Permit CITY OF TIGARD ELECTRICAL PERMIT
1111 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00553
Date Issued: 10/13/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9699 SW WASHINGTON SQUARE RD C10
Project: Portland Seafood Company Subdivision:VASHINGTON SQUARE ESTATES NO Lot: 108
Project Description: Sign lighting.
Contractor: TUBE ART SIGNS & SPORTS DISPLAYS Owner: PPR WASHINGTON SQUARE LLC
4243 -A SE INTERNATIONAL WAY BY THOMSON PROPERTY TAX SERVICES
MILWAUKIE, OR 97222 ATTN HILARY RAYMOND
2235 FARADY AVE, STE 0
CARLSBAD, CA 92008
PHONE. 503 - 653 -1133 PHONE
FAX• 503 - 659 -9191
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 10/13/2011 $67 84
Specifics:
1 ea 12% State Surcharge - 10/13/2011 $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 Special 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 .-suance, or if wor - uspended for more the 180
days ATTENTION. Oregon law requires you to follow the rules adopted by the Oregon Utility Notificati• Center os- r les are set forth in OAR
952- 001 -0010 through OAR 952 - 001 -0090 You may obtain a copy of the ru ect questions to OUNC by calling 503 2 ,' • : or . ;00 3 / 344
Issued By: ermittee Signature: A.Ao/
AWN 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.
.5A) e9-011-- Vol It
Received
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard 1 D at e /B' �
II
�1 /1 Penmt No . /- I _ Ci
" 13125 SW Hall Blvd Tig OR 97 f
, a 1
c Plan Review Othet Permit
Phone 503 718 2439 Fax 503 598 1 60 O C - ` ® INS)
DateB
Inspection Line: 503 639 4175 N\ ate Ready/By El See Page 2 for
�
Internet www tlgard- or.gov \ 0 A,\ G \ 1 ot /Method Supplemental Information
TYPE OF WORK ���\\`, VAN PLAN REVIEW
® New construction El Addition /alteration/r racement 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: SIGN 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 ® Commercial /industrial ❑ Accessory building amps for all other installations buildings
❑ Multi- famil ❑ Master builder LI Other: ❑ Fire pump ❑ Installation of 75 KVA of
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
100HP or more occupancy
Job no.: 528347 Job site address: 9699 SW Washington Square Rd. ❑ Six or more residential units ❑ Recreational vehicle parks
City /State /ZIP: Tigard, OR 97223 ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: Project name: Portland Seafood Company ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street /directions to job site: Tenant in the Washington Square Mall Description I ptv• I Fee. I Total I
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'l 500 sq ft. or portion 33 92 1
Tax map /parcel no.: Limited energy, residential
sq ft 75 00 2
DESCRIPTION OF WORK' (with a bove q )
Limited energy, multi - family 75 00 2
Replace "Newport Bay" sign over sunroom with "Portland Seafood Company "sign residential (with above sq. ft )
Services or feeders installation, alteration, and /or relocation
200 amps or less 100 70 2
❑ PROPERTY OWNER El TENANT a 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 I 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: Tube Art Group B Fee for branch circuits without
service or feeder fee, first 56 18 2
Contact name: Dan Osterman 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
t3 dwelling, service and/or feeder
Phone: ( ) Fax:: ( ) Reconnect only 67 84 2
Pump or irrigation circle 67 84 2
E - mail: dosterman @tubeart.com Sign or outline lighting 1 67.84 ( 2
CONTRACT OR Signal circuit(s) or limited- energy
Business name: Tube Art Group panel, alteration, or extension Page 2 2
Each additional inspection over allowable in any of the above
Address: 4243 -A SE International Way Additional inspection (1 hr min) 66 25/ hr
City /State /ZIP: Milwaukie, OR 97222 Investigation (1 hr mm) 66 25/ hr
Industrial plant (1 hr min) 7818/hr
Phone: 503 653 - 1133 Fax: (503) Inspections for which no fee is
Phone: ( 503) ( ) ) 659 -9191 90 00/ hr
CCB Lic.: 70956 iA A Electrical Lic.: 37554cls / / try Suprv. Lic.: 366sig jGl /llt' specifically listed (% hr mm) ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 67.
Plan review (25% of permit fee):
—
Print name: Ken Schultz Date: /5/11 State surcharge (12% of permit fee) � ', ( Y'
TOTAL PERMIT FEE. '7S c � ' Authorized Signature: O F This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Dan Osterm n Date: 10 /5 /11 * Number of inspections allowed per permit
I \Building\Permits\ELC- PermitApp doc 07/01/10 440 -46t 5T(11/05/COM/VEB