Permit CITY OF TIGARD ELECTRICAL PERMIT
III 2 COMMUNITY DEVELOPMENT Permit #: ELC2012 -00259
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/04/2012
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9581 SW WASHINGTON SQUARE RD B08
Project: Brookstone Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: (1) sign lighting
Contractor: SECURITY SIGNS INC Owner: PPR WASHINGTON SQUARE LLC
2424 SE HOLGATE BLVD BY THOMSON PROPERTY TAX SERVICES
PORTLAND, OR 97202 ATTN HILARY RAYMOND
2235 FARADY AVE, STE 0
CARLSBAD, CA 92008
PHONE: 503 - 546 -7114 PHONE:
FAX: 503 - 230 -1861
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 05/04/2012 $67.84
Specifics:
1 ea 12% State Surcharge - 05/04/2012 $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. ATTENTI• - -gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 •ugh OA• 952- 0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503. 987 or 1.800.332.2344.
Issued By: XL // /1 11 Permittee Signature ��� ' �i� /SO
�� _ice
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 Applicatilipptive r OFFICE USE ONE Y
City of Tigard V •1 OR
t ceivad Permit No.:
n 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
• Phone: 503.639.4171 Fax: 503.598.1960 - 2 2012 D ate /B y: Other Permit:
T I G a t; O Inspection Line: 503.639.4175 Date Ready/By; Turin. ® See Page 2 for
Internet: www,tigard CITY OF TIGARD Notified/Method: Supplemental Information
{ . 3:^;t;"'7��� - t 4C 5`ti" :+r ::y j .•• q••. { -S ' °� - C::; "K- •:- �+ -- •N. y y ^. 1 r
C a "gsti •t'c ifs 3 '� � y r;, £ e' },4, . , r ' i1 s f • ati 3 .S W ,. 1 .5�e'��. su tit N •., •�_ t x1 -S y s ' , 1-dAba i °, Z.t•:.on n£'P a
5 ik G f... _ _'1saaa _ti a,.-_ _ �h a ,' that art s� bmitt 2 s • .. /item "�. �E4 •. below):
❑ New construct ® A dd i t i on/alteration/replacement Reese check all that ap ply (submit Z sets of plena w /sterna checked below):
❑ service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
y��*�• ,,.�,.. .* ti,'•- = �;;;; .:� °' : v = - zrsd� ,:,'`y „: ;;�r=;,�_sa'?3�;y� ^ ; c w'si`e' exceeds 10,000 amps et 150 votes or ❑ Floating buildings.
&i:' .; , 5;' = � a 221 �.i �` sb'.' l�� ui� ? '.- G . *•.t L. ,, rr�12::'�* ,...n..� i:r:'cti exceeds
A S �•
less to ground, or exceeds 14,000 ❑ Commercial - use agricultural
❑ I- 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
*� q r � - � ; , .,•;?..., ,. r�:e e ;ors:: s: >r .,.::, ❑ Emergency system larger separately derived system.
�•�.``�,���x?�- '=J � ;.";�a� a {al:,. � �� �,>v � kak � ['Addition of new motor load of 12.. ,. 2 .... I . 3 ..
Job no.: Job site address: /Se I L Z 100HP or more. occupancy.
❑ Six or more residential units,
CI Recreational vehicle parks.
❑ Health -care facilities. ['Supply voltage for more than
❑ Hazardous locations. 600 volts
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: inscription on. En. A rotas
New residential single- or multi - family dwelling unit. •
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map /parcel no,: Ea. add'l 500 sq, ft, or portion 33.92 1
_ 1' limited energy, residential
f 67.84 2
` ' L n c -e2 0 '; 1 •1 • $Ntot -I s . 1 3
`- ; x ; W "
, �+ ti: : • S (with flbove R.)
.r • 7 .trl � <Y�• -cl �' 4 �iF.v..^sy �. P '
�..x w N � 4•i., aq.
_ti, -; ._. Z• Lx .t.y: _ Li energy, multi- family
residential (with above sq. ft.) 67.84 2
• kt z._ •
-..--z;.:a,:A
less to pound, or exceeds 14,000 0 cornmercui
*Mount Only* 200 amps or less 100.70 2
•
{- z r I -1v. , 1. ' ,.,-� -1
L, ut } � ' ' G$i t •V, w x' Y t. r ^` *- �'bati c . - S ` � r�� a , , , ,_� �� 201 amps to 400 amps 133.56 2
4.
_.. v��a.�ttl'.` ;r> ...v:'�x c. t l�aw:�,�. �. �vx?�r• �;��: ..K •x �.st .:z, 401 amps to 600 amps 200,34 2
Nam
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 lass 59.36 1 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.
Branch circuits - new, alteration, or extension, r panel
Owner signature: _ Date: A. Fee for branch circuits with
'T.l i. e ,.:r: V.;:r_ r: iSTA � S '- `� ` '∎ `� : : f; ;
E? � ,
?' � `` ` � w � r- ;s"ri'h " � € ,, ? �� 1 _: � , �a �� 3R Yn above service or feeder fee, 7.42 2
�1` each branch circuit
Business name: Security Signs B. Pee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: Melissa Hayden branch circuit
Lath add'I branch circuit 7.42 2
Address: 2424 SE Holgate Blvd Miscellaneous (service or feeder not included)
Each manufactured or modula
City /State/ZIP: Portland, OR 97202 dwelling, service and/or feeder 67.84 2
Phone: (503) 546.7114 Fax:: (503) 230.1861 connect only 67.84 2
E -mail Melissa@SecuritySigns.com
Pump or irrigation circle 67.84 2
y i' y Z, ^•. � ': -^' .:� 4 �-", �•'c viii -�• u� . •F-t, S'*+.'�> r ;.L ,. . , i Sign or outline IiF,t'tting 67.84 67 0 2
-.. 4 - .. - �- a, rSv ?�• a . a rc : M ��? Signal circuit(s) or limited energy
Business name: Security Signs panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the abov
Address: 2424 SE ilolgate Blvd Additional inspevdon (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
-- City/State/ZIP: Portland, OR 97202 Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 546.7114 S % I Fax; (503) 230.1861 Inspections for which no fee is 90
a • 'ficall listed Oh hr min)
FCCB Lie.: 122809 I I Electrical Lic.: 26560CLS Suprv. Lic.: 3S3S1G ` x h'1 * 1N7 - ir :; mss' ; "
Suprv. Electrician signature, Subtotal: , 7. `
Su '
p gnature, required:
4 Plan review (25% of permit fee): ----
Print name; Marc Linguist Date: State surcharge (12% of permit fee): ". / zf
Authorized signature:
' TOTAL PERMIT FEE: 75. sg
,/ This permit application expired if a permit is not obtained withi tz ,
Print name: Melissa ayden Date: days after It has been accepted as complete.
Number of inspections allowed per permit.
lams;tdins\ecnit el.c- PermeApp.uoc Ituntm9 44ua615T(11ms/COM/wga
TO'd 9t7:TT ZTOZ Z 6.2 14 T98TO2Z2OS :x 2 d 3uI su6ts fi1t.Inoos