Permit . ELECTRICAL PERMIT
.1- ' CITY OF TIGARD
PERMIT #: ELC2005 -00830
DEVELOPMENT SERVICES DATE ISSUED: 10/25/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600-00300
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: Sign lighting.
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:
WASHINGTON SQUARE LLC HIGHLIGHT SIGN CORP
BY THE MAC ERIC H COMPANY PO BOX 23667
9585 SW WASHINGTON SQUARE RD TIGARD, OR 97281 -3667
TIGARD, OR 97223
Phone: Phone: 503 - 620 -8205
FEES Reg #: LIC 104599
SUP 3
Description Date Amount
ELE 37-660 - 660CLS
[ELPRMT] ELC Permit 10/25/200: $53.40
[TAX] 8% State Surcharge 10/25/200' $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 th_e_Orrgon- Ut+1ity- Nvhftcation Center. Those
est�'�n
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of rules or direct qu to at
503 - 246 -6699 or 1- 33 - 344
Issued By: Permittee Signature: ,
I
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.
. 5 6 aOOs - 003 0.
Ele Permit Application FOR OFFICE USE ONLY
g
City of Tigard RECE VE Received
DateB • 10 . / 1 Permit No /IC . 5 , 13
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax. 503.598 1960 1 I ' ' 4"��1 :C l?l I f l \ Date/B Other Permit
Inspection Line: 503.639.4175 0C ,� 9 1 - ! ill j Date Ready/By URI ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method Supplemental information
h, A-, ti'Sr n ,t .. 4L �. 'F? . .N.V_,l ` 1 � ,,, t�,,,, �� A ,l :::" "-S'%4.n:... ii ' ry t ?: "i�•J:J -m �• �_r,
' `s-c 's ilia ',' .!•r ,.:71-: ` "''',' y''kli`,"•7'"•" Y.PE .�. (ja . Y , . ,;,: i 'a„A.: .f i� 1 te .z <'.'�, a., %,. Z ' � , 4r 1,� :-7 4,'"` T`a•° -," )^.1C1: 3�:,
_
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New construction ❑ Additi Please check all that apply
El Demolition ❑ Other: ['Service over 225 amps, comm'I 0 Hazardous location
;y , - ., , r . ; _,- � . ['Service over 320 amps - rating ❑ Buildng over 10,000 sq ft., • '.' - .. i'.-2--''k.,", 4 ;; ` EG'O t$ ,-,CONSZC.T.rO$t '...4..,x.-'4.,-74v:. -.,�:, 1, t; '' -...N „y A =1,..:t,.1..1.4- dwellings 4 or more new residential
::ir �l�_ .�'t• �'�'��s�..6:%;A�a' -. �r - __t_�. ..u;. +k•.1`:•s.. � -�.. ..il v.e�'. :A�,'"` -�,%' : %3:r_?:Y: r= 'r``...r`�C of 1 - and 2-family
❑ 1 - and 2- family dwelling XLCommercial/industriai ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑ Master builder ❑ Other: ❑Building over three stones ❑Feeders, 400 amps or more
w .r �, - f p_ + _ v ['Occupant l over 99 persons ❑Manufactured structures or
� ; , hh" i :� K' J OB FFO 3 `Jt • LOCA_`TIONf'.• . x'! Re
,,, . .>r ,, . ; 1 " ' :- .- ❑E gress /l RV park
ighting p lan
Job no.: I Job site address: "° J O 1 4 sq ❑Health-care facility ❑Other:
+ Submit 2 sets of plans with any of the above.
City/State /ZIP: ¶ GA 6 . - q The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: Project name:
r sr'�. ".::..t. '',.:' �' ;%":-A1��` r.'. kj:.S`,C',sI��D�;��;a==; '` ::' .
Description I Qty. Fee. I Total
Cross street/directions to job site: New residential single -or multi - family dwelling unit.
^ '� 1 Includes attached garage.
ida r� 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
�, } �: - Limited energy, non - residential 75.00 2
.�
- i� �- { •; ';::: x_' '' "- :. ,w ,` `I $CE:PIT' 0ON "Q i!OR , '- 7„ `=t:*2.. #4.•-". i '`:.!..t;f Each manufactured or modular
dwellin service and/or feeder 90.90 2
%� i ('f Services or feeders installation, alteration, and/or relocation
�� ! f� : 141P 200 amps or less 80.30 2
' .., . , aPRO ERTT'"'`oWNER` a: l
"�` - � , ;: . %....' .41 ' .. ; - ' -:- : `' ' ' 1; �- 201 amps to 400 amps 106 85 2
,a. , " Y _ , - = r ''` ' • ", , y -;, .�'. TLNAN'C:. `_ :. c ;
— ' "` Il "" 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
Phone: ( ) Fax: ( ) relocation
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
x' *' •:`, '-� ate, .Q• AEiI:ICANTx?i ° LtF: la tif!'t' ` Q4,:'gN. CT' Q i. ' : ", A. Fee for branch circuits with
service or der fee, each 6.65 2
Business name: branch circuit
Contact name: B. Fee for branch circuits
without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'I branch circuit 6 65 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 9 53 40 2
E -mail: Signal circuit(s) or limited-
4,n•` t 7 s : ,'}.; ,:rr r ' `• r ` ., . ` •-w._ t` = ,:,.,.,,,. - F 's energy L� 1s �.>i�����'� =a� / '.��:�:• . •• �. ' �..Y
. .�bAl- .. , , .:? ;� • ',�- � ° ,- a.. gY P anel, alteration, or
extension. Describe: Page 2 2
Business name: OA KT 4160 CD v
Address: "' j 2,- Each additional inspection over allowable in any of the above
Per inspection 62 50
City /State /ZIP: 111 � 1 D , q �� Investigation per hour (1 hr min) 62.50
Phone: ( ) /��"�d ') Fax: ( ) Industrial plant per hour 73 75
L� r x,t;: � -``# :;➢ t,J.,LFIZ C ' 'Ek.w roF,S; 4 `, :i:. ? . '' ',_:
CCB Lic.: 10q s4 9 Electrical Lie.: 5/ - s /6, Suprv. Lic.: _ Subtotal . 53 ..0
Suprv. Electrician signature, required: Plan review (25% of permit fee)
' State surcharge (8% of perrrut fee) 4. 4 Print name: I L°� , Date: 2,9 6 (- - V a r � /
TOTAL PERMIT FEE 5'), (0 '7
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 Tn- County Building Industry Service Board
•• Number of inspections per permit allowed.
i \Building\Permits\ELC- PernutApp doc 12103 440 4615r(10 /02/COM(WEB
C. < _
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
:ERE IDE : VA 411 E4
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ 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
❑ Other •
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i \Building'.Perrruts\ELC- PernutApp doc 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00830
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/2612005
Phone: (503) 639 -4171 �1°A
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/11/2006 TIME: 7:01AM PAGE: 43
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SEPHOR.A
DESCRIPTION: Sign lighting.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: HIGHLIGHT SIGN CORP PHONE #: 503- 620.8206
Inspection Request Scheduled For: Date: 1/11/2006 Pour Time:
Code # Inspection Description Confirm. # Contact # Message
140 Sign installation _ 024768 -01 801-520-5734 N
Corrections/Comments/Instructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL - ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �- v� Date: ij ��I a ,Phone #: (503) 7182%