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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: AuWYI'� DEVELOPMENT SERVICES DATE ISSUED: 9/4 02002 -00442 ., II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S126C0-01107 SITE ADDRESS: 09755 SW WASHINGTON SQUARE RD D -3 SUBDIVISION: WASHINGTON SQUARE ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: Electrical service for (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: PPR WASHINGTON SQUARE LLC MULTI -LIGHT SIGN CO. P.O.BOX 21545 809 N E LOMBARD SEATTLE, WA 98111 PORTLAND, OR 97211 Phone: Phone: 281 -3083 Reg #: LIC 64107 SUP 343SIG ELE 26 -90CLS FEES Required Inspections Type By Date Amount Receipt Rough -in PRMT CTR 9/4/02 $53.40 2720020000( Elect'I Final 5PCT CTR 9/4/02 $4.27 2720020000( 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 than 180 days. ATTENTI• ►: Oregon law requires you to folio utes acted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 throu• • OAR 952 - 001 -00 . ou may obtain copies of these rules or dired questions to Permit Signature: L• Issued By: , _ • ouL, 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 639 -4175 by 7:00pm for an inspection the next business day Electrical Permit Application -/ D ate received: 9 ©0p) Permit no.: E . ,, -, _pip Y/_, ``i -) , City of Tigard Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.: Phone: (503) 639 -4171 Case file no.: Payment type: Fax: (503) 598 -1960 Land use approval: TYPE OF PERMIT G ommercial/industrial ❑ Multi- family 6 enant improvement ❑ 1 & 2 family dwelling or accessory 0 Partial New construction ❑ Addition/alteration/replacement ❑ Other: JOB SITE INFORMATION Job address: 97 6,j 64/ Lor AA vos .5 b , /29 Bldg. no.: Suite no.: D 3 Tax map /tax lot/account no.: r lot; Block: ' Subdivision: Project name: I' Rio. I I, c ( Description and location of work on premises: %pp i4 -t Q .1,QCT ' is Estimated date of completion/inspection: CI-13^ 0 2 CONTRACTOR APPLICATION -' - '' "`\. FEE SCHEDULE Fee Max Job no: Descri ption Qty. (ea.) Total no. insp Business name: 1Y\lJll. - ri k %Slnr �' New residential - single or multi- family per Address: grQC v e . 1., t+tn Avg dwelling unit. Includes attached garage. � 9 72) Service included: City: 1 .) 00 - 11 4 4 4/ t, > Stan:: Q Q ,(t I ZIP: ( 4 ] 000 sq. ft. or less Phone: 1 -30A F ax: I E-mail: Zg 3 R Each additional 500 sq. ft. or portion thereof 2 CCB no.: j I Elec. bus. lic. no: ?-6 -co t° (,, Limited energy, residential Ea energy, non-residential 2 City /metro lic. no.: ti 9_ y Each manufactured home or modular dwelling 2 Service and/or feeder Signature o e ing electrician ( required) Date Services or feeders — installation, Sup. elect. name (print): "re Q 2, 0 t,v _ License no -I $ I alteration or relocation: PROPERTY OWNER 200 amps or less 2 201 amps to 400 amps 2 Name (print): 401 amps to 600 amps 2 6 01 amps to 1000 amps 2 Mailing address: 2 City: I State: I ZIP: Over 1000 amps or volts 2 Phone: I Fax: I E -mail: Reconnect only Temporary services or feeders - Owner installation: The installation is being made on property I own installation, alteration, or relocation: which is not intended for sale, lease, rent, or exchange according to 200 amps or less 2 ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2 Owner's s Date: 401 to 600 amps 2 Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of 2 service or feeder fee, each branch circuit Address: I Slate: I ZIP: B. Fee for branch circuits without purchase 2 City: of service or feeder fee, first branch circuit: Phone: Fax: E -mail: Each additional branch circuit PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): 2 ❑ Health-care Each pump or irrigation circle ' 2 ❑ Service over 225 amps - commercial ty Each sign or outline lighting ❑ Service over 320 amps -rating of 1&2 ❑ Hazardous location Signal h s sign n a i ghti n energy panel, family dwellings ❑ Building over 10,000 square feet four or 2 ❑ System over 600 volts nominal more residential units in one structure alteration, or extension* ❑ Building over three stories ❑ Feeders, 400 amps or more *Description. ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: I ❑ Egress/lightingplan ❑ Other Per inspection Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Permit fee $ Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Plan review (at %) $ ❑ Visa ❑ MasterCard expires if a permit is not obtained State surcharge (8 %) .... $ Credit card number: / within 180 days after it has been TOTAL $ Expires accepted as complete. —�— Name of cardholder as shown on credit card $ 440-4615 (6/00 /COM) Cardholder signature Amount CITY OF TIGARD , 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested 5 / f AM PM BUP Location D P 7 S> S ceiQ > X s /4/ Suite U- 3 MEC Contact Person Ph ( ) I) 3d g3 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Z -Ud (/ 7 Z Footing Foundation ELC 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 A( � 1 q, _n Fire Sprinkler L ^ 1 1 Fire Alarm Susp'd Ceiling j Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final P. • ; RT FAIL Service Rough -In UG/Slab Low Voltage Fire Alarm in ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. S PART FAIL SI Please call for einspection RE: Unable to inspect - no access Fire Supply Line 7 /6 ADA Approach/Sidewalk Date Inspector Other: Final DO NOT REMOVE this inspection record from the PASS PART FAIL