY dwelling, service and/or feeder
Phone: ( ) Fax :: ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail: Sign or outline lighting i 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy
.---+ panel, alteration, or extension. Page 2 2
Business name: A7.... 364' zt,3 -4.) . 1�e - Each additional inspection over allowable in any of the above
Address: en t. O s i 1 y' J _ Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City /State /ZIP: P C2 or., D 41 ei 6144 a—, / C, 7a J I. Industrial plant (1 hr min) 78.18/ hr
Phone: (Si,) .7 2'7 - s Fax: ( )3) 17? 0-21. o Inspections for which no fee is 90.00/ hr
specifically listed (Y. hr min)
CCB Lic.: to 3Yaa Electrical Lic.: gc,i6cpcCs Su . Lic.: (,72 7 C .... ELECTRICAL PERMIT FEES .
Subtotal: (p?
Suprv. Electrician signature, required:
Plan review (25% of permit fee):
Print name: 1 Date: t o State surcharge (12% of permit fee): 8 J
TOTAL PERMIT FEE: 75 vr._
Authorized signature _ This permit application expires if a permit is not obtained within 180
!� days after it has been accepted as complete.
Print name: TS ..t µ 4/(e4/ D ate: 5.- a i ( -a • Number of inspections allowed per permit.
1:\ Building ' Permits\ELC- PermitApp.doc 07/01/10 440- 46t5T(11/05 /COM/WEB
Rec. PIAT. vp El.c too - 00'44
Electrical Permit Application . F(11z oFl lcl1 NISI: O' l.\
•
City of Tigard •:'.. eived / Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 �� Plan Re
'� `
C Phone: 503.639.4171 Fax: 503.598.1960 0 DateBy: Other Permit:
Inspection Line: 503.639.4175 0 a ate Ready/By: Juris: ® See Page 2 for
Internet: www.tigard or.gov ,,G, ! !.tified/Method: Supplemental Information
TYPE OF WORK G �� • o� PLAN REVIEW
® New construction ❑ Addition/alteration/repl e Please check all that apply (submit a sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: 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 ® 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 ", "1 -3 ",
Job no.: Job site address: Qfp I00HP or more. occupancy.
�! �� • W AF+s1, ��. i,7. Q • ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP:^ i I Q - ❑ Health-care facilities. 0 Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Cos Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: 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 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
+.7�p 11J � Re C i' fir -) r!. t ,. , I-f•s � residential (with above sq. ft.)
�J Services or feeders installation, alteration, and/or relocation
i S I� 200 amps or less 100.70 2
❑ PROPERTY 1 ❑ TENANT 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: ( ) Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, 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'l branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
tY dwelling, service and/or feeder
Phone:( )
Fax:: ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: Sign or outline lighting t 67.84 13 5 2
CONTRACTOR Signal circuit(s) or limited- energy
• panel, alteration, or extension. Page 2 2
Business name: Q kis R S 1441 to Each additional inspection over allowable in any of the above
Address: Qlloo 5.E 1;W11% AU2. Additional inspection (I hr min) 66.25/hr
Investigation (1 hr min) 66.25/ hr
City /State /ZIP:
'1:50.1,3.,104,m..6 �U Q eS Industrial plant (1 hr min) 78.18/ hr
Phone: ( ) 7 N 7 7. 8'.5" Fax: (.5 03) 7 77 -O a2.0 Inspections for which no fee is 90.00 / hr
specifically list (%r hr min)
CCB Lic.: (03422 Electrical Lic.: 21 Suprv. • .: t , ELECTRICAL PERMIT FEES
Suprv. Electrician signature, require O` Subtotal: / $ 9
Plan review (25% of permit fee): y
Print name: 11,Qm 3ROww.) " 1 Date: ti State surcharge (12% of permit fee): 16
l TOTAL PERMIT FE ' qt
mi
Authorized signature: This permit application expires if a permit is not obiiAed within I1i
days after it has been accepted as complete.
Print name: Date: • Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 07/01 /10 440.4615T(1 I /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
:\ Building \Permits\ELC- PermitApp.doc 07/01/10