Permit CITY OF TIGARD ELECTRICAL PERMIT
71 ° PERMIT #: ELC2007 -00413
COMMUNITY DEVELOPMENT DATE ISSUED: 6/18/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09601 SW WASHINGTON SQUARE RD L -1 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
PROJECT: FOREVER 21
Project Description: (4) 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: 4
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 VANCOUVER SIGN COMPANY, INC
BY THE MACERICH COMPANY 6615 SW HWY 99
9585 SW WASHINGTON SQUARE RD VANCOUVER, WA 98665
TIGARD, OR 97223
Phone: Contact #: PRI 360 693 - 4773
FAX 360- 693 -2747
FEES
Description Date Amount Reg #: ELE 37 -46CLS
[ELPRMT] ELC Permit 6/18/2007 $213.60 LIC 63951
[TAX] 8% State Surcharge 6/18/2007 $17.08 SUP 525SIG
Total $230.68 REQUIRED ITEMS AND REPORTS
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 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6609:332 2 44.
Issued By: 44 ' Permittee Signature. 1 t r _
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.
rT
rEl &c - ical Permit Applicatio f EI V 1 (1rrlcI: usr ONI.V
City of Tigard J UN 18 200 - 'it) :/ i s Permit No„ / _ _tiJ�U /3
13125 SW Hall Blvd., Tigard, OR 97223 �}�v Plan Review
Phone: 503.639.4171 Fax: 503.598 Date/By: Other Permit:
T I G A l: 0 inspection Line: 503.639.4175 1 j ' Received
O Ii (JA i f if ` B . kris Supplemental P ag e e 1 f or ormation
Internet: www.tigard- or.gov 13T DAT - ( �T 7�
TYPE OF ( WORK `" • 1t ION' PLAN REVIEW i
❑ New construction 0 Addition/alteration/replacement Please check all that apply (submit 2 sets of pleas w /items checked below):
/ ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition Other
l l , l \„ where the available fault current 13 Marinas and boatyards.
CATEGORY OF CONDUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1 - and 2- family dwelling Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other. ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system_ larger separately derived system
JOB SITE INFORMATION AND LOCATION 9
Q/ ( ❑ Addition of new motor load of ❑ "A" E" "1 -2" "I -3"
..� 1 100HP or more. occupancy.
Job no.: Job site address: f �ti4l� / - 1,L C /1II 1 1.6 i1 ❑ Six or more residential units. ❑ Recreational vehicle parks.
/ V
City/State/ZIP: ( j (+ n f' 0 Cl 1 i j 7 ca oil. ❑ Health -care facilities. ❑ Supply voltage for more than
y i 1� ( , 1�' ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: � D ((p t , ) u- QJ ❑ Service or feeder 600 amps or more.
i. FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. I Fee. 1 Total I •
New residential single- or multi - family dwelling unit.
includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.:
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. R.)
A 17 I , .cam 'q to Li f f / / Pd -4 Limited mited energy, multi- family 75.00 2
,�j � IV -4/(i ti residential with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I j`] TENANT 201 amps to 400 amps 106.85 2
Name:. 51 '�� 0 qq 401 amps to 600 amps 160.60 2
C p (' � , '! 601 amps to 1,000 amps 240.60 2
Address: C
J S l f i � 1 ,(,� ' / 11,v12 . k ( l. Over 1,000 amps or volts 454.65 2
City/State/ZIP: I S' O 1 `7 � % 7 ) Temporary services or feeders installation, alteration, and/or q yJ i / relocation
Phone: ( ) 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 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date:
A. Fee for branch circuits with
APPLICANT I CONTACT PERSON above service or feeder fee, 6.65 2
r - each branch circuit
Business name:, �� ; f� �� ,�� , ( �/, f B. Fee for branch circuits
l r A � 1 � � ��� CCCJJJ 1` w wit bran or feeder fee,
Contact name: 10 n 1 46.85 2
JL first branch circuit
Address: u I 1)� \ 5 ' {-1 I r� ; 1 ( /9 Each add'I branch circuit 6.65 2
J 1 v 1 '� y Miscellaneous (service or feeder not included)
City/State/ZIP: V a ` ` j IA t f A (r , t Each manufactured or modular
) / 0 u dwelling, service and/or feeder 90.90 2
Phone: ( (. O U � - 417 7 Fax:: 6(Ul) � t' 9 ) -1.� J only Reconnect onl 66.85 2
E -mail: �(l) `� J tk, Li1 1010 Cd , l 0 IY1 Pump or irrigation circle 53.40 , 2
CO ji9.41 OR Sign or outline lighting 4 53.40 all-a) 2
Business name: 1/ Di C ) L i- ` O �' + Signal circuits) limited -
� energy panel, alteration, or
Address: 1 extension. Describe: Page 2 2
City/State/ZIP: I lrilfil iffI , Each additional inspection over allowable in any of the above
Phone: Per inspection 62.50
hone: ( ) Fax:
( ) investigation per hour (I In min) 62.50
CCB Lic.: LoQj95 / I Electrical Lic.: -We e (SI Su rv. Lic.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: i
= / Plan review (25% of permit fee): -7
Print name: / G��T j2(45T -C. r I-fie:'� /{ 3 /Et /� -7
it /// State surcharge (8% of permit fee): — 1 .0 3.;‘,
Authorized signature: (� 4,1 1 y + TOTAL PERMIT FEE: o (
Print nam C / v T his permit application expires if a permit is not obtained within 180
��-�� r
Date: t ' '/ _ I days after It has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Build ing\Permits \ELC- PermitApp.doc 05/23/06 440- 4615T(11/05 /COM/WEB
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00413
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/18/2007
Phone: (503) 639 -4171 . !aw+egp, j � l rl
Inspection Requests (24 Hrs.): (503) 639 -4175 '!+� _..
INSPECTION WORKSHEET FOR DATE: 6/22/2007 TIME: 7:03AM PAGE: 88
SITE ADDRESS: 09601 SW WASHINGTON SQUARE RD L -1 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: FOREVER 21
DESCRIPTION: (4) sign lighting.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: VANCOUVER SIGN COMPANY, INC PHONE #: 360- 693.4773
Inspection Request Scheduled For: Date: 6/22/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
140 Sign installation 050694 -01 360-693-4773 N
,
Corrections /Comments /Instructions:
\N2\'
v
RPASS U PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' •fai Date: 6-22= 0) Phone #: (503) 718 = 11-4111