Permit ,t. CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00354
� DEVELOPMENT SERVICES DATE ISSUED: 5/26/2005
" ' ---� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 1S126CA -01000
SITE ADDRESS: 09009 SW HALL BLVD 142 ZONING: C -G
SUBDIVISION: WASHINGTON CIRCLE PLAZA LOT: JURISDICTION: TIG
Project Description: (1) sign.
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:
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 PLAZA SIGN MASTERS INC
BY THE CAFARO COMPANY 5105 SW 45TH AVE
P 0 BOX 422 PORTLAND, OR 97221
FLORHAM PARK, NJ 07932
Phone: Phone: 503 - 245 - 5056
FEES Reg #: ELE 26- 1051CLS
Description Date Amount
LIC 779 SUP 779 28
28
[ELPRMT] ELC Permit 5/26/2005 $53.40
[TAX] 8% State Surcharge 5/26/2005 $4.27 REQUIRED ITEMS AND REPORTS
Total $57.67
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 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: 7/ f / ' Permittee Signature: S:e .PL Pr
` 1
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.
0
Electrical Permit Application , • ` ( FOR'OFFICE usE ONLY ' , . •
City of Tigard • Date ,� 0 7)`� �j Permit No. :t J `' 5
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 �y��,i',N : p ' l l \ Date/ : Other Permit.
Inspection Line: 503.639.4175 2y► ` •. Date Ready/By: MI H See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
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. ���s. au?c�a���:. �.,.; i���° �s�:- �: �: R.- aa'�.s�•:a.�'n4a�,.....,_._ xxfia...,, ., ,. � .._= s 5' �:` � ; <: - > , � t�.�.��.�:.�.. .�.. , .
New construction ` ❑ Addition/alteration /replacement Please check all that apply:
❑ Demolition ❑ Other: EService over 225 amps, comm'l ❑ Hazardous location
F x_ u4 x_:: , ".r ;� „ , ,: .": GP
}; .:; - = :rv;.:,•a. .:. „ " . Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
kU 'g k '-x ";., aril— CA.+I E,G.OR , OF 'GQIV .e * I2;i-,xON z w= °' , it ..•.:l -a • i'.4�e, ' of 1- and 2- family dwellings 4 or more new residential
i' �'''=' N. 4�' je< s+.,= a„ �,, �' i:! �. ���a�,.:. >< o.. sr <rw�:�.arda:...,�r,�� W r� «`t, - fi. �;;»% ��.�..�,�s,?..w:r..' ='�a�::t�:
❑ 1 and 2 family dwelling Er Commercial/industrial ❑ Accessory building ❑ System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder ❑ Other: ❑Building over three stories ['Feeders, 400 amps or more
- - tea
r ;. ;.m ; , , w, ; , , . uk ,a , : A : a t , , a , .* ,.. ❑Occupant load over 99 persons ❑ RVn arklured structures or
's$� 3 .t is°�; "JOB S ORM �.- zaA ti T OGA -ONI ...,. m „ ❑Egress /lighting plan P
❑Health -care f
Job no.: . Job site address: 9� j S W piALL ecu y2 facility ❑ � Submit 2 sets of plat ns with any of the above.
above.
City /State /ZIP: ` G i Ocz, 17223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: � fy 1 ) ' IE S< I D j ' °`:: '`
'I-J /\ /.tom`-' Description Qty. Fee. Total
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
�;. ;, , '.r = :k M:",: =' x, .tt_ . = „� ,,:.•r -.: - :,` :; Limited energy, non-residential 75.00 2
, • , _ M, .` z v^, ,a,. :fit 1` , ,,,,„ $ T IO , ” O ° _ , s ,;, ,„,: a, , " Each manufactured or modular
r=�'us m�, w ��r....*,�'`''"s..'�.r.n =,. -; •�rv..�, Kr�.k -,. ��t�, ..4'��5.:.:.�.'-"� "u..4�a.> ,tea �..�f
- I n� dwelling, service and /or feeder 90.90 2
L/`-1S (i� SIGH Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
i , } : . ~ ., : .a3.;, i ti*_ . , °, , ° °. v l , i' :. ;o, : " ,. » wa _ - ;,: f' 'ti r 201 amps to 400 amps 106.85 2
es,„.1. F ;,, " ® �P � �'R T�r; 1�R':`' °. �,, , ` �,.., �, , s�'�� .Y�;,.a,� -, �`. ,s.'� , � ,.�;.� ?�� "�.
M « x"" 4, •- ,4 :,5., -. _ - ;. „: 4. a rtV �.. tW %.. --.a. y i �° a 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
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 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
V iz. :;_ t .. M K ) I 4 ', h ^ ix Q T A. , ..,....Ti : A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 46.85 2
Address:
Each add'I branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( )
Sign or outline lighting / 53.40 2
E - mail: Signal circuit(s) or limited -
r `.;w >-{; ?. ", = A".: ; �.,' °,; =iaj� .� �`n:a v '.- -�..:s�, t.,e�! >- (_ energy Panel, alteration, or
N °xtt »���,..,�`k�`r���� �. �� ` °'':�� � � -T'QR: r Wit": ��'�;: .�., �._ �'� �.
,;...::,�a:, ' �§ :La;i�a�?i�kz�r::�,,.cE�� °.�::� a �5 ��. °� .: ��xil�=:'a.^���:�`t� Baca , "..:.:::��' � �'i. *, � . '�
extension. Describe: Page 2 2
Business name: 5 p /1 fSf&S zN,
Address: 5/ p 5(,,) e j Or .A e sut�' Each additional inspection over allowable in any of the above
JV Per inspection 62.50 .
1 City /State /ZIP: f(`'J ' .� i) 9 72-1 -I Investigation per hour (1 hr min) 62.50
` 7 c � Industrial plant per hour 73.75
p Phone: ( ) a '1 J S ib-[ Fax: (s - c,$) 2y5- 5 03 Z ; <
-a., CCB Lic.: `) °) 9 2_6 Electrical Lic.: ac_ )7cL L Suprv. Lic.: t` Subtotal 5-, cI O + k •
Suprv. Electrician signature, required: — ' Plan review (25% of permit fee) 7
* Print name: Gdl'R2 i' pti'c �/ wS Date: 67205- State surcharge (8% of permit fee) �, ,9 /
TOTAL PERMIT FEE
Authorized signature: • This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per permit allowed.
i:\ Building \permits\ELC- PermitApp.doc 12/03 440- 4615TQ0 /02/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
n - c,�:sm�+�ws.:,�.�m..aar a max. £ ,�u-e.,.1�)•':�, .'°°'��� x'S °a;� �.� �; n :,�..,. - �..,..
i2 3SXD : QO M ,.., i , ..
n �� �`[ =.��r.,. �' � � � •� P 'Ia'� c'x,'z�+� ,s�4::Sk:��:.�'^a7:„`.' °•r",,1� S�.s
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alaim
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
Fee for each commercial system $75.00
(SEE OAR 918 - 260 -260)
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
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1: \Bu4lding\Penniu\ELC -Peru itApp.doc 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200S -00354
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/26/2006
Phone: (503) 639 - 4171 °
Inspection Requests (24 Hrs.): (503) 639 -4175!i -
INSPECTION WORKSHEET FOR DATE: 6/7/2005 TIME: 7:17AM PAGE: 67
SITE ADDRESS: 09009 SW HALL BLVD 142 CLASS OF WORK:
SUBDIVISION: WASHINGTON CIRCLE PLAZA LOT #: TYPE OF USE:
PROJECT NAME: BAJIO
DESCRIPTION: (1) sign.
OWNER: WASHINGTON SQUARE PLAZA, PHONE #:
CONTRACTOR: SIGN MASTERS INC PHONE #: 503.245 -5056
•
Inspection Request Scheduled For: Date: 6/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message •
140 Sign installation 008610-01 503.849.6075 Y
Corrections /Comments/ Instructions:
•
•
•
PASS ❑ PARTIAL APP OVAL ❑ CANCEL El NO ACCESS
❑ FAIL ❑ CALL FOR INS ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ` 7 Phone #: (503) 718-
CITY OF TIGARD
' BUILDING DIVISION' PERMIT #: ELC2005 -00364
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/26/2005
Phone: (503) 639- 4 171 ' r�' y 'U� I �iiippl f
Inspection Requests (24 Hrs.): (503) 639 -4175 `� I °'_ !—
INSPECTI WORKSHEET FOR DATE: &&2006 TIME: 7:13AM PAGE: 95
SITE ADDRESS: 09009 SW HALL BLVD 142 CLASS OF WORK:
SUBDIVISION: WASHINGTON CIRCLE PLAZA LOT #: TYPE OF USE: -
PROJECT NAME: BAJIQ
DESCRIPTION: (1) sign..
OWNER: WASHINGTON SQUARE PLAZA, PHONE #:
CONTRACTOR: SIGN MASTERS INC PHONE #: 503 - 245.5056
Inspection Request Scheduled For: Date: 6/6/2005 Pour Time:
1 Code # Inspection Description Confirm # Contact # Message
140 _ -: . -Ilation 008432 -01 503 -849 -6875 N
Corrections /C. a ii -. structions:
\ ■ VV A,%' k'L I 5 V\\, r \--4431/4S--, ; .\, \\I 0 P iL-bliv \
L \U- uk- ''`)
. 1 PV
PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
)Skr444- ❑ CALL FOR INSPECTION ❑ ADD( O AL FEES ASSESSED
//
Inspector: ir' li�� Dater C �_� Phone #: (503) 718 -
�- '