Permit C ITY OF TIGARD ELECTRICAL PERMIT
; PERMIT #: ELC2006 -10039
DEVELOPMENT 1
r SERVICES � 503-639-4171
DATE ISSUED: 3/13/2006
13125 PARCEL: 1S12600-00300
SITE ADDRESS: 09625 SW WASHINGTON SQUARE RD FC -1 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: (1) 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 SECURITY SIGNS INC
BY THE MACERICH COMPANY 2424 SE HOLGATE BLVD
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97214
TIGARD, OR 97223
Phone: Contact #: PRI 503 - 232 -4172
FAX 503- 230 -1861
FEES
Description Date Amount Reg #: ELE 26 560CLS
[TAX] 8% State Surcharge 4/3/2006 $4.27 LIC 122809
[ELPRMT] ELC Permit 4/3/2006 $53.40
Total $57.67 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 se - • - ' OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503-246-;.99 or 1 -80' -. -
Issued :y: Permittee Signatur •
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 Application l�-oli oI:I IcI� Iisl ()NIA.
�
City of Tigard Date/B . „ MO / Permit No . g(.Q v w,/�
� iG. /3
Received
13125 SW Hall Blvd., Tigard, OR 97223 i' f d Plan Review
i
Phone: 503.639.4171 Fax: 503.598.1960 b:. f D Other Permit
Inspection Line: 503.639.4175 J_ _,; =' IL ' , Date Ready/By: re. ® See Page 2•for
Internet: www.ci.tigard.or.us Notified/Method. Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ❑Service over 225 amps, come! ❑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 ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑ Master builder ❑ Other: ❑Building over three stories 0 Feeders, 400 amps or more
❑Occupant load over 99 persons ❑ Mann factured structures or
JOB SITE INFORMATION AND LOCATION 0 Egress/lighting plan RV park
Job no.: Job site address: I� O` 5 ❑Health -care facility ❑der:
ale - rink( Sat IR1Za -- gv Submit 2 sets of plans with any of the above.
City /State/ZIP: The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: I Project name: Wre � ` FEE* SCHEDULE • —
Deatription I Qty. I 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'l 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
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and/or feeder 90.90 2
.((7, W WA--r .L ' t (_SL( 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
1 1 401 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
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 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: first branch circuit
Each add'I 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 I 53.40 53 511 2
E -mail: Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: ..4 wg, S LC'u S
Address: Z-�-� Z 51� 1Zw � c .vn Each additional inspection over allowable in any of the abov
Per inspection 62.50
City /State/ZIP: e� L M LoeL Investigation per hour (I hr min) 62.50
� .3 i2.--3 Z t U7 I ()3C) i $ 6 , r Industrial p lant per hour 73.75
Phone: Fa x: ELECTRICAL PERMIT FEES*
CCB Lic.: (2"Z i Electrical Lic.Z_ .. 0 . h ... uprv. Lic.: :3 Sic", Subtotal .53 Ile
So b Suprv. Electric mitr equired: I. ' Plan review (25% of permit fee)
ao Print name: ( Date: State surcharge (8% of permit fee) y. �.�
/4(L t k(Gt 11 ST 3 ' (3 • TOTAL PERMIT FEE S7 • ( 7
Authorized signature: ��, lt1 This
permit application expires if a permit is not obtained within 1 0
days after it has been accepted as complete
Print name �� c BIZ Date -- . -3 Fee methodology set by Tn- County Building Industry Service Board
J
' Number of inspectiona per permit allowed.
i \ Building\Penmts\E1.C- PermitApp doc 12/03 440- 4615T(10/02/COM/WEB
Electrical Permit Application - City of Tigard
Page 2;= Supplemental Information
LIMITED ENERGY PERMIT FEES:
I RESIDENTIAL WORK ONLY:
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:
r COMMERCIAL WORK ONLY:
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 'N
i \Building\Peunus\ELC- PetmitApp doc 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ( ZOO ( -406 3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 1 /
Inspection Requests (24 Hrs.): (503) 639- 4175�il�..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: ! "7_5 W / S 6 ' CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
•
Inspection Request Scheduled For: Date: 3 - / 5 U Pour Time:
Code # Inspection Description Confirm # Contact # Message
/ q q • Cc (N..
Corrections /Comments /Instructs• s:
•
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES.ASSESSED
Inspector: 6-41/4 O l ()E Date: 3115 Phone #: (503) 718- 2.M '+(, ,