Permit CITY OF TIGARD ELECTRICAL PERMIT
' s• COMMUNITY DEVELOPMENT Permit #: ELC2012 -00732
T WARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/24/2012
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9534 SW WASHINGTON SQUARE RD H12
Project: Bare Minerals Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: (2) sign or outline lighting
Contractor: SECURITY SIGNS INC Owner: PPR WASHINGTON SQUARE LLC
2424 SE HOLGATE BLVD PO BOX 847
PORTLAND, OR 97202 CARLSBAD, CA 92018
PHONE: 503 - 546 -7114 PHONE:
FAX: 503 - 230 -1861
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 12/24/2012 $135.68
Specifics:
1 ea 12% State Surcharge - 12/24/2012 $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 OA 952 - 001 -00 0. You ma obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: v/ lit (� Permittee Signature: o /3 LAPPCI t—F 1 I ki
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.
RECEIVED
Electrical Permit Application volt off I I t ;SE t.> L\
City of Tigard 4 2012 Received /?-/a MIN Permit Nc•6 /c-_ CO7 3 —
a 13 125 S W H all Blvd Tigard, OR 97 2 Plan Review
0 Phone: 503.639.4171 Fax: 503.59&IY OF TIGARD Date/8 ; Other Permit:
Inspection Line: 503.639,4175 81 J II DING DIVISION ate Ready /By: IF See Page 2 for
1` "' u `)
Internet: ww.tigard- or.gov SION Notifted/Method: liMor Supplemental Information
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❑ New construction n Addition /alteration/replacement Please elwek all that apply (submit 2 sets of plans w/items checked below)
❑ S or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current 0 Marinas and boatyards.
4^ :` i ,.' ;;;; ;'" y;TM . F i. � .: ZI” ` � =• : ••. o�;'' ` *t " g`�i 1 ; : , , 4 exceeds 10,000 amps at 150 volts or ❑ Floating buildings,
l ; .''`i�:a�4 0? Ir 'i "� ..: 6j 1 '� `,- F e c •. ' ..: �..- - .. : 1 :� less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling Z Commercial/industrial ❑ Accessory building amps for all other installations. buildinbs.
❑ Multi - family Q Master builder ❑ Other: O Fire pump. ❑ Installation of 76 KVA or
f r � ... � , Additioaof„ewmotorlo ¢ dof
❑ Emergency system. larger separately derived system.
-'i '`i`.' "K " " i''' ` ! ,5 ., li 6,d �,,,,` ``l..t ! �9 52 �x'"1: "..
}.,,�,� .d ej: kt�„�,� � `�`ti*�er~ •' . � • �_ °� �, t;�.���1ti'�?:vt.��fr ❑
Job no.: lob site address: R p<. „ ., „
t 4.4" 100HP or more. occupancy.
J L� B ❑Six Or more residential units. ❑ Recreational vehicle parks.
City / State/ZIP: ^p _ ( 0 Health -care facilities, Q Supply voltage for more than
_ [� D Hazardous locations, 600 volts nominal.
Suite/bldg. /apt. no.: Project name; itifi novo/ ❑ service or feeder 600 amps or more.
Cross street/directions to job site: — t r1 h1�. — r � ' _ Dm ri non It i31�� °
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq ft. or less 168.54 l 4_
Es. add'1 500 sq. ft, or portion 33.92 I
Tax map /parcel no.: Limited energy, residential
r •:+ ' r; vs sir m -• ' T ,: �a ,� ni (with abo sq. ft.) 67.84 2
r „Y`�r,�4 ;k?F tTC a ir t. ? :.7f.,''f r Y. i _ " 4 a — d : " : ` cSic a are r Z 0 ., ,; ,'..,a .,� ..—
Limited energy, multi- family 67,84
Cl.- t 11 S residential (with above sq, ft.)
L` Se rvices or feeders installation. alteration, and/or relocation
`Mount Only* 200 amps or less 100.70 2
xg
re';' , mi c e r
; @ _: "! a �z Y "'., „` , 9il l�a �" �� R . + . � .,i7 4 * + , '7RZ.. �: 7 201 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
Temporary services or feeders installation, alteration, and/or
City / State/ZIP: relocation
Phone: ( ) I Fax; ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 165.54
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
Sv: >%PS <,JiL!?3 "r ., v:.., �• :. }:TM;. :.}i`; r "5: f'',a " . + :ask ti, ;.3:ri .42 2
above service or feeder fee, 7
s
. YY� ,i'& } td ; y+��U " }i :�!t E ti •� ,a?r. csff ' each branch circuit
Business name: Security Signs a, Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: Melissa Hayden branch circuit
Each add'] branch circuit 7.42 n 2
Address: 2424 SE Holgate Blvd Miscellaneous (service or feeder not included)
City /State/ZIP; Portland, OR 97202 Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: (503) 546.7114 I Fax: : (503) 230.1861 Reconnect only 67,84 2
Pump or irrigation circle 67.84 2
E-mail: Melissa @SecuritySigtts.eotn Sign or outline lighting ° Z.,._ 67.84 2
r r , a * V i . rc m e . '�` Y l a 6 u _ a 'i " i,` ` , , ' . 1 : 0 4 . » „ .I4, wb ^ 8 s i g n a l circuits) litniteci-energy
Business name: Security Signs panel, alteration. or extension. Page 2 2
Each additional inspection over allowable in any of the abov
Address: 2424 SE Holgate Blvd Additional inspection (I hr min) 66.25/ hr
C Investigation (l hr min) 66 25/ hr
ity / State/ZIP: Portland, OR 97202
Industrial plant (1 hr min) 78.16 / hr
Phone: (503) 546.7114 Fax: (303) 230.1861 Inspections for which no fee is 40.00/ hr
s 'flail listed i4 hr min)
CCB Lic.; 122809 I Electrical Lie.: 26560CLS i Suprv. Lie.: 383S1G - }` ,,,,,'� ,a,` - `g:atl' . �t!� ;'� 'i P'' 17 =
Subtotal:
Suprv. Electrician signature, required:
Plan review (25% of permit fee):
Print name: Marc Linguist �� Date State surcharge (12% of permit fee):
TOTAL PERMIT FEE: /37.. [
Authorized signature: / This perm application expires if a permit is not obtained within 1
days after it has been accepted as complete.
Print name: Melissa Hay. en �- Date: " Number of inspections allowed per permit.
lAnuilding \PcrmttAlt1.C- PermitApp.ane 10/01/n9 440.4615T(1t/05/COM/W1i13
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