Permit a CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -10068
DEVELOPMENT SERVICES DATE ISSUED: 3/23/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09681 SW WASHINGTON SQUARE RD C6 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 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
FEES
Description Date Amount Reg #: ELE 37 - 46CLS
[ELPRMT] ELC Permit 4/5/2006 $53.40 LIC 63951
[TAX] 8% State Surcharge 4/5/2006 $4.27 SUP 525SIG
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 set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100 You may obtain copies of these r -s or direct questions to OUNC at
503 - 246-66 or 1 -8 3 344 �
Issued B • (�_ Permittee Signatur:. ik1I/reffP
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.
E1ectrtcl1 Permit Application FOR OFFICE USE ONE)"
Cl of Tigard Received ��
City g DateBy: .�1S Q , Permit Permit No.: 4• l Q
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review V
Phone: 503.639.4171 Fax: 503.598.1960 ^ !/�ty my ll Date/By:
Other Permit:
Inspection Line: 503.639.4175 —a+i ^•__� i u Date Ready/By: l l� See Page 2 for • Internet: www.ci.tigard.or.us Notified/Method. / l ( Supple Info
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
Demolition �1 I/ ❑Service over 225 amps, comm'I ['Hazardous location
'�"
['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ❑ Conunercial/industrial ❑ Accessory building ❑S over 600 volts nominal units in one structure
['Building over three stories OFeeders, 400 amps or more
Multi- family El Master builder ig Other: S► f'■•
['Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ['Egress/lighting plan RV park
❑Health - care facility ['Other:
Job no.: 1 97eg r .w w kskil , 5iguak. -kG 06 Submit 2 sets of plans with any of the above.
City/State /ZIP: .O- ti MAfrF) I.. 411J-13 The above are not applicable to temporary construction service.
no.: FEE* SCHEDULE
Suite/bldg./apt.
G• Q(, I Pro ject name: he 4( I
V Desc ipdon I Qty. I Fee. J Total I **
Cross street/directions to job site: W As Iv, ry k s Qv p (e.. 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
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, OF WORK ergy, non - residential 75.00 2
Each manufactured or modular
I dwelling, service and/or feeder 90.90 2
N S k A\l Al 1„ . o4 I1I0-IISA t-G 0 S t rj N • Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ti TENANT 201 amps to 400 amps 106.85 2
Name: MQ Yp A k 401 amps to 600 amps 160.60 2
1 601 amps to 1,000 amps 240.60 2
Address: G% co h/AS 1n� 1 , _ S((��(t 11 Vi u c Over 1,000 amps or volts 454.65 2
(� Reconnect only 66.85 2
City/State /ZIP: - i I ti Ai # ( 0 t e `7 ))3 Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( )
200 amps or less 66.85 l
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
A APPLICANT I Fi CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: VA
NC pt/ gad S CO N G0. 1 WC., branch circuit
B. Fee for branch circuits
Contact name:
l �"\ {e 2 ( without service or feeder fee,
Ne 1 l 1 +�`-y a1 each branch circuit
Address: G G (5 46.85 2
F ach add'l branch circuit 6.65 2
City/State /ZIP: V f\ NC OLv it( 1,--AT d t` Miscellaneous (service or feeder not included)
1 l /� Pump or irrigation circle 53.40 2
Phone:
( 3C0) ti3 47 73 Fax:: ( 360) (, °t 1 (l 7 Sign or outline lighting i 53.40 5 j 2
E- mail: -r 46 E L f cre, V A n. St NC o . Coil Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: Vf-1 CUL,/ e( � (.5nl Cu- NC.
'
Address: �� i 5 NQ ' f y /� Each additional inspection over allowable in any of the above
-1 Per inspection 62.50
City/State /ZIP: V C , ( A C %64L Investigation per hour (1 hr min) 62.50
73.75
Phone: (3(,0) 6 oi 1 -4 773 Fax: (3C 0) C A —.2 7(.17 I plant per hour ELECTRICAL PERMIT FEES*
CCB Lic.: ( /S(lElectrical Lic.: 17-4 Su rv. Lic.:
63"1S 1 `D p 513 - Su Subtotal 5-5. yp
Suprv. Electrician signature, required: 11 ( y Plan review (25% of permit fee)
Print name: V C IA,, , ,Sf WO nil Date:1. State surcharge (8% of permit fee) y,
�� _ G O TOTAL PERMIT FEE 57, 1
Authorized signature: V ` R ' ` I ' This permit application expires if a permit is not obtained within 8
"----. days after it has been accepted as complete
Print name: kM P ctr ` t r Q r ' Date: 3/2 ! * Fee methodology set by Tri-County Building Industry Service Board
r (/ o 0 b ** Number of inspections per permit allowed
i \ Braiding\Permits\ELC- PeamitApp.doc 12/03 440 -4615T(10 /02/COM/WEB
CITY OF TIGARDC
BUILDING DIVISION PERMIT # ( , - /pp 68
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171M#
Inspection Requests (24 Hrs.): (503) 639 -4175 '`'I
•
•
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
ITE : II RES . W p 4 CLASS OF WORK:
SUB' ON: W'� LOf #: TYPE OF USE:
PROJECT NAME: 9tal
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: Qp keg e 4 i l PHONE #:
Inspection Request Scheduled For Date: 3 a T - 8 �o Pour ,i 4 V Y
� F ,�
Code # Inspection Description Confirm # Contact # Messa• - u;�•�`�
/ L( / e7o 6`l3- `t -173
�e
Corre ions /Comments /Instructions:
C
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CrAzt itsg Date: 31 ot Phone #: (503) 718 - 2.441.•
CITY OF TIGARD 2r�b
BUILDING DIVISION PERMIT #:t
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1 1 `' ° v °
Phone:.(503) 639 -4171 !om,QAe�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 9 (a, Lo.P.6 µ i i q i Nbv 644, , CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: N 3 ® L Pour Time:
v
Code Inspection Description Confirm # Contact # Message
' l F d
Correc ions nts /Instructions:
PASS ❑ PARTIAL APPROVAL , ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ,ADDITIONAL FEES ASSESSED
Inspector: N4 6 K Date: 13 I (* Phone #: (503) 718 - 1 ' LVO