Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 -00227
TWA R O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date issued: 04/18/2013
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9424 SW WASHINGTON SQUARE RD K05
Project: Hot Topic Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: (1) illumintated wall sign
Contractor: VANCOUVER SIGN COMPANY INC Owner: PPR WASHINGTON SQUARE LLC
2600 NE ANDRESEN RD #50 PO BOX 847
VANCOUVER, WA 98661 CARLSBAD, CA 92018
PHONE: 360 - 693 -4773 PHONE:
FAX: 360 - 693 -2747
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 04/18/2013 $67.84
Specifics:
1 ea 12% State Surcharge - 04/18/2013 $8.14
Electrical
Type of Use: COM
Class of Work: OTR
Type of Const:
Occupancy Grp:
Total $75.98
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Tho - rules are set forth in OAR
952- 001 -0010 through OAR 95 - 001 -00 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or .8 • ..332.234 -
c
Issued By: (f Permittee Signature: / / -
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Application �uL:�. FOR OFFICE USE ONLY'
7111 Cit Of Tl and Received (
Plan Rev Permit No ?
a 1312 Hall Blvd., Ti 2 OR 97223
Date/By: 1 (� (� �i - - 13 ��°��1
g iew
s Phone: 503.639.4171 Fax: 503.598 .196 P R 1 8 2 013 Date/By: Other Permit: c V/ 3 DOG
1 t It l� Inspection Line: 503.639 Date ReadyB Luri Ea See Page 2 for
IrA Internet: www.tigard - or.gov (PITY OFTIGARD Notified/Method: Supplemental Information
TYPE OF 1$t w_ PLAN REVIEW
ET New construction ❑ Addition /alteration /replacement Please check all that apply (submit sets of plans wlitems che.ked heloss
❑ 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.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE . ❑ Emergency system. larger separately derived system.
• . INFORMATION AND LOCATION
0 Addition of new motor load of ❑ "A ", "E ". "I -2 ", "1 -3 ",
Job no.: Job site address: I00HP or more. occupancy.
-�- I `( z 5 Lk) r~�ush+ tl$tI')11. �t ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: r t e air i D A l -721--
(� ❑ Health-care facilities. 0 Supply voltage for more than
J ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: O 5 - Project name: I O .r- I / r ❑ Service or feeder 600 amps or more
P FEE SCHEDULE
Cross street/directions to job site: w 1_ i n n y i Luc � e A t t Description I Qt.. I Fee. I Total I •
,4 L rYUI New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'! 500 sq. ft. or portion 33.92 l
Tax map /parcel no.:
Limited energy, residential 67.84 2
DESCRIPTION OF WORK (with above sq. ft.)
t Limited energy, multi- family 67.84 2
C• L 11 �w(ill (Ate CL u )� I i S C�1/1 residential (with above sq. ft.)
J Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
, 0 I PROPERTY OWNER A TENANT 201 amps to 400 amps 133.56 2
— Name: C((9 t O r L r # +/ K p S 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address:- L{ Z y 5 k) 1/0Ul-S YL t v' VII, 1I, Sri &tot re- Over 1,000 amps or volts 552.26 2
�1 ard l
City / State/ZIP: O Temporary services or feeders installation, alteration, and/or
q 7 Z Z , 3 L relocation
Phone: ( ) 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
21 APPLICANT 1 ® CONTACT PERSON above service or feeder fee,
7.42 2
each branch circuit
`I
Business name: v ari.l.o ki v e Si 1 B. Fee for branch circuits
without service or feeder fee,
Contact name: R, stn first branch circuit 56.18 2
q
Address: z oo 1F. Art. � e e,,r Al so Each add'l branch circuit 7.42 2
-
Miscellaneous (service or feeder not included)
City /State/ZIP: Va.r1�o �V ex W A, ! � 6Cc Each manufactured or modular econnect t only 67.84 2
Phone: (3 4, 0) (9 3 4/77 3 Fax:: ( 360 6 q g Z79 7 R ne, ye and/or feeder 67.84 2
Recon
E-mail: Pump or irrigation circle 67.84 2
v Fy ,, ma x, ,
x =' ; { r iA" On [ � Sign or outline lighting () 67.84 2
Business name: Signal circuit(s) or limited -
�r2 l'1.l.Pi u vP.i SigYJ energy panel, alteration, or
Address: 2 (0 - o N e Arid,( e_yi `J TI CS , '# SQ extension. Describe: Page 2 2
City / State/ZIP: , Each additional inspection over allowable in any of the above
V /A j�, G O 11�U>✓� (.�� g (n G, Per inspection 66.25
4 ,c( Phone: ( 36,0) 4 ,c( 3 h/ 7 7 ..-c Fax: (3 6o) 64i93 2,72i7 Investigation per hour (t hr min) 66.25
CCB Lic.: 6 gci 5 I Electrical Lic.: 37 _ Li GCsi Su . Lie.: SZt'o - 51 Industrial plant per hour 78.18
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: 4 q ,)�� Subtotal:
. � / Plan review (25% of permit fee):
Print name: g4 Date: ! /z f / /3
T permit alication State surcharge (12% of permit fee): � J/
,(
Authorized signature: // // - " /f U
/ �cy' TOTAL PERMIT FEE: - ? <
Print name: �(' vl� s�� r rill. Date: L permit expires if a permit is not obtained within 180
! / 7 i/ / days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\ Building \Permits\EL.C- PermitApp.doc 10/01/09 0- 4615r(I1 /05/COM/WEB
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9424 SW WASHINGTON SQUARE RD K05,
TIGARD, OR, 97223
Commercial - Electrical
140 Sign installation
PASS
ELC2013-00227
Jeff Grove
Violation Summary:
Inspector Contractor