Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00774
DEVELOPMENT SERVICES DATE ISSUED: 10/18/2005
1p7 II 13125 SW Hall Blvd., Tigard, OR 97223 503-639-4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09345 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: Sign lighting for (1) 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:
WASHINGTON SQUARE LLC MULTI -LIGHT SIGN CO.
BY THE MACERICH COMPANY 809 NE LOMBARD ST
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97211
TIGARD, OR 97223
Phone: 503 - 639 -8865 Phone: 503 - 281 - 3083
FEES Reg #: LIC 64107
Description Date Amount SUP 672SIG
ELE 26 -90CLS
[ELPRMT] ELC Permit 10/18/200: $53.40
[TAX] 8% State Surcharge 10/18/200: $4.28 REQUIRED ITEMS AND REPORTS
Total $57.68
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 issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utili N ificat•6n Center. Those rules are set
eons forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct q - t. OUN r at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: f Permittee Signature: C•_ _.. -
or
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 , oos 0orQ 9
Electrical Permit Application Fes^ OFFICE USE ONLY
M City it�f Tigard Received / ��� /j Permit No . E4 ,�
Date/B 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
i°
503 639.4171 Fax. 503 598 1960 " °"a d' cl Date/By Other Permit
Inspection Line: 503 639 4175 c ` Date Ready/By J�un El See Page 2 for
Internet. www.ci.tigard or.us Notified/Method / C / Supplemental Information
` TYPE OF WORK - PLAN REVIEW
ew construction ❑ Addition/alteration/replacement Please check all that apply
❑ Demolition ❑ Other: ❑Service over 225 amps, comm l ['Hazardous location
['Service over 320 amps - rating EBuildng over 10,000 sq ft ,
ATEEGG C RY OF CONSTRUCTION _ ' -_ - - - - of 1- 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
❑ Multi - family ❑ Master builder ❑ Other: ❑Buildin over three stories ['Feeders, 400 amps or more
['Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑E /li plan RV park
Job no.: Job site address: 43 S— 5/ s - ❑Health - care facility ['Other
Al ■ I /..- Submit 2 sets of plans with any of the above.
City/State /ZIP: fil / #!� , ii _ • The above are not applicable to temporary construction service
Suite/bldg. /apt. n o..5 ._0 1 Project nam lj / / A� 5 Sm0 ,,,, s/ FEE*
Description Qty. SCHEDU Fee. I Total I ••
/` ��/�
Cross street/directions to job site: 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'1 500 sq. ft. or portion 33 40 1
Tax map /p no.: tV f F/'! Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
. DESCRIPTION OF WORK . Each manufactured or modular
dwelling, service and /or feeder 90.90 2
li/ IJ /1 / _/ / ✓ 4 2 d/ Services or feeders installation, alteration, and/or relocation
200 amps or less 80 30 2
❑ PROPERTY OWNER I ❑ TENANT - 201 amps to 400 amps 106 85 2
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: ( ) 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
• ❑ APPLI T • CONTACT PERSON A. Fee for branch circuits with
Business name.
service or feeder fee, each 6 65 2
/// branch circuit
Contact name: i B. Fee for branch circuits
/ �� � �0',���1/1 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 imgation circle 53.40 2
Sign or outline lighting 1 53 40 ,93• b 2
E - mail: Signal circuit(s) or limited -
C NTRACTOR / energy panel, alteration, or
Business name: /�/ �/�1 i J ��// 6 h extension Describe Page 2 2
Address: Air/ _ Each additional inspection over allowable in any of the above
de - /i•- Per inspection 62 50
City/State /ZIP: A� �� � . / Investigation per hour (t hr min) 62 50
Phone: r ' , r _ ' = Fax: s l) ) !D ' Industrial plant per hour 73.75
• - ELECTRICAL PERMIT FEES* ' I
CCB Lic.• i. �� �a Suprv. Lie.: • – �, Subtotal 5%/ , 7 b
Suprv. Electrician signature, re i ued: /� l ,,,'� — ! Plan review (25% of permit fee) �j
�// State surcharge (8% of permit fee) V.
9 O
Print name: � Date: '0 / Al /
TOTAL PERMIT FEE ? f (.F g
Authorized sign_ tare: ., / This permit application expires if a permit is not obtained within 180
� �� days after it has been accepted as complete
Print name: ,� Iii r• A Dat , ( • S • Fee methodology set by Tn- County Building Industry Service Board
r - — "" Number of inspections per permit allowed
I \Bwldmg\Perrtuts\ELC- PemutApp doe 12/03 440- 4615T(10 /02/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
•
LIMITED ENERGY PERMIT FEES:
ry a,�.seA.;» r - :�e,d, "m - -4 s,.r�v °;4A�` x�.
R abT:5 OItK,.O:AVO - °a R- , • , r.,v,.
Fee for all residential systems combined $75.00 •
Check Type of Work Involved:
❑ Audio and Stereo Systems*
n Burglar Alarm •
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
NCO i CZA W 1: 61:LY 4- .:=:,.,=:,, 7
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
\Buddmg\Pernuts\ELC- PermnApp doc 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: t 4-CPG6 0 _ --77
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 p �� ) , i A
Inspection Requests (24 Hrs.): (503) 639 -4175 _.._ L
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 734,4.5"
j 4'.5" ( /4-t Se' `_ D. CLASS OF WORK:
SUBDIVISION: � LOT #: r 5' ` TYPE OF USE:
PROJECT NAME: cui../ / c,.;6 �Y 1)
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: /1 -1 7 — 65 Pour Time:
Code # Inspection Description Confirm # Contact # Message
I” Fivi i.€ 6� ,tea -- 7 W g
Corrections /Comments /Instructions:
L. s p ste‘k) ®iLL, IS5 ems,
o po U XV TRA tevok.tvn, 1 5
S E YYNAV 4 &__ . ea__ ..stZ .
s zit rw C c-k , Lic pa& c (
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
X FAIL • XCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
`\
Inspector: �� Date: 111 [1l `c Phone #: (503) 718 - 1-IM'
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: ELC2005 -0077t1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/18/2006
Phone: (503) 639 -4171 ('�
Inspection Reque- s (24 Hrs.): (503) 639 -4175
INSPECTION WORKSH= T FOR DATE: 12/1/2005 TIME: 7:08AM PAGE: 49
SITE ADDRESS: 09345 WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHIN TON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: POTTERY ARN KIDS
DESCRIPTION: Sign lighting r (1) sign.
OWNER: WASHINGTON •QUARE LLC, PHONE #: 503.639 -8865
CONTRACTOR: MULTI - LIGHT SI t CO. PHONE #: 503281 - 3083
Inspection Request Scheduled For: Date: 12/1/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 022721 -01 503-281 -3083 N
•
Corrections /Comments /Instructions: htt—t-t7:1
gl al
C PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
R INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: GINC<A6 Date: it �� �" Phone #: (503) 718- 24415.