Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00076
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/02/2012
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9532 SW WASHINGTON SQUARE RD H11
Project: The Body Shop Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: Sign Lighting.
Contractor: RAMSAY SIGNS INC Owner: PPR WASHINGTON SQUARE LLC
9160 SE 74TH AVE BY THOMSON PROPERTY TAX SERVICES
PORTLAND, OR 97206 ATTN HILARY RAYMOND
2235 FARADY AVE, STE 0
CARLSBAD, CA 92008
PHONE: 503 - 777 -4555 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 02/02/2012 $67.84
Specifics:
1 ea 12% State Surcharge - 02/02/2012 $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 you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952 - 001 -0090. You ma obtain 0• • - - - or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
i
Issued By: Permittee Signature: c ANOIl __li
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 o. 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 OFFICE USE ONLY
City of Tigard Date/By: / Permit No.: (_ -c . I ��
Ili q
13125 SW Hall Blvd., Tigard, OR 97223 r‘ Plan Review
/ �
Phone: 503.718.2439 Fax: 503.598.1.6fl � � \ Date /By: Other Permit:
TIGARD Inspection Line: 503.639.4175 )j ' A, �Q Date Ready /By: ions: 0 See Page 2 for
_ Internet:_ www.tigard- or.gov _ OF,yb?g WO / '‘C
et:. Notified /Method: (O Supplemental Information
TYPE NRK(sv � e <ck, PLAN REVIEW
New construction ❑Addition /alteration /replem d P `' - Please check all that apply (submit 2 sets of plans w /items checked below):
r\ c`ti'• 0 Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition ❑ Other: sd 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 - 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: qs 32. w 100HP or more. occupancy.
2 E. gSt-i e ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP:7-1Q 4(kb W A * c mt• ❑ Health-care facilities. vo ❑ Supply voltage for more than
.. 0 Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 1352. Project name: 7 #kE z1bi S NO9 ❑ Service or feeder 600 amps or more.
FEE SCHEDULE,
Cross street /directions to job site: Description I Qty. I Fee. I Total I *
New residential single- or multi - family dwelling unit.
Includes attached garage.
1 ,000 sq. ft. or less 168.54 4
Subdivision: Lot no.: .
no.: Ea. add'l 500 sq. ft. or portion 33.92 1
Tax map/parcel
Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
. Limited energy, multi- family 75.00 2
St%,VZ QA Q,t , residential (with above sq. ft.)
�.4Ar Services or feeders installation, alteration, and/or relocation
200 amps or less 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 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 1=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
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 67.84 414 y 2
CONTRACTOR , Signal circuit(s) or limited - energy
Business name: it iN 1��pil t
V N `1 u panel, alteration, or extension. Page 2 2
it ,` � Each additional inspection over allowable in any of the above
Address: q ,0 S y Th /► ue . Additional inspection (1 hr min) 66.25/ hr
19 4: Investigation (1 hr min) 66.25/ hr
City /State /Z1P: ? ® g t -rk ft 4 i �® �
�t®1 Industrial plant (1 hr min) 78.18/ hr
1
Phone: 6 3) r-1 e-� i ., ',Is' "" s Fa x: ( ) Inspections for which no fee is 90.00/ hr
specifically listed CA hr min)
CCB Lic.: (L75122... Electrical Lic.:26. o( Suprv. Lic.: i4g3S1G, ELECTRICAL PERMIT FEES ��
uprv. Electrician signature, required: / /if Subtotal: 47 Plan review (25% of permit fee): •
Print name: h I L r t /_ ' er r& Date: I " 27. t I Z State surcharge (12% of permit fee): I
V TOTAL PERMIT FEE: 52 1-----
AuthorlZed Signature: This permit application expires if a permit is not obtained within 180
Print name: days after it has been accepted as complete.
Date: * Number of inspections allowed per permit.
I: \Building \Permits \ELC- PermitApp doe 07/01/10 440- 4615T(I1/05 /COM/WEB