Permit ;�— ELECTRICAL PERMIT
CITY OF TIGARD PERMIT #: ELC2005 -00503
�i�1► DEVELOPMENT SERVICES DATE ISSUED: 7/14/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL:• 1S12600 -00300
SITE ADDRESS: 09516 SW WASHINGTON SQUARE RD H -4,5 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: 2 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: 2
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI 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 MACERICH 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 - 7/14/2005 $106.80
[TAX] 8% State Surcharge 7/14/2005 $8.54 REQUIRED ITEMS AND REPORTS
Total $115.34 •
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 1_80 days of issuance,, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through 0 R 952 - 001 -0100. You may obtain copies of these rum- or questions at
503- 246 -6699 or 1 ∎∎=332 -2 � y
Issued By: � �. / // - ee& Permittee Signet • .
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 Agplicat'mi� FOR OFFICE USE ONLY
City of Tigard I I J ��
Date/By: I* 0 S $.6 Pert No "a%-1 .00 —60 ,cos
13125 SW Hall Blvd., Tigard, OR 97223 I � i Plan Review+
Phone: 503.639.4171 Fax: 503.598.1960Y;, J� i 7e, v Other Permit.
q ��t''�I�I' Dat
Inspection Line: 503.639.4175 Date Ready/By: Juris. El See Page 2 for
Internet: www.ci"tigard.or.us CE
MY Notified/Method 77��// % yy!! Supplemental Information
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r #h T�' > �t tl ki�ik!�', i � ';at h �c 4.,'�. �, .il 'a�a�?r =� lvtt��. x# �; 4< ar' d��r�ru^"_ �6� {�e?/t:."«'Yty.'^;= ,�''r��.h '"��
❑ New construction A Addition/alteration/replacement Please check all that apply:
['Service over 225 amps, comm'l 0 Hazardous location
❑ Demolition ❑Other: ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
���x��� � �G�O�Yfi,M, , � �, A , 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
['Building over three stories ['Feeders, 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other:
f .,, Ml ❑Occupant load over 99 persons ❑Manufactured structures or
( " vW:i. r O * Y.i " TAO � ' :.',:.',0,10'715,7:- . tl 0 J" "o- . ❑Egress/lighting plan RV park
Job no.: Job site address:' ° OAST -k. 433> r t ❑Health -care facility ❑ abov
•Submit 2 sets of plans with any of the above.
City/State/ZIP: - n6191120 Cii_u3 q,5 / (o („j,p S The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: '
name: ` r` •ir 'h, i .J = , : �: .l .- ra_fti"a. t=_ ,;•,�-, ..
�'� • Description I Qty. I Fee. I Total
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: I Lot no.: Ea. add'I 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
^ 1 z ° r -3 gt 1t•' .90, , O : ,a -- ■ v ` /' ` Each manufactured or modular
1 0 //��� dwelling, service and /or feeder 90.90 2
1"t{ � _" � -� Services or feeders installation, alteration, and/or relocation
''' IL,..... 200 amps or less 80.30 2
t_ Pte�_ ,;: „ e .,„ �, l ., :7 - ..- -. 9 9s } ,, : ..• z r:•+ 201 amps to 400 amps 106 "85 2
+:., , .sus.. .- , . . ,� E ` ' r : - . ie
' ' „' k: - 41 x , < 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
Ii s ?�21 ; .7 F c ! f 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,
Address:
each branch circuit 46.85 2
Each add'l 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 v 53.40 j0&.,10 2
E -mail: Signal circuit(s) or limited -
« 4 : 1 i ', ";•; .,: P "`` Y s. y "i ` V -._ ,: energy panel, alteration, or
� 1 �r _ , � , - r� _____,,,,q;24::> extension. Describe: Page 2 2
Business name: (r �.� [' � -a` ���
Address: TOT e))6 7,„1--- Each additional inspection over allowable in any of the above
ll Per inspection 62.50 _
City / State/ZIP: �Q J? �2z Investigation per hour (1 hr min) 62.50
Phone: ( ) 0 g� Fax: ( ) Industrial plant per hour 73 75
CCB Lic.: l 045-91 Electrical Lic.5 C.I...;Ruprv. Lie.: 511 51 G. Subtotal `O • g b
_ 6 6 Suprv. Electrician signature, required: loir,- Plan review (25% of permit fee) ,sy'
Print name: IN 'lsc__ ( � Date: E5 - -• State surcharge (8% of permit fee)
4 TOTAL PERMIT FEE 115- , 3 I"!'
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: I ate: • Fee methodology set by Tri -County Building Industry Service Board
•• Number of inspections per permit allowed.
i•\ Building\Permits\ELC- pnnitApp.doc 12/03 440- 461ST(l0 /02JCOM/WEB
•
Electrical Permit Application - City of Tigard
•
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
�ry
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
t ABuilding\Pvrtuts\ELC•PermitApp doc 04/03
CITY04.0F TIGARD s, - .
BUILDING DIVISION PERMIT #: ELC2005.00503
13125 SW Hall Blvd., Tigard, OR 97223 ' DATE ISSUED: 7/14/2005
Phone: (503) 639 -4171 - Alb
y :alit
iection Requests, (24 Hrs.): (503) 639 -4175 —_-..- '
INSPECTI i' , WORKSHEET FOR DATE: 9/9/2005 TIME: 7:07AM PAGE: 86
SITE ADDRESS: 516 SW WASHINGTON SQUARE RD H -4,5 CLASS OF WORK:
SUBDIVISION: W SQUARE LOT #: TYPE OF USE:
PROJECT NAME: Egli, „• — ) .
QGE.JE.INELERS__�_
DESCRIPTION: &ign Ii._ ting. . •
OWNER: WASHINGT4 SQUARE LLC, ' PHONE #: 503 - 639-8865
CONTRACTOR: HIGHLIGHT SI t CORP PHONE #: 503.620 -8205
Inspection Request Scheduled For: \ \ Date: 9/9/2005 Pour Time:
Code # Inspection Description \' Confirm # Contact .# Message
ti
199 • Electrical final ` . 015228 -01 612 - 845 -5719 YL:13
. Corrections /Comments /Instructions:
•
•
•
•
•
F1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ .ADDITIONAL FEES ASSESSED
Inspector: c_ 9 Date: - Phone #: (503) 718 -