Permit A CITY OF F TIGAR ELECTRICAL PERMIT
' r` PERMIT #: ELC2005 -00867
Jul ii DEVELOPMENT SERVICES DATE ISSUED: 11/3/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PARCEL: 1S12600 - 00300
SITE ADDRESS: 09330 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: 503 -639 -8865 Phone: 503 - 620 -8205
FEES Reg #: LIC 104599
SUP 517SIG
Description Date Amount ELE 37 660CLS
[ELPRMT] ELC Permit 11/3/2005 $53.40
[TAX] 8% State Surcharge 11/3/2005 $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 applicabl- laws
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days o ' - .: •-, or if w
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the • = • • n tility Notification Center. ose
rules a re set forth in OA: 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of th- - es or direct questions to OUNC at
503 - 246 -6699 or 1 P a-332-2344. _ /
Issued By: • ,e Permittee Signatur -. - ra w , cs�
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.
Electrical Permit AD i'd`GGEOVEV rtllrz)l ICf t?51 O is
City of Tigard Date/B ved /1 3 05 �. • Permit No. I - X05 —'OD71
13125 SW Hall Blvd., Tigard, OR 97223 NOV 3 2005 A Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 1 ,- .14. t i ,�`• Dat • Other Permit
Inspection Line: 503.639.4175 CITY OF TIGA" 4 :1� 'I I � Date Ready/By MINI _________ See Page 2 for
Internet: www.ci.tigard.or.us BUILDING DIVIS • ' Nonfied/Method , i Supplemental Information
TYPE OF WORK PLAN REVIEW ,
,,,N New construction ❑ Addition/alteration/replacement Please check all that apply:
Demolition ❑Other: ❑Service over 225 amps, comm'I ❑Hazardous location
0 Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION • - of 1- and 2- family dwellings 4 or more new residential
❑ 1 and 2 family dwelling ❑ 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
DOccupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
^'— — - ❑Health-care facility ❑der"
Job no.: Job site address: `9330 ` I \ Submit 2 sets of plans with any of the above.
City/State/ZIP: -- icv f) TT2- 13 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: 5b l Y A FEE* SCHEDULE
I Qty. I Fee. I Total I --
Description
C street/directions to job site: , New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 14 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion )3.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
. DESCRIPTION OF WORK Each manufactured or modular
/ - ` n 0 / . J - �"" RK �� J dwelling, service and/or feeder 90.90 2
GCJLY (�f Services or feeders installation, alteration, and/or relocation
200 amps or less 80. 2
0 PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
U - 401 amps to 600 amps 160.60 2
Name: ��1 CC - 'V U - , 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: ( ) I 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
❑' APPLICANT I ❑ CONTACT PERSON 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, 46.85 2
Address: each branch circuit
i ce' Each add'I branch circuit 6.65 2
City/ State/ZIP: /! Miscellaneous (service or feeder not included)
Phone: ( ) I Fax :: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 1 53.40 S3'd 2
E - mail: Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration, or
4-j � extension. Describe: Page 2 2
Business name: L
Address: ?e ead %‘:;,6 Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: ^ j i h, A A c7 ' 7 3 Investigation per hour (I hr min) 62.50
Phone: ( ) &Zoe . S705 Fax: ( ) 6;24,/, - Z�� Industrial plant per hour 73.75
CCB Lic.: 0 Electrical Lic.: p. Lic. :34 / � ELECTRICAL PERMIT FEES , f
511 5�1 - J( S ury . Lic: 34 i& octs Subtotal 53 '''T O
Suprv. Electrician signature, required: re— /G,0,,,.4 Plan review (25% of permit fee)
Print name: t"l/\ �"� Date: ? A 9' State surcharge (8% of permit fee) !/'. 2-
��c'6� � 'V�,V Drs../ TOTAL PERMIT FEE 57. 6
Authorized signature: This permit application expires if a permit is not obtained within 80
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 dot 12/03 4104615T(10/02/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:,
Fee for all residential systems combined $75.0!
Check Type of Work Involved:
❑ Audio and Stereo Systems*
N Burglar Alarm
Garage Door Opener*
❑ ting, Ventilation and Air Conditio . ng
System
❑ Vacuu Systems*
❑ Other:
. - COMMERCIAL WO 'is ONLY:
Fee for each commercial stem... $75.00
(SEE OAR 918 - 260 -260)
Check Type of Work Involved•
❑ Audio and Stereo Syste s
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecom a nication Installation
❑ Fire Alarm I' tallation
❑ HVAC
❑ Instru entation
❑ Inte• om and'Paging Systems
❑ . ndscape Irrigation Control*
• Medical
/1 Nurse Calls
r Outdoor Landscape Lighting*
❑ Protective Signaling
El Other
'Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i1Buildmg\PennR+\ELC- PermitApp doc 04/03
TIGARD °
BUILDING DIVISION PERMIT #: ELC2005 -00867
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/3/2005
Phone: (503) 639 -4 1 te a ' •
Inspection Requests (4 Hrs.): (503) 639 -4175 + L I 'I _ � ..
INSPECTION WORKSHE T FOR DATE: 11/4/2005 TIME: 7:08AM PAGE: 49
SITE ADDRESS: 09330 ; WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHIN .1-ON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SOMA •
DESCRIPTION: Sign Lighting.
OWNER: WASHINGTON UARE LLC, PHONE #: 503 - 639-8865
CONTRACTOR: HIGHLIGHT SIGN a ORP PHONE #: 503-620-8205
Inspection Request Scheduled For: Date: 11/4/2005 Pour Time:
Code # . , . '.n Description Confirm # Contact # Message
199 Electrical fina 120375.01 503 - 620 -8205 N
Corrections /Comments /Instructions:
•
•
r\ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N Le Date: � ` ' C Phone #: (503) 718- ALA