Permit CITY OF TIGARD ELECTRICAL PERMIT
'F! COMMUNITY DEVELOPMENT Permit #: ELC2010 00647
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/16/2010
, , Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9416 SW WASHINGTON SQUARE RD K08
Project: GNC Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project Description: Sign lighting for (2) signs.
Contractor: SECURITY SIGNS INC Owner: PPR WASHINGTON SQUARE LLC
2424 SE HOLGATE BLVD 2235 FARADAY AVE STE #O
PORTLAND, OR 97202 CARLSBAD, CA 92008
PHONE: 503 - 546 -7114 PHONE.
FAX: 503 - 230 -1861
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 11/16/2010 $135.68
Specifics:
1 ea 12% State Surcharge - 11/16/2010 $16.28
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $151.96
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 work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 throu• • e 952 -001 -0090. You may obtain , • • •f th ule_ s or direct questions to OUNC by calling 503. .1987 or 1.800.332.2344,
Issued B ` —/ Permittee Signature: r v
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 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.
Electrical Permit Application 9 -1,-)1,t Ot 1 ICE l SiA)Nt.1'
• NO V 1 Receives
City of Tigard 5 2 .010 Date/H ; lL% Perth $o.: d 0 la' '
°I 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ,
. t ` Phone: 503.639.4171 Fax: 503.598.19 I OF TIGA Di v' O ther Permit; 't
�1d— C � tE
3'1 t;n H Inspection Line: 503.639.4175 � LDING D ID Date Ready/13y: lane: See Page 2 for
Internet: vvww.tigard- or.gov ISIO Notified/Method: 'tF S upplemental Information
TYPE f WOE1
i •1 ! I ' t r, I ;PLAN ; ` 9 W!', ! "i % i : ",
0 New construction Cil Addition/alteration/replacement
$
ti J lt Plea c heck all that apply (submit? sets of p lans w /iterne checked below)
I: service or feeder 400 amps or more ID Building over three stories,
❑ Demolition 0 Other where the available fault current 0 Marinas and boatyards,
(A CO t 01F C'UIVSTItUCTIdiV :'
•' " exceeds 10,000 amps at 150 volts o r In Floating buildings,
lase to ground, or exceeds 14,000 ❑ Commercial-use agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial [] Accessory building amps for all other installations. buildings,
❑ Mull anlily 0 Master builder 0 Other: 0 ❑ Fire pump. Installation of 75 KVA or
_ ❑ &mergancY system larger separately derived systen
,. ;j0)B 61`I'E 1.0.0,g Ni CA'TI01�7 ;. .. ❑ Addition of new motor load of ❑ ° ° ° ` °1.9 °
Job no.: I Job site address: 941 Co t T 100HP or morn, occupancy.
❑
❑Six Or more residential units Recreational vehicle parks.
City /State/ZIP: /'� , L ❑ ealth-c�ue faoit.ties. ❑ Supply voltage for more than
{..la- Q Hesardous locations 600 volts nominal.
Suite/bldg. /apt, no.: I Project name: c ❑ Service or ti eder 600 amps or more.
Cross street/directions to job site: nwcophon I on I see_ 1 Total l •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
'Pax map/parcel no.: Ea add'I 500 sq. h. or portion 33.92 _ 1
'Limited energy, residential
--- „T aY; l ,'. (with Obo sq. ft.)
67,84 2
Limited energy, multi - family 67.54 2
r ¶ r.& � " 104..3 cz , ( . residential ( with above s9. ft.)
`i 3 Services or feeders installation, alteration, and/or relocation
t'Adount Only* 200 ampa or less 100.70 2
2 01 a to 4 00 a ura a 133.56 2 2
I�,pROF�RTX' OSS�R � �,T�`N .A�1'i' ; , Ps P
Name: - 401 amps to 600 amps 200.34
. _ 601 amps to 1,000 amps 301,04 2
Address; Over 1,000 amps or volts 552.26 2
City /State /ZIP: Temporary services or feeders installation, alteration, and/or
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 I own which is not 401 amps to 599 amps 168.54
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701,
I T Branch circuits — new. alteration, or extension.. er pa nel.
Owner signature: Date: A. Fee for branch tarcaits with •
it 1 ., d O 'A 1 01� .; ' : above service or fender fee, 7.42 2
- - '' each branch circuit
Business name: Security Signs B. Fee for branch circuits without
. _ ... . service or feeder fee, first 56,18 2
Contact name: Melissa Hayden branch circuit
Each add °1 branch circuit 7.42 2
Address: 2424 SE Holgate Blvd Miscellaneous (service or feeder not included)
City /State/ZIP: Portland, OR 97202 Each manufactured or modular 67.84 2
dwellin : service and/or feeder
Phone: (503) 546.7114 Fax:: (503) 230.1861 Reconnect only 67 2
Pump or irrigation circle 67,84 2
E-mail: Melissa@SecurttySi
griS.COm Sign or outline lighting ?_ 67.84 i35- 6g 2
, '
:.COli�l`r1tA4"T011
..; :.,•:: ' :'. "' ! `; Sir�ltalarcvit(s)orlimited-energy
.
Business name: Security Signs panel, alteration, or extension. Page 2 _ 2
Each additional inspection over allowable in any of the above
Address: 2424 SE Holgate Blvd Additional inspection (1 hr min) 66.25/ hr
City /State /ZIP: Portland, OR 97202 Investigation (1 hr ruin) 66,251 hr
- industrial plant (1 hr min) 78,18/ hr _
Phone: (503) 546.7114 Fax: (503) 230.1861 Inspections for which no fee is 90,00/ hr,
specifically listed M hr min)
CCB Lie.: 122$09 Electrical Lic,: 26560CLS Su rv. Lie.: 383S1G ;,EL, .. , ;"
P "�i�' CIO '�i.T~`P1�R11i710<'i;T`It'ItS
Suprv. Electrician signature, required: Subtotal: l •:S'
Plan review (25% o permit fee);
Print name: Marc Linguist Date: State surcharge (12% of perrntt fee): 1 ( ,
Authorized signature: TOTAL PERMIT FEE: i 1- 'Ic
This permit. application expires if a permit is not obtained within ISO
Print name: Melissa Ha Date: days after it has been accepted as complete.
Hay N umber o inspections allowed par permit.
I: tauildizg9PnrmitAELC- PamltApp,doc 1G/O1/09 441-461ST(11/OS/COM/WEB
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