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Permit CITY OF T I G A R D ELECTRICAL PERMIT PERMIT #: ELC2002 -00155 'd DEVELOPMENT SERVICES DATE ISSUED: 4/5/02 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S126C0 -01107 SITE ADDRESS: 09785 SW WASHINGTON SQUARE RD D -12 SUBDIVISION: WASHINGTON SQUARE ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: 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: 1 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: PPR WASHINGTON SQUARE LLC YOUNG ELECTRIC SIGN CO P.O.BOX 21545 10535 SW AVERY STREET SEATTLE, WA 98111 TUALATIN, OR 97062 Phone: Phone: 503 - 612 -6672 Reg #: LIC 69308 SUP 445SIG ELE 37-51CLS • FEES Required Inspections Type By Date Amount Receipt Wall Cover PRMT CTR 4/5/02 $53.40 2720020000( Elect'I Final 5PCT CTR 4/5/02 $4.27 2720020000( 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 -0080. You may obtain copies of these rules or direct questions to Permit Signature: Issued By: �— ® 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 639 -4175 by 7:00pm for an inspection the next business day 04/02/2002 10:19 FAX 5035981960 CITY OF TIGARD 002 I., a ir Electrical Permit ` licatio OFFICE USE ONLY Ilit - \:J Date received: Permit no: I:Q/90 /, jc' ,..,,, �J1 City of Tigard Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigar , RA 972223 ',V - ) Date issued: Receipt no : Phone: (503) 639 -4171 Payment Fax; (503) 598 -1960 C��lL Ure g 1 Case file no.: Y type; Land use approval: FaDW DWI° 0 N TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi family ❑ Tenant improvement O Ncw construction 0 Addition /alteration/replacement ❑ Other: ,❑ Partial JOB SITE INFORMATION Job address: - S,1W . •►v)10C.Zr Bldg. no.: Suite no.: Tax map tax lot /account no.: Lot: Block: Subdivision: Project name: - AP qoe prCY� Description and location of work on premises: 1saSi L 5s4-c�7 b; c ��AG, Estimated date of completion/inspection: A$61.ti ` 1 + 2t 'e ,i _ :" C.COATRACTOIL�__APPLLICADON_ `• ' - FEE SCIILDULE � "'. Fee Max Job no: Description Qty. (ea) p �0 C Total no. ins Business name: � �C � a,, Description residential or multi - family per Address; 1 05.36 5,1Y'i, `d - ` y 3 s1 J dwelllttgemit.InciudesatiachadgarrAl;e- Ciry• -T\WSSI 1 State: •1 ZIP: r i'1b of Servkeincluded: 1000 sq. ft. or less 4 Phone: ( )� �0(o`7`L I Fax: I E -mail: Each additional 500 sq. >t or portion thereof CCB 6Cf 3o g' Elec .115. lac. no: Limited energy, residential 2 Ci m � r / _ Each eufc non-residential ;0 0 Bac 2 h manufgetttu ucd home or modular dwelling Signature o s crnsing ale • ciao (required) =V„.....2 -Q _ Service and/or feeder 2 Li no6 s 7` G Services or feeders- installation, Sup. aloe[ name (print): i 0 C , . ,. o: t4 ( alteration or relocation: PROPERTY OWNER zoo amp. or less 2 _ 201 amps a 400 amps 2 Name (print): VU�LS C�t� �.�-L� - 401 amps to 600 amps 2 Mailing address: N S 0 - J�"g - 601 amps to loon e 2 City: leTc0Y.A ba70 I State: y )1 ZIP: 9t„- D.5 - Over 1000 amps er volts 2 Phone:'Jt5Q(J J JFax: E -mail: Reconnect on 1 Owner installation: The installation is being made on property I own Temporary services or feeders - Installation, alteration, or relocation: which is not intended for sale, lease, rent, or exchange according to 200 amps or less • 2 ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2 Owner's signature: Date: , 401 to 600 amps 2 ENNG l NEER Branch circuits - new, alteration, or extension per panel: Name: A. Foe for branch circuits with purchase of Address: _ service or feeder foe, each branch circuit 2 City: 1 State: ZIP: H. Fee for bmnth circuits without purchase of service or Ibuder fee, first branch circuit. 2 Phone: Fax: E Each additional branch circuit: Mist, (Service or (ceder not included): ❑ Service over 225 amps •commercial ❑ Health-care facility Each pump or irrigation circle 2 U Service over 320 amps- rating of 18c2 U Hazardous location Each sign or outline h hung I 2 family dwellings D Budding over 10,000 square feet four or Signal circuit(s) or a limited energy panel. ❑ System over 600 volts nominal more residential unio in one structure alteration, or extension* 2 ❑ Building over three storirs ❑ Feeders, 400 amps or more rDcscription: -- C-- %-.--'"'" 0 Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional i spection over the allowable In any of the above: ❑ Egressllighting plan ❑ Other Per inspection ,J Submit _ sets of plans with any of the above. Investigation foe The above are not applicable to temporary construction service. Other Permitfee $ 5 y� Not on Jurisdictions accept credit cards, plea,. call junadierion for more infbmmtian. Notice: This permit application Plan review (at %) $ ❑ Visa ❑ MasterCard expires if a permit is not obtained Credit card number: / / within 180 days after it has been State surcharge (8 %) 5 ' Ex accepted as complete. TOTAL $ 57, /Di Name of cardholder as shown an credit card Cardholder srgnaturc Amount 440 -4615 (11/00/COM) `I 0`? 02/2002 10:19 FAX 5035981960 CITY OF TIGARD al 003 C - ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: TYPE OF WORK INVOLVED • RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total -I, - Check Type of Work Invove: Residential - per unit 1000 sq. ft or less $145.15 4 ' ❑ Audio and Stereo Systems" Each additional 500 sq. ft. or portion thereof $ 33,40 1 0 Burglar Alarm Limited Energy ‘ $ 75 . 00 Each Manurd Home or Modular °welling Service or Feeder $90.90 2 ❑ Garage Door Opener Services or Feeders ❑ Healing, Ventilation and Air Conditioning System" lnetallatton, alteration, or relocation 200 amps or lass $ 80 . 30 2 ❑ Vacuum Systems 201 amps to 400 amps S106. 2 401 amps to 600 amps 5160.60 2 601 amps to 1000 amps $240.60 2 ❑ Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 - Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system.... $75.00 200 amps or less 566.85 2 (SEE OAR 918 -260 -260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see "b" above. 0 Audio and Stereo Systems Branch Circuits - Bo iler Controls New, alteration or extension per panel a) The fee for branch circuits Clock Systems with purchase of sondes or Ej feeder fee. Each branch circuit $5.65 2 El Data Telecommunication Installation b) The fee for branch circuits without purchase of service 0 Fire Alarm Installation or feeder fee. First branch dreult 546.85 HVAC Each additional branch circuit $6.65 Miscellaneous ❑ Instrumentation (Service or feeder not Included) Each pump or Irrigation circle $53.40 intercom and Paging Systems Each sign or outline lighting — I — $53.40 S-s .'ID, Signal circult(s) or a limited energy Landsr�pe irrigation Control' penal, alteration or extension 575.00 Minor Labels (10) $ 125 . 00 Each additional inspection over 0 Medical the allowable in any of the above Nurse Calls Per Inspection $62 50 Per hour $62.50 In Plant $73.75 ri Outdoor Landscape Lighting' Fees; 0 Protective Signaling Enter total of above fees $ 5 .11 D. 0 Other b% State Surcharge $ `' Z7 Number of Systems 25% Plan Review Fee • No licenses am required. Licenses are required for all other Installations See Review" section on $ front of application. Fees: Total Balance Due $ 57. io7 Enter total of above fees $ ❑ Trust Account if 8%a State Surcharge s Total Balance Due $ All New Commercial Buildings require 2 sets of plans. i :tdsts \ forms \cic- fees.doc 02/05/02 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received q Date Requested /2.- AM PM BUP Location l 7 R /.f) ft- - Suite MEC Contact Person Ph ( ) / oZ '' 7� PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner J ELC n0/ Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT . Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Final . Final tt � I e( _ PASS PART FAIL PLUMBING � A, Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan • Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Serve Rough -In UG/Slab Low Voltage Fire. larm //) f er • ina Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SITE Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line � /� ADA 2 o / 0 Inspector lV Ext Approach/Sidewalk Date �� Ins eCto� , Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF T I GARD -' ELECTRICAL PERMIT PERMIT #: ELC2002 -00155 Al* DEVELOPMENT SERVICES DATE ISSUED: 4/5/02 I 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 1S126C0-01107 SITE ADDRESS: 09785 SW WASHINGTON SQUARE RD D -12 SUBDIVISION: WASHINGTON SQUARE ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: 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: 1 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: PPR WASHINGTON SQUARE LLC YOUNG ELECTRIC SIGN CO P.O.BOX 21545 10535 SW AVERY STREET SEATTLE, WA 98111 TUALATIN, OR 97062 Phone: Phone: 503 - 612 -6672 Reg #: LIC 69308 SUP 445SIG ELE 37 -51CLS FEES Required Inspections Type By Date Amount Receipt Wall Cover PRMT CTR 4/5/02 $53.40 2720020000( Elect'I Final 5PCT CTR 4/5/02 $4.27 2720020000( Total $57.67 rl This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable CS 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 -0080. You may obtain copies of these rules or direct questions Permit Signature: a 4 , Issued By: � O /7 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: O • CONTRACTOR INSTALLATION ONLY ` SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: (17 Call 639 -4175 by 7:00pm for an inspection the next business day t BUP - Building Permit ELC - Electrical Permit -4 Inspection Description Date Passed By Inspection Description Date Passed By Footing /Setback Underground cover Foundation walls Wall cover Footing drain Ceiling cover Waterproof bsmt walls Electrical rough -in Slab Electrical service Crawl drain Electrical final Underfloor insulation Post/beam structural Shear walls /anchors ELR - Restricted Energy Permit Roof nailing I Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry /Reinforcement Framing MFG - Structure set -up MEC - Mechanical Permit Insulation Drywall nailing � Inspection Description Date Passed By Post/beam mechanical Suspended ceiling _ Gas line Engineered soils Mechanical rough -in Welding Lab Final Fire damper Concrete Lab Final Duct work Bolting Lab Final Smoke detector Structural observation Mechanical final Fireproofing Lab Final Final inspection PLM - Plumbing Permit BUP — Fire Protection System Permit Inspection Description Date Passed By Plumbing underslab 11 Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP /backflow preventer Fire alarm final Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer -4 Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls , Plumbing final Sprinkler supply lines Sprinkler underfloor /slab Catch basin/Manhole SWR - Sewer Permit Engineered soils 11 Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits i:\dsts \forms\ nspRecordBUP.doc 04 /17/01