Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00560
DEVELOPMENT SERVICES DATE ISSUED: 10/4/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09751 SW WASHINGTON SQUARE RD D1 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: Advanced Nutrition. (1) sign inside mall.
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 LUMINITE SIGNS OF OREGON
BY THE MACERICH COMPANY 9126 SW RIDDER RD
9585 SW WASHINGTON SQUARE RD WILSONVILLE, OR 97070
TIGARD, OR 97223
Phone: 503 - 639 -8865 Contact #: PRI 503 - 570 - 6137
FAX 503 - 570 -6138
FEES
Description Date Amount Reg #: LIC 156703
[ELPRMT] ELC Permit 10/4/2006 $53.40 SUP 159SIG
[TAX] 8% State Surcharge 10/4/2006 $4.27
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 rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: '2) Permittee Signature: s
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.
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Electrical Permit Ai lie .tioiV FOR O111( F I'Sl; 0\I.1
due
City of Tigard 06 ;i4 a(p �,nitNo. ,1La(1 Gp_c
13125 SW Hall Blvd.. Tigard, OR 97223 T 0 sD 200
Phone: 503.639.4171 Fax: 503.598.1960 i .., ,r..; Date/By: Other Permit:
Inspection Line: 503.639.4175 CITY OF TIGARD . . � i
Date Ready/By: kris' ' 65 See Page 2 for
Internet: www.ci.tigard_or.us BUILDING DIVISIOf` "' "' - Notified/method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
El Demolition ®Other Sign ❑Service over 225 amps, comrn'l ['Hazardous location
❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. R,
CATEGORY OF CONSTRUCTION of 1 - and 2- family dwellin 4 or more new residential
❑ I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
El Multi-family ❑Master builder El Other: Sign ❑Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park J �j
Job no.: I Job site address:-95g Washington Square Rd. ❑Health -care facility g�ei S 1
Submit 2 sets of plans with any of above.
City/State/ZIP: Tigard, Oregon 97223 95-P7 / The above are not applicable to temporary construction service.
Suite/bldgJapL no.: Project name: Advanced Nutrition FEE* SCHEDULE
Description I Qty. I Fee. Total 1 ••
Cross street/directions to job site: Inside Mall across from Newport Bay 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
New Electrical Sign inside Washington Square Mall dwelling, service and/or feeder 90.90 2
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
401 amps to 600 amps 160.60 2
Name: Jim Foster 601 amps to 1,000 amps 240.60 2
Address: 1116 Lancaster Dr. N.E. Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Salem, OR 97301 Temporary services or feeders installation, alteration, and/or
Phone: (503)364 -9392 I Fax: (503)364 -9511 relocation •
200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 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: Luminite Signs • branch circuit ,
B. Fee for branch circuits
Contact name: Cheryl Morrill without service or feeder fee,
first branch circuit 46.85 2
Address: 9126 SW Ridder Rd. -
Each add•1 branch circuit I 6.65 2
City /State/ZIP: Wilsonville, OR 97070 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (503) 570 -6137 Fax: : (503) 570 Sign or outline lighting / 53.40 ;r,;, SIC 2
E -mail: cheryl@luminitesigns.com Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: Luminite Signs
Address: 9126 SW Ridder Rd Each additional inspection over allowable in any of the above
Per inspection 62.50
City / State/ZIP: Wilsonville, OR 97070 Investigation per hour (1 hr min) 62.50
Phone: (503) 5704137 l Fax: (503) 570-6138 Industrial plant per how 73.75
ELECTRICAL PERMIT FEES"
CCB Lic.: 156703 I Electrical Lic.: 3 530 CLS Suprv. Lic.: tO" dl li Subtotal S3, v )
Suprv. Electrician signature, required: /+ �� / 3Ci Plan review (2.5% of permit fee)
1
Print name: ....lei, 4L Date' • j State surch (8% of pe fee) i' �with� 7 180
Date: T PERMIT FEE 517 i n 7
Authorized signature: This permit a pplicatio n e xpires if a permit is not obtained i
days after it has been accepted as complete
Print name: e QZ t N � I Date. • Fee methodology set by Tri- County Budding Industry Service Board
1�"�
•• Number of inspections per permit allowed.
r. UBwldingtPermiIi \ELC- PernutApp.doc 12/03 440- 4615r0lYO2 JOMIWEb
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200& -00560
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 101.1/2006
Phone: (503) 639 -4171 + �
Inspection Requests (24 Hrs.): (503) 639 -4175 IL.
INSPECTION WORKSHEET FOR DATE: 10/20/2006 TIME: 7 :01AM PAGE: 70 '
SITE ADDRESS: 03751 SW WASHINGTON SQUARE RD D'1 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: ADVANCED NUTRITION
DESCRIPTION: Advanced Nutrition. (1) sign inside mall.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503-639-8865 '
CONTRACTOR: LUMINITE SIGNS OF OREGON PHONE #: 503 - 570 -6137
a
Inspection Request Scheduled For: Date: •10/2012006 Pour Time: •
Code # Inspection Description Confirm # Contact # Message
140 Sign installation 038548 -01 503- 572 -0577 N
Corrections /Comments /Instructions:
'N' : ‘ , ' ,,
)4PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V S LE Date: 11 0 0 Phone #: (503) 718- I'I
1
CITY OF TIGARD
1 BUILDING DIVISION PERMIT #: ELC200C}00560
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/412006
Phone: (503) 639 -4171 �. , •'iLF
Inspection Requests (24 Hrs.): (503) 639 -4175 .n'.!�- f'`: -..
INSPECTION WORKSHEET FOR DATE: 10/18/2006 TIME: 7:06AM PAGE: 95 ' ll
SITE ADDRESS: 09751 SW WASHINGTON SQUARE RD D1 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: ,TYPE OF USE: '
PROJECT NAME: ADVANCED NUTRITION '
DESCRIPTION: Advanced Nutrition. (1) sign inside mall.
OWNER: WASHINGTON SQUARE LLC, S1� AwN NI cvkaL5 PHONE #: 503-639-8865
CONTRACTOR: LUMINITE SIGNS OF OREGON PHONE #: 503 - 570 - 6137
Inspection Request Scheduled For: Date: 10/18/2006 Pour Time:
Code # Inspection Description onfirm - #' Contact # Message
140 Sign installation ,038355 -0 503 -572 -0577 V
Corrections /Comments /Instructions:
0 YY\®at - Ts ma C La c44 b ®im N Its (5-•kci %) S_D .
1...avct... acs 'pct /a v% DIE C.k cal. tk Sr to
Gl X1 1 -i N {) - 6F etiva.. 1,- v ..
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
X FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N t, d (_1 Date: 4CI I 30 Phone #: (503) 718- 14