Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2007 -00442
ITY DEVELOPMENT
MUN
COM DATE ISSUED: 6/29/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD MGMT ZONING: C -
SUBDIVISION: $A�IGTON SQUARE LOT : JURISDICTION: TIG
A
PROJECT: DICKS SPORTING GOODS
Project Description: (2) sign lighting. See attached location.
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: 2
LIMITED ENERGY: 401 - 600 amp: SIGNAUPANEL:
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 ES & A SIGN & AWNING
BY THE MACERICH COMPANY 1210 OAK PATCH RD
9585 SW WASHINGTON SQUARE RD EUGENE, OR 97402
TIGARD, OR 97223
Phone: Contact #: PRI 541- 485 -5546
FAX 541 - 485 -5813
FEES
Description Date Amount Reg #: ELE 20- 243CLS
[ELPRMT] ELC Permit 6/29/2007 $106.80 LIC 163470
[TAX] 8% State Surcharge 6/29/2007 $8.54 SUP 305SIG
Total $115.34 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: cj Permittee Signature: 0`r\
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.
. A -v1 —190 /5
E Permit Application ; °i',' ;4 = it 'A FOR OFFICE USE ONLY
City of Tigard Received as e 7 PentN.�I D0b7_OO 2 _
13125 SW Hall Blvd., Tigard, OR 97223 11 ''. : 2:j R eview
0 � , Asher Permit:
Phone: 503.639.4171 Fax: 503.598.1960 Date/By
Inspection Line: 503.639.4175 Date Ready/By: luns fa See Page 2 for
T I G A It D Internet: www.tigard - or.gov : .1 : '/ - I ` ' • Notified/Method. Supplemental Information
TYPE OF WORK . PLAN REVIEW
❑ New construction Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other: 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
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
El Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E "I -2 ", "1 -3 ",
✓�� ��� f A�{�� J Q ❑ Recreational vehicle parks.
Six or or a resi occupancy
Job no.: Job site address:
S 7 ❑Six or more residential units.
❑ Health -care facilities. ❑ Supply voltage for more than
City/State/ZIP:
7751,Gil i O_ • 7f aSO�.� ❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt. no.: Project name:D/ 0 5Jl+u / s 6&xi 5 ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: fi 414 1` Description I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: 011) V cd // ik e tub:cpp. 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. ft)
n IC d T w L / Limited energy, multi - family 75.00 2
� /��/ •T Ithot x' f RGht I C Pro vl D e..�) residential (with above sq. ft )
`` V Services or feeders installation, alteration, and/or relocation
6. l 6 • d. (e e_ - -dttc- l L 200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: �J'], AeR g 4 , 0 401 amps to 600 amps 160.60 2
� � ' V 601 amps to 1,000 amps 240.60 2
b � 1 �
Address: 1 7 � /4 /7L/ S- . Over 1,000 amps or volts 454.65 , 2
City/State/ZIP: REo M D -b, it _ 98Csc2 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (t{) wo„a 6 ,1 D Fax: ( 40151 Y491 -. 15 7 200 amps or less 66.85 1
Owner installation: This inst is being made on property that I 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 599 amps 133 75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
8n A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: .. rM 4Qt.e c .7 - A , p . B. Fee for branch circuits
, without service or feeder fee,
�'i CM14d /t✓S 2 first branch circuit 46 85 2
Contact name: 'r
a p i vii its 4�/ Each add'I branch circuit 6.65 2
Address: 4 5
� Miscellaneous (service or feeder not included)
City/State/ZIP: 77/5"),g)4,...... C� 1✓�� P4 / 9001 Each manufactured or modular 90.90 2
r dwelling, service and/or feeder
Phone: 0 - ,', Xioez I Fax: : ? /s e ) Q'at, ..p5-/ Reconnect only 66.85 2
E -mail: if d ?t 2 ovj ,,, e Al b , d.49/VJ Pump or imgation circle 53.40 2
CONTRACTOR Sign or outline lighting D., 53.40 2
or o Signal circuit(s) or limited -
Business name: gS ( '°�- JI r ,� /� A f � �,/ ? ,�i, /
energy panel, alteration, or
Address: `,��/ !A i a A, `..A . id �rT) extension. Describe: Page 2 2
City/State/ZIP: cOt-�A o p_ . . g• Each additional inspection over allowable in any of the above
7 Per inspection 62.50
Phone: (6 7.30- ? ` Fax: (' ) Investigation per hour (I hr min) 62.50 _
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
Suprv. Electrician signature, required: ELECTRICAL PERMIT FEES
Su
P 9 Subtotal: 11; .97
Print name: Date: Plan review (25% of permit fee):
State surcharge (8% of permit fee): g,
Authorized signature: K( C.-� R s C.) TOTAL PERMIT FEE: // 5
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
I \Building\ Permits \ELC- PermitApp doe 0523/06 440.4615T( 1 1/05 /COMIWEB