Permit `� --
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00624
DEVELOPMENT SERVICES DATE ISSUED: 10/8/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1 S126C0 -01107
SITE ADDRESS: 09651 SW WASHINGTON SQUARE RD
SUBDIVISION: Q1INGTON SQUARE ZONING: C -G
II
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of sign lighting for (1) sign. Job no. 101695/
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:
PPR WASHINGTON SQUARE LLC TUBEART SIGNS
BY THE MACERICH COMPANY 4243 -A SE INTERNATIONAL WAY
9585 SW WASHINGTON SQ. RD. MILWAUKIE, OR 97222
PORTLAND, OR 97223
Phone: Phone: 503 - 653 - 1133
Reg #: LIC 70956
SUP 366S1G
FEES ELE 37- 554CLS
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 10/8/03 $53.40
[TAX] 8% State Tax 10/8/03 $4 Rough -
Elect'l Final
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 lou da . 'TTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
fort ' OAR 952-001-0011 rough OAR 952 - 001 -0100. You may obtain copies of these rules or direct uestions to OUNC at (503) 246-6699 or
1 00- 332 -2344.
ssued By: - % / Permit 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:
CO RACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: " /71 DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
n
Electrical Perinit Application
- Date received: - , Ar, d - . Permit no.:__
City of Tigard,. • Jr.:::. - _ ..., Projecttappl. no.: '-' --',----.-', - '-i ', EipirViite:
... ......
City ofTigard Address: 13125 SW HallEl OR .97223 " -- Date issued: -: - .--- - — • - By:---- -Receipt no.:---
Phone: (503) 639-4171 • .-.. -
„ • ....Ili :' " ...:Uw...t. --
Fax: (503). 598-1960 ' ' -- — Case file no.: — - .----. ----.., Paymenttype:„,;,._ ,.,
Land use approliai: ._.:
., 4-,,,_9,-
TYPE OF PERMIT . .
,- -- i
01 & 2 family dwelling or accesiO ry-' T Coiiiiiiercialrmilustrial i E 0 MUNAMilY 0 Te9/PPTYsTeLnel.,:i5Pt
0 New construction, . , .-1:1 Addition/alteration/replacemenf00ther: "---- 0 Partial ,-..1-.:;
tw % rre.8.-.m4-4 : .,; ---
-
. JOB SITE INFORAIATION '
Job address 4 r
. -d - - : - :, ,:, , - ../51..-,J. Bldg. nci.: -'''-'-= Suiteito::- i Taiintip/tax loitiCeOlinYnTgMt-;f-',
Lot IBlocIc Subdi ' io ., ,--- 2._ka ..,2;;;" ,
. _ . .
Project name: "1 - I Description and location of work on premises: ' 04A7-)91,6 0 j
Estimated date of completionrmspection: 1 0 , 00' - 04 L. r . ' -
CONTRACTOR APPLICATION - — -.., ; ' FEE SCHEDULE
Job no ' ''''''''''''''''''' - rr ,, : ,- ..,7: !..;-:,';-_-::::-.:°!,:.**, .
. ft...0 41113(
- 21:ksaiptioa -
Business name: l'adr4er . . ._ -. . 'Qty. (ea.); '.Total - no:Insp
New residential single or multi-family per - s- -., i.Cr - _ , 4 , cr, ,
Address:'- <A- r.,i - 44 .- tjj0 , -/ . clivelrtnganit.Inebiilestraehedgarage. ?.: . F._ (5 ,
City: ,k Ah4y(49 .., , ..,, -., .. I State -jAe I ZIP : WZZz senicelndride&
Phone: 503 453//gil Fax:‘, sy..._49/91 E-mail: 1000 or less
CCB no.: - )f,f 5 I Elec. bu.1 lie. no: 37,SC/Cic Each additional 500 sq. ft. or piton thereof
Limited energy, residential
• ' 111.(XAc. 0., 2.,A20
/0 i 09 Limited energy, non-residential
- .A... I AIL m-s-)? - Each manufactured home or modular dwelling
Si: ; • f supervising electriat (required), .. - .. Date - - Service and/or feeder
Sup. elect. name (puint): I it 1 eitir License no -
: st i s 14., Services or feeders- installation, --
.
‘; alteration or relocation:
PROPERTY OWNER
. • 200 amps or less , _ ., 2
Name (print): ./ - aril 201 amps to 400 amps
• :A .. /I- ..i -I !J).'. , - _ - - . 2
Mailing address: togi '1-, *- A( Z2 ge.• 401 amps to 600 ainps _
601 amps to 1000 amps , 2,.: - t: ‘-' , --,_ 2
2 ..
,
City: 10-,to - statt:t4.1m: Over 1000 amps or volts • ._ , „ , . . _ , . 2 . .
Phone:‘,39:::cdt,,,d, k Tax: , , - - t - I E-mail: ! ' Reconnect only ., • t 1
Owner installation: The installation is being made on property I own . Telli fir feed - --
, _ , ., : , .1 -
which is not intended for sale, lease, rent, or exchange according to Installation,alterationor relocation: _ - - .
ORS 447 4 479 200 amps or less ' ' ' . . r. .,-:. . , - 2
, 55, , 670, 701.
, 201 amps to 400 amps - • 2
. Owner's signature: Date: 401 to 600- , - , . -. . . , 2
ENGINEER Branch circuits - new, alteration, . , - „ V ,
or extension per panel _
Name: A Fee for branch circuits with purchase of - V -
Address: ,. _ _.: . _ service or feeder fee, each branch circuit 2
City: ,- , . I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit:
Phone: Fax: E-mail:
Each additional brimch circuit
PLAN REVIEW (Please check all that apply) Misc;(Senice or feeder not included): .
O Service over 225 amps-commercial ,,- V 0 Health-carefacility Eadi.pump or irrigation circle 2
0 Service over 320 amps-rating of 18(.2 0 Hazarddus location Eadisign or outline lighting ,., . 40 / - 2
family dwellings , - _. 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ' . .
0 System over 600 volts nominal 'more residential units in one structure alteration, or extension . 2
0 Building ihreaciries - - 0 Feeders, 400 amps or more •Descripfion: , ' '
O Occupant load over 99 persons 0 Manufactured structures or RV park Each asididonal inspection over the allowable in any of the above
0 Egess/lighting plan 0 Other: Perinapection ' I i I ' I , -
Submit sets of plans with iniiif the above. Investigation fee
_ _ The above are not applicable to temporaryconstructi'on service. Other
5 i'l&I
Not all jurisdictions accept =fit cards, please call Jurisdiction for more information. - Notice: This permit application" Permit fee $
0 Visa 0 MasterCard - - expires if a permit is not obtained. Plan review (at ____ %) $
Cre cant number / / within 180 days after it has been 4 A
State surcharge (8%) .... $ , . 7
Expires TOTAL $ ‘57 . 6 ?
accepted as complete.
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440t (6/00/COM)
7 56 e ts
P
El : P e r m i t F ' _ - Limited Energy Fees:
-- lete Fee Schedule Below: TWE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Restricted Energy Fee - .: $75.00
- -- Number of Inspections per permit allowed , (FOR ALL . SYSTEMS) , ,
' Service included: ' -- i - Items Cost - - Total .. f
-- Check Type of Work Involved: . -
Residential - per unit
1000 sq. ft. or less _ _ $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
on thereof T ;F , •$33,40 __ 1
• •• •x -P�. - ,,� .3ar._ ,, . .
� ;,� .,�—� _ , ® .,PBur Atann
,,• � ° „Y.
Limited "4391
-_,',, ”. Y`" -; " : .7: - r$75.00' _ „ ;' *; ,' .' , , ' - a , . "-' .` •'•
Each Maned Home or Modular - • - . � '
Dwelling Service or Feeder - '°• °u- '$90.90'" -- 2 Garage Door Opener' ,
Services or,.Eeeders ,i' ,; tFt:':•
. - _. „ ;,.- _Tv„zz ,. , - - ;: - .:- _. ,_,. Hi V, ntilatio
Ven_ and Air Conditioning System'
- 1nsfalia6 '' njor - 1On q " ,.„, • - �-; t "� eat
..��. g-,. ..e:` r . _f,_ °N- ; , ` ma y .t
'r }lr ='p,� �� ry..±?h- ..`..'^'.if.'sy��'Y3� �:� �• t�:, h -� If. '� r.• ��''�. =_ �j � y . -_ _ � '+•E'r,.
, ,�.. i .i'* os . • --.-1- ?" sd. , _ : fir. , �7°'' a - }. rc ?, -'�,- '�• fi. .^f ; '''J'",!-',1., -.-.,,:,„ E -a _
20Q amps or le ss ' ".. , ' � .$80:30 - .m. 2 µ ' cuum . - -" .
- 201 amps to- 400amps - . - _ -. - : - -. $106.85 - ,,' = 2 _-7-'....,,-, ❑ ,Vacuum Systems
401 amps to 600 amps $160.60 2 . : - - ,
-- -- -- -. .- Other --
` .601 amps to 1000 amps $240,60: -: -- "
- , 2
- - - Oves' 1000 amps or Volts : - -- - $454.65 ' - --. 2 2 ' ; - - ._.— - ,
, - .Reconnect only. $66.85 ' , 2 - -
r" ::_' ': y '^. :y'N :, '_ t ` TYPE i WOR K INVOLVED - COMMERCIAL ONLY • Temporary Services orF , i -TZ_' _;i= ,/_, - -, -., ,• - °4 _ - �' � • , $75.00
Installation, alteration. or relocation Feeler ead(system r - $
` . h. 200 amps or less': : -Tr; - ; 466.85 2 - - - - -- (SEE -OAR 918 -260 -260) - --
. 201 amps to 400 amps 4 - $100.30. - - , • - 72 ' •
401 amps to 600 amps _$133/5 , - : ..2 Check Type of Work Involved:
Over 600 amps to 1000 volts, f _ _ _ _ __ . _ .
' see "b" above- ❑ -- Audio and Stereo Systems
Branch Circuits -. - xte -
New, alteration or ension per panel . ❑ Boiler Controls
a) The fee for branch circuits ,
-- - with purchase of service or - - - ❑ - Clod( Systems • feeder fee.
- Each branch circuit - - - -- $6.65 - - - 2 _ _ ❑ Data Telecommunication Installation
b) The fee for branch circuits -
without purchase of service Fire Alarm Insta ,
or feeder fee..' -
' _ _ First branch circuit $46.85
Each additional branch circuit , $6.65 , . -- ' ` ' ❑ - HVAC •
-Miscellaneous , - - - El ; Instrumentation
- (Service or feeder not included) - - _ , - -
. Each pump or irrigation circle i $53.40 ,- /O� ❑
Each sign or outline lighting $53.40 _ Intercom and Paging Systems
Signal drouit(s) or a limited energy
panel, alteration or extension $75,00. ❑ Landscape Irrigation Control*
Minor Labels (10) -- $125.00
Each additional inspection over - - El Medical
the allowable in any of the above = `
Per inspection $62.50 - - - ❑ - NurseCalls
Per hour $62.50 - ,
In Plant - $73.75 ❑ Outdoor Landscape Lighting'
Fees: ( - ❑ -- Protective Signaling
- Enter total of above fees - - - - $ r " ❑ • Other . . •
8% State Surcharge - $ 7 • Number of Systems
25% Plan Review Fee
See 'Plan Revievf section on $ * No licenses are required. Licenses are required for all other installations
front application.
of plication.
_ ._ T _. _ ._ __- _ - :. Fees:
Total Balance Due $ 67-‘
- -- _ Enter total of above fees - $
-- - Trust Account # - ' ' - 8% State Surcharge ' - $
. . Total Balance Due $
i:Wsts\forms Yelc- fees,doc 10/09/00
CITY OF TIGARD 24 -Hour •
BUILDING Inspection Line:4503) 639 -4175
INSPECTION DIVISION ' Business Line: (503) 639 -4171 MST
�t BUP
Received Date Requested l 1-1 7 AM PM BUP
Location 94.5 In/s/.11.1 Suite l d MEC
Contact Person / Ph ( ) Co < — 1/ PLM
Contractor Ph( '- 3 ) '1 V - 3 - 1"3 ) SWR
BUILDING Tenant/Owner P 0 V t �� ELC
Footing , ( OP S — 004
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling '
Roof
__ - - _Other: -
Final
PASS PART FAIL )d
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service _
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
P • PART FAIL
Npp
'os
Rough-
.
Gas Line
_r_
�;- Day •ers .
a „�„:__ PART FAIL
Service
Rough -In
UG /Slab
Low Voltage
larm . -
ASS PART FAIL El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE El Please call for reinspec 'on RE: ❑ Unable to inspect — no access
Fire Supply Line /
ADA `/ �L�J d, Inspecto U ../ // , 4 Ext
Approach/Sidewalk D p
Other:
Final DO NOT REMOVE this inspection recor . from th Job site. •
PASS PART FAIL