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Permit
A CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00659 DEVELOPMENT SERVICES DATE ISSUED: 9/8/2005 '`�--- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600-00300 SITE ADDRESS: 09336 SW WASHINGTON SQUARE RD ZONING: C -G SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG Project Description: Sigh 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 MEYER SIGN CO OF OREGON BY THE MACERICH COMPANY 15205 SW 74TH AVE 9585 SW WASHINGTON SQUARE RD TIGARD, OR 97223 • TIGARD, OR 97223 Phone: 503 - 639 -8865 Phone: 620 -8200 FEES Reg #: LIC 64014 SUP 566SIG Description Date Amount ELE 20 I90CLS [ELPRMT] ELC Permit 9/8/2005 $53.40 [TAX] 8% State Surcharge 9/8/2005 $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 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 95 - 001 -0010 through OAR 952 - 001 -0100 You may obtain copies of these rules or direct que • s to OUNC at 503 - 246 -6699 or 1 -800- - Issued By: Lei ) Permittee Signature: 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. 1.ecfrical Permit Application . . FOR OFFICE USE ONL _.___ , City of Tigard j ;' ' -!I 1 9 6/05 86 Permit No .h 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie ....0,4,5-1 Phone: 503.6394171 Fax: 503.598 1960 CITY OF TIGAR 4N I.' • DateB Other Permit. Inspection Line: 503.639.4175 BUILDING DWOC , : . I , l ` _ l I � Date Ready/By y • ®See Page 2 for Internet: www.ci.tigard.or.us Noufied/Method tJ 1.4. Supplemental Information ' ' - TYPE OF WORK PLAN REVIEW , ❑ New construction . ' ❑ Addition/alteration/replacement Please check all that apply: ❑ Demolition Other: r2 ['Service over 225 amps, comm'l ['Hazardous location ❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of I - and 2- family dwellings 4 or more new residential ❑ 1 - and 2 family dwelling ,mmercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure El Multi - family El Master builder ❑Other ['Building over three stories ['Feeders, 400 amps or more ❑Occupant load over 99 persons 0 Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park Job no.: Job site address: Q�3 ..,u) � i d K , ❑Health care facility ❑ � Submit 2 sets of plans with any of the above. City /State/ZIP: 774 ) Oa ?7 2,2 3 The above are not applicable to temporary construction service. .` 1 / FEE* SCHEDULE , Suite/bldg. /apt. no.: Project name: wi )4a� e� aR / K�I�j/ � Destriptioa I Qty. I Fee. Total I •• Cross street/directions to job site: w r c ,. A a t( New residential single - or multi- family dwelling unit. Includes attached garage. 1,000 sq. ft. or less [ 145.15 4 Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular i _ „0 //\ / c �, a dwelling, service and/or feeder 90.90. 2 PY�b ( J Y�LL�C (/(/ Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 [il PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: w frit AL it) aroN . 6,04/2_0- �,¢L/ , 601 amps to 1,000 amps 240.60 2 Address: 9 5 --- 1 ? s- W,4 , gsz Y2A Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 I I 2 City /State/ZIP: W 42_)S ) o/ q7 Z2. Temporary services or feeders installation, alteration, and /or relocation Phone: ('J3) ( _ .8A26, I Fax: ( ) 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 --E ONTACT PERSON • A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: / 6 zrnQ d branch circuit Contact name: / B. Fee for branch circuits v7z V - �,(,(,(2� without service or feeder fee, Address: each branch circuit 46.85 2 Each add'l branch circuit 6.65 2 City/State/ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) I Fax: : ( ) Sign or outline lighting / 53.40 53.40 2 E - mail: Signal circuit(s) or limited- . • . . CONTRACTOR energy panel, alteration, or p � / extension. Describe: Page 2 2 Business name: f /A (---(e ( - 3) a, _ `C) O p . Address: _ rr /� Each additional inspection over allowable in any of the above ) S w i 7 7 �� Per inspection 62.50 City/ State/ZIP: < pj O2 9-1 1 t / Investigation per hour (I hr mm) 62.50 Phone: (653 ) 6, 26,—,8.200 I Fax: (,' ) T _ 7 7 ' , / Industrial p lant per hour F 3 f ELL ECTRICAL PERMIT FEES* S* CCB Lic.: Z, (i ©l ti Electrical .: AA _) LS' Suprv. Lic.: 5'6 6 Subtotal 53.40 Suprv. Electrician signature, required: / Plan review (25% of permit fee) Print name: sf � , Date: 9 _ 8 2 --0,...t--- State surcharge (8% of permit fee) Lt- Z `L / ` '+ / TOTAL PERMIT FEE 5 7 , - 7 / Authorized signature: • �" \ ��, r 4" This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: c ._ ; d t p p 1111, Date: T--6 • Fee methodology set by Tri- County Building Industry Service Board / ""'"- •• Number of inspections per permit allowed. i \Buiiding Tennits\ELC- PennitApp doe 12/03 440- 4615T(l0/02/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 .. $75.00 Check Type of Work Involved: El Audio and Stereo Systems* ❑ Burglar Alarm El Garage Door Opener* ❑ Heating, Ventilation Air Conditioning System* El Vacuum Systems* ❑ Other: COMblERCIAL WORK ONLY:' __. _ - 71 Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: El Audio and Stereo Systems El Boiler Controls El Clock Systems El Data Telecommunication Installation El Fire Alarm Installation El HVAC El Instrumentation ❑ Intercom and Paging Systems El Landscape Irrigation Control* El Medical El Nurse Calls ❑ Outdoor Landscape Lighting* • El Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I UEuildmg\Pennne\EL.C- PermnApp doc 04/03 PSTILOPTIGARD • BUILDING DIVISION PERMIT #: ELC200S -00669 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/8/2005 Phone: (503) 639 -4171 �'r Inspection Requests (24 Hrs.): (503) 639 -4175 `'I / -- INSPECTION WORKSHEET FOR DATE: 11 /3/2005 TIME: 7: 06AM PAGE: 50 SITE ADDRESS: 09336 SW WASHINGTON SQUARE RD CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: WHITEHOUSE.BLACK MARKET DESCRIPTION: Sigh lighting. OWNER: WASHINGTON SQUARE LLC, PHONE #: 603- 639 -8865 CONTRACTOR: MEYER SIGN CO OF OREGON PHONE #: 620 -8200 . Inspection Request Scheduled For: Date: 11/3/2006 Pour Time: Code # Inspection Description Contact # Message 199 Electrical final 020226 -01 603-620-8200 N Corrections /Comments /Instructions: 113 11E P : A i h i . - - ill - " " "' ' 7 • 1°17 - - I ' : - 7 - 1--Sk- = = - ! 7 liValli I . UWIllialatralkilertil 01111111011MIN9 �� . it � ' 1 ■ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED , , Inspector: 1448 (.----_ Date: `A - 7 -i Phone #: (503) 718- 234410•