Permit CITY OF TIGARD ELECTRICAL PERMIT
°'� COMMUNITY DEVELOPMEN Permit #: ELC2011 00147
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/22/2011
Parcel: 151260000300
Jurisdiction: TIGARD
Site address: 9581 SW WASHINGTON SQUARE RD B08
Project: Sony Style Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project Description: (1) branch circuit for wall sign.
Contractor: MEYER SIGN CO OF OREGON Owner: PPR WASHINGTON SQUARE LLC
15205 SW 74TH AVE 2235 FARADAY AVE STE #0
TIGARD, OR 97224 CARLSBAD, CA 92008
PHONE: 503 - 620 -8200 PHONE:
FAX: 503 - 620 -7074
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 03/22/2011 $67.84
Specifics:.
1 ea 12% State Surcharge - 03/22/2011 $8.14
Electrical
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 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 ou to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OA' • 001-0090 may obtain a cop • • - - = direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �� � � Permittee Signature: _ II
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 FOR OFFICE USE ON IN
perndt No
City of Tigard ? [
j Received �
't 13125 SW Hall Blvd., Tigard, OR 97223 Date : '' //[/graPe — iL / — ji -i1 f 7
g B i/ �� Plan Review Other Permit:
Phone: 503.718.2439 Fax: 503.598 4 , ,�\ Date/By:
1'1GARD Inspection Line: 503.639.4175 �) {� Date ReadyBy: Juris: B! See Page 2 for • Internet: www.tigard - or.gov 5 ,, V NotiFed/Method: IMP. , Supplemental Information
M :1 W r°ff" -1 m , a.t`> V-' 1A d ,,I lr t r , ,:r s _. 5 c - �i. "*` -�:
1 } . y A.,�.�1�� d`0 / j a'C 0 $� h e f ; t k5 r.� 1 ,a a.ls d ' is = f 2fr tis `+
` l� el; ''® �.� ���.` .�1i • a�it�� � `�� rl ,r� �'z�ri� � 3 �. i �. � ��_ "` .� ,�� �' � y
Mtt����x.,a,�r.� art�d:t�fl's r,• c�t� .'Y.i��`ian,..��Fiik'l•.j.`i>a . r� � .r�,c•p - �� a -t Rlla.,. �rtt`.� t,1
❑ New construction ❑ Addition /alteration /replak' _¢113, Please cheek all that apply (subtnit a sets of plans Wham checked below):
(,\ \`�q� ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition 7..4 Other: b ,J V` where the available fault mutant ❑ Menses and boatyards.
l% , 'I:. { i, " >� :l'S "r• a� r-ir rr 5 t ax , t�K f ^ t
eft' u v G r i , Ui C ) c� a to ' rl a ry ' t( , i", �t• exceeds 10,000 amps at 150 volts or D Floating buildings,
. -:Y ' ,)_SrF n . ' Vla.r r -_,st ,r I art r �F:,,f _.,A.I. #1 .0 rzt,^HI. lass 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 0 Master builder ❑_Other ❑ Fire pump. ❑ Installation of 7SKVAor
•+'rr a P + n v a } ,in , +s ,,,, t4 , ❑ Emergency system. larger separately derived system.
a0 ��°� + lt d 0 i 110 x 4 1 0 0 x [p "F L '
� i Ji w;�r€ _'.'s� F�,A: *����i . � �� 0 Addition of new motor load of [I ••A "B ", "1-2", "2-3",
Job no.: Job site address: • S a 1 s 1 . IOO o o more residential Recreation.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: 6y.._, 9 --) . - 3 rs' ' - ` 0 Health -care facilities. ❑ Supply voltage for more titan
0 Hazardous locations, 600 volts nominal.
Suite/bIdg./apt. no.: Project name: ❑ Service or feeder 600 snips or more.
.i SSr lr¢F '?xy _ mS` W..,ry i - r
Cross street/directions to job site: � (1 i `, ` lQ_ �'1 \&Q..�. "pI '}" ' t e e . •
a
.1 ` O Desertpll°q Q Ate. Total
� New residential single- or mulll- family dwelling unit. •
y\ 4 t `50 Pa.( r » 6 Qc I eel. Includes attached garage.
Subdivision: Lot no.: 1,000 sq. it or less 168.54 4
Ea. add'I 500 sq. fl. or portion 33.92 1
Tax map/parcel no Limited energy, residential
I ';f t�„l -aF �,ta lEr y y p tt)r - f - " �,1 n t , a. , isx}� tit tY 2�ti3 1`,a. • -G Ill .1 n : 75.00 2
.rr.,Z'3 ; e � .aizr r'X41;nF in -ft Ci � d9 r�?�ayit`1 f4 ° A li:'Y.t.ti a i 1 x t aV4 (with above sq- 0.)
/� /� Limited energy, multi family 75,00 2
t /1 i I �rkQ i C S i c - \Yl ta_ _ -I . 'Y•�,s4X - -�„/ residential (with above sq. R.)
1 �sL t "� ' Services or feeders insta11atlonolteratlon, and/or relocation _
� _Ly __ �. 200 amps or less 100.70 2
Elz'a ,s e . .. 6 ., , 3 -y .. El , �. fl 1 1 . .ta , . 3i 4 201 amps to 400 amps 13356 2
C 401 amps to 600 amps 200.34 2
Name: `) tyY1. 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: ( ) I Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 1 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits- new, alteration, or extension, er panel
Owner signature: Date: A. Fee for branch circuits with
m °a: _ It t° r b ra s f C4 i' v + — �"�� ove serve ic or er f 7
ti xt: tk�?ti 'Z- a_tIn`l l�s``5; ffIESK PTAR of ' " l e .IIIO n i, yy , .42 2
..... .::: .,... ,� . ,,_.��,re_:}� +ai._,< .n,.r. eaa branchcircun f ee d
Business name. � -
B.' Fee for branch circuits without
■ y {� C . service or feeder fee, flint $6.18 2
Contact name: brenchaircuit
1 Q r te-- Each addl branch circuit 7,42 2
Address: Miscellaneous (service or feeder not Included)
Each manufactured or City /State/ZIP: dwelling, service a ld/or feeder 67.84 2
Phone: GbV .(n (I - ? - , I I Fax: : (g),*) &:, - y 3 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail: « i I a . &* ! -a a — • ' • � or outline lighting l 67.84 ( 2
a ,.,,�. �, -.1+. f�1�:1;: `�i��sE�: .,, h I`� Signal circuit(s) or limited - energy
Business name: el ,_alteration, or extension. _ Page 2 2
s co tom" YZ CO Each additional inspection over allowable In any of the above
Address: ' c o� ( . '-1 C - poiaL, , Additional inspection (I hr min) 66.25/ hr
City /State/ZI -� Q Investigation (I hr min) 66.25/ hr
l lnAv. 1 ` -1 Industrial plant (I hr mitt) 78.18 /hr
Phone: ( �n 4 _ ? / ' Fax: (C' 36(4 _,4 3 1 S' Inspections for which no fee is 90.00 /hr
7iJJ,,77 ° iL� s • eiQeall listed % hr min
CCB Lie,: 6 Electrical Lic.: Suprv. Lic.: 'ib' " 'l T� - .,i 2i a,� "t ^1 :i}t�d jtit °' ' :,,, , `
2(- -190 p S�o(o— 514
SubtoleL ( , 2;2 Suprv. Electrician signature, reglrired ,.-'% c
ter • - = . r • , r Plan review {25% of pem++t Cee)
Print nam.� a Q.ti no s Y Date: 3 I. 1 1 i 1 State surcharge (12% of permit fee): •t`l
r TOTAL PERMIT FEB: 7s-, a g
Authorized signature: This permit application expires if a permit Is not obtained within 180
Print name: Date: days after it has been accepted as complete.
Number of inspections allowed per permit.
I; BuitdinaWamits '0iC•PermitApp.doc 07/01/10 440- 46I37(11105/COM/WEB