Permit v CITY OF TIGARD ELECTRICAL PERMIT
111111 _ : COMMUNITY DEVELOPMENT Permit #: ELC2012 -00727
T [(5 AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/20/2012
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9759 SW WASHINGTON SQUARE RD D05
Project: The Art of Shaving Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: (2) sign or outline lighting
Contractor: E S & A SIGN & AWNING Owner: PPR WASHINGTON SQUARE LLC
89975 PRAIRIE RD PO BOX 847
EUGENE, OR 97402 CARLSBAD, CA 92018
PHONE: 541 -485 -5546 PHONE:
FAX: 541 -485 -5813
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 12/20/2012 $135 68
Specifics:
2 ea 12% State Surcharge - 12/20/2012 $16 28
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $151 96
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law 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 the 180
days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952 -001 -0010 through OAR / 952 - 001 - 0 You � may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 or 1 800.332 2344. �
Issued By: U(�t /LC-1.1 w L n .0 f Permittee Signature: 0k t 1'"C PP(1 e 4700
0 0
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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
From:ESA SIGN & AWNING 541 485 5813 12/20/2012 08:43 #848 P.001/002
Electrical Permit Application RECEIVE i! tr12 0I F. 1 SI O \I.1
City of Tigard / _ .. I a. --z,- Permit No. x0 / -- 00 -)�7
13125 SW HaII Blvd., Tigard, OR 97223 t C 2 0 2012 Plan Review
: f1 _ II Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
1 1 C; A R D Inspection Line: 503.639.4175 n � s Da Ready/By: tuns ® See Page 2 for
Internet: www.tigard- or.gov CITY OF TIG 1 Notified/Method: -ri Supplemental Information
TYPE OF W(J II'DING DIVISION PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all Out apply (submit j sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ] Other: b►.LS where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ I- and 2- family dwelling & Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
El A Addition ition of new motor load of ❑ "A ", "E ", "1 -2 ", "1.3 ^,
Job no.: Job site address:
100HP or more. occupancy.
Sl �� 8 ,Q � 5w w 145th NboG.I Q • ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/ State/ZIP: 'ri 6 , � IW , (Wk hiu61bAl ❑ Health -cue facilities. ❑ Supply voltage for more than
("A a_ L— �' 0 Hazardous locations. 600 volts nominal.
Su ite/bldg. /apt no.: _0s". Project name :T , — OF S i‘Onnt4 Es ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Dsscriptton 1 017. I pee. I Total I •
New residential single - or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
75.00 2 • DESCRIPTION OF WORK - (with above sq. ft.)
Limited energy, multi - family 75.00 2
INS Tku- (Y) 7100 / 1 -I-iJ M . w 4 '14 , 5l lvnL S l.IS I OC residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
Q -
$4,(104.-- 200 amps or less 100.70 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State /ZIP:
Temporary t s or feeders installation, alteration, and/or
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
//��� ' Branch circuits — new, alteration , or extension, per panel
Owner signature: ( Date: A. Fee for branch circuits with
APPLICANT I pg. CONTACT PERSON above service or feeder fee, 7 42 2
each branch circuit
Business name: e.-.54 k Sit/A.1 7 kLUAlII.ICr B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: 1tleA he,r_ pou,u 1 branch circuit
f i
Each add branch circuit 7.42 2
Address: 7n 41 ' pp,. l Or, Miscellaneous (service or feeder not included)
�"J Each manufactured or modular
City / State/ZIP:
f7 Q—
���L t q 0� dwelli s ervice and/or feeder 67.84 2
Phone: (9, f ) gig 23& , I Fax: : ('34) LiK. 6f11 3 Reconnect only 67.84 2
t7 Pump or irrigation circle 67.84 2
E -mail:
i'P�'LA1PX p�PUJ(@ e .Ca,st 4 YI . dew, Sign or outline lighting '2.- 67.84 twee 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: eS AA. 51 bull M.t D ki / AJ&S panel, alteration, or extension. io Page 2 2
Each additional inspection over_allowable in any of the above
Address: 4 ef c pun mit a en Additional inspection (1 hr min) 66.25/ hr
b n q7'i -
Investigation plant 1 hr
hr min) 78.18/hr
min) 66.25/ hr
City /State/ZIP:
�lO ( Q�- Industrial plain (1
Phone: (sj,41) Rog, 2,3i-3 I Fax: (/4I ) , 5,5t3 r
C 1 t i, Inspections for which no fee is
`f specifically listed ('A hr min) 90.00/ hr
CCB Lic.: if„, 34-10 I Electrical Lic.::. ,0 - 5 1 1961_4 Suprv. Lic.: 5 14s 1 a ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: / ? �I o Subtotal: I ! . s
Plan review (25% of permit fee):
Print name: ' 1 , goz- p Z( Date: 4 +9 I 4 /20-2_ State surcharge (12% of permit fee): 1 0 . 243
Authorized signature: L yi TOTAL PERMIT FEE: i e51 -9 4,
Thi permit application expires if a permit is not obtained witbin 180
Print name: (3411 Fl 41 e, W eA I Date: 12 1 Z days after it has been accepted as complete
('` ' Number of inspections allowed per permit.
IABuildinglitrmitstELC- PenniiApp.doc 07/01/10 440- 4615T(11/05/COM/WEB