Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00586
' � DEVELOPMENT SERVICES DATE ISSUED: 9/17/2004
! II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09800 SW WASHINGTON SQUARE RD
SUBDIVISION: flAfgliNGTON SQUARE ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Lighting for (9) signs.
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: 9
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 MEYER SIGN CO OF OREGON
BY THE MACERICH COMPANY 15205 SW 74TH AVE
9585 SW WASHINGTON SQ. RD. TIGARD, OR 97223
PORTLAND, OR 97223
Phone: Phone: 620 - 8200
Reg #: LIC 64014
SUP 566S1G
FEES ELE 20- 190CLS
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 9/17/2004 $480.60
[TAX] 8% State Surcharge 9/17/2004 $38.45 Rough -in
Elect'l Final
Total $519.05
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are se : • ! • R 952 - 001 -0010 through OAR 952 - 001 -0100 You may obtain copies of these rules or direct questions to OUNC at (503)
246 -669t or 1 .800 -332- ' 44.
Issue' By: ■ ■ ti ! .1 • Permit Signature: _ Ar
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: • DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
• 'r'OR OFFICE USE ONLY
Electrical Permit Application Received Electrical ff'
Date/B t?y Permit No.: `L. 00 - • -
City of Tigard Planning Approval Sign
Date/B Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/B : Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use
�+ rd rv; i' +�
Contact : Case No.:
Internet: www.ci.tigard.or.us ■ F • ' I Contact ® See Page 2 for
`^ ""
.24 -hour Inspection Request: 503 -639 -4175 -- Name/Method: Su. lemental Information.
5a A) J c c — 00P. 37
=f,:-,.;:$.-. :_. 1L t __ _ . , :i ";,'.,f S'= ,L'c,'' '- _- , ase.check•a'll aPPlY)' _ ., ;V
- , _ •:- .` -.: .- =TYPE OF.:VNORK�. : .' ;: , : - . # ,.".. T _ . � ..:� PIJdN�REVIE W:(Ple
❑ New construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility
commercial ❑ Hazardous location
❑ Addition/alteration/replacement ® Other: (6,4./.5 ❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet,
' ` ' •_ ; . '''"CATEGORY OF ; CONSTRY)CTI'ON ; '': 'ic-wi) =. _ 1 & 2 family dwellings four or more residential units in
0 1 & 2- Family dwelling IJ Commercial/Industrial ❑ System over 600 volts nominal one structure -
❑ Building over three stories ❑ Feeders, 400 amps or more
❑ Accessory Building III _ Multi- Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
-' ' ; • •'JO B:SITE INFORMATION aid LOCATION'`- = G >• :' :T . ; - Submit _ sets of plans with any of the above.
'i: - The above are not applicable to temporary construction service.
Job site address: Q ROO 5W Afil5W-1 4 a-to 0 S, f Pia , - •.. - % : q FEE".:SCHEDULE ` _ . ,., -: . - ,` „;4 = ;°;
Suite #: I Bldg. /Apt. #: Number of inspections per permit allowed
Project Name: 3&Z_' j . e.a24(5 #(4-e-t1-+t5 Description Qty Fee (ea.) Total
New residential - single or multi- family per j
Cross street/Directions to job site: dwelling unit. Includes attached garage.
vJ y4 , , l2 , Service included:
1000 sq. ft. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 1
Limited energy, residential 75.00 2
Subdivision: I Lot #: Limited energy, non residential 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
•i 9.� . ,: � ')ESCRIPTION OF'WORK . - i'' ''. service and/or feeder 90.90 2
�
_ ”" /w Services or feeders - Installation,
� � lit q I �7 C{t71U alteration or relocation: 80.30 2
' "- � 7 0 200 amps or less
i/14 -(< C�� (, J l{ 0s 201 amps to 400 amps 106.85 2
U 401 amps to 600 amps 160.60 2
t.0-PROPERTY OWNER' - • .. ,.1 aTENANT' ' •. 601 amps to 1000 amps 240 2 ,
Over 1000 amps or volts •
Name: 5 ■ __ IP a • Reconnect only 66.85 2
Address: ',BM ,,a/ nla% 1i vll , 1 • Temporary services or feeders - installation,
alteration, or relocation:
City /State /Zip: C5-ib2- , 9 7 Z 7 "' 200 amps or less 66.85 1
Phone: (5—:: P ax: 201 amps to 400 amps 100.30 2
401 to 600 amps 133.75 2
:APPLC: i: - '' (..CONTACT PERSON: - . Branch circuits - new, alteration, or
Name: 1y r itt u RQ /Pt( extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 6.65 2
City /State /Zip: B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 46.85 2
Phone: I Fax: Each additional branch circuit 6.65 2
E -mail: Misc.(Service or feeder not included):
Each pump or irrigation circle 53.40 / 2
:; . - . CONTRACTOR Each sign or outline lighting 53.40 63,40 2
Job No: Signal circuit(s) or a limited energy panel,
alteration, or extension Page 2 2
Business Name: �,((� y(�(z 6‘4,,,) a. c 1)12 J / Description
Address: r*SzvC ,sip 7`/ I /4ik.e_ ' -
Eac dditional inspection over the allowable in any of the above:
City /State /Zip: y-[ 6-19-12.- o�Z , q 7 7 7 L / P inspecti n per hour (min. I hour) 62.50 k Phone: 6 70 — A 2Dce, Fax: 6 ? - o —702 V vestigation fee:
CCB Lic. #: (� CO / I L • #: .z0 -190 C L5 Other. ? Electrical Permit Fees* • '
Supervising electrician /1 Subtotal $ 1 20 . /c) signature required: / _ Plan Review (25% of Permit Fee) $
Print Name: P /4-{ L :1, `. I lc. : 61 c 56 , State Surcharge (8% of Permit Fee) $ "A-- TOTAL PERMIT FEE $ • D
Authorized k / / Notice: This permit application expires if a permit is not obtained within
Signature: � ` \ D T � S i ate: gil 180 days after It has been accepted as complete.
d— *Fee methodology set by Tri- County Building Industry Service Board.
5�hV� /Ut4i
(Please print na e) _ _ („ Q 7 95 — 34Fg2
i:\Dsts\Perm m
it Fors\ElcPermitApp.doc 01/03 �-�". �
Electrical Permit Application - City of Tigard
.Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all systems . $75.00
Check Type of Work Involved: ,
❑ Audio and Stereo Systems* -
0 Burglar Alarm • . - .
• Gar Door Opener
O Heating, Ventilation and Air Conditioning System * -
- _
•
O Vacuum Systems '
-' Other - - '
COMMERCIAL WORK ONLY:.
Fee for each system $75.00
(SEE OAR 918 -260 -260) .
Check Type of Work Involved: - - " , V - • -
n
0 Audio and Stereo Systems '
0 Boiler Controls '
0 Clock Systems -
0 Data Telecommunication Installation .
0 Fire Alarm Installation .
n HVAC
0 Instrumentation
Ell Intercom and Paging Systems •
O Landscape Irrigation Control
0 Medical
LI Nurse Calls
11 Outdoor Landscape Lighting
0 Protective Signaling
n Other
Number of Systems
* No licenses are required. Licenses are required for all
other installations
•
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