Permit CITY OF TIGARD ELECTRICAL PERMIT
•. COMMUNITY DEVELOPMENT Permit#: ELC2013 00507
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/12/2013
Parcel: 1 S 135 BA00102
Jurisdiction: Tigard
Site address: 10164 SW WASHINGTON SQUARE RD
Project: Hannah Pet Society Subdivision: OAKBURG Lot: 9
Project Description: Sign lighting for(1)3 ft by 13 ft.wall sign.
Contractor: INTEGRITY SIGNS OREGON Owner: PPR SQUARE TOO LLC
PO BOX 88 PO BOX 847
HUBBARD,OR 97032 CARLSBAD,CA 92018
PHONE: 503-981-3743 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 09/12/2013 $67.84
Specifics:
1 ea 12%State Surcharge- 09/12/2013 $8.14
Electrical
Type of Use: COM
Class of Work: ALT
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. Those rules are set forth in OAR
952-001-0010 through OA 5 090. ou may obtain a copy of the rules or direct questions to OUNC by calling 503. .1987 or 1.800.332.23•�
Issued By: Permittee Signature: ' a /_• ' //_
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 503.839.4175 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 � � FOR OFFICE usH.ONLY
City of Tigard ��7` " Date/By: �h—�(33_ gigrr Permit No.: �/ / O1?_ 0,1
y' �='�� O is �f
13125 SW Hall Blvd.,Tigard,OR 97223 01'l Plan Review Other Permit: n
l °.,., Phone: 503.718.2439 Fax: 503.598.196 I Date/By: /' /3_064,ls-
T I G A R D Inspection Line: 503.639.4175 L� ,,-
'.Z , II Date Ready/By: luris: 7 ® See Page 2 for
Internet: www.tigard-or.gov rely' tfied/Method: I Supplemental Information
TYPE OF WORK ex, G��1S
�'V(a� PLAN REVIEW
❑ New construction ❑Addition/alteration/rI Riertl Please check all that apply(submit 2 sets of plans w/items checked below):
D"
El Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition .Other:rj(t9A) 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 Iola-1�
❑ I-and 2-family dwelling gc ommercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or �
JOB SITE INFORMATION AND LOCATION
El Emergency system. larger separately derived system. lJ
❑Addition of new motor load of ❑"A"."E 'l-2"."I-3".
`� I r 100HP or more. occupancy.
❑
Job no.: Job site address: 101 64 ✓1� SYII SD 1LS4 ❑Six or more residential units. Recreational vehicle parks.
City/State/ZIPTr . ` Gr ) ❑Health-care facilities. ❑Supply voltage for more than `t�'
l 1�e�vd I Ly`/ ❑Hazardous locations. 600 volts nominal. V V
Suite/bldg./apt. no.: Project name:..4al,V,� `1rw' Sir,A ❑Service or feeder 600 amps or more.
""""� FEE SCHEDULE. D
Cross street/directions to job site:C /‘..0.sPN. IP Description I Qty. Fee. I Total
1�,�� New residential single-or multi-family dwelling unit. lI
Includes attached garage.
O
Subdivision: Lot no.: 1.000 sq.ft.or less 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 1 `�
Tax map/parcel no.: Limited energy.residential
DESCRIPTION OF WORK (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
fin, •)'l e ` S`C residential(with above sq.ft.)
1 �►K.�l �/ l J Renewable Energy _ ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2 1
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1.000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax: ( ) relocation
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
Owner signature: Date: Branch circuits—new,alteration,or extension,per panel
APPLICANT CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee.
7.42
Business name: ,Siel..i. Cc.� Q� each branch circuit
2q Y I vlgYlS `�Ya~�J - B.Fee for branch circuits without
Contact name: \ ` V _�J vV V branch it feeder fee,first 56.18 2
v 'e branch circuit
Address: Each add'l branch circuit 7.42 2
City/State/ZIP: Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
Phone: 4b3) CIO )_3-71.4..3 Fax: : (Q3) ei g.a_8'i S3 dwelling.service and/or feeder
Reconnect only 67.84 2
E-mail: P mp or irrigation circle 67.84 2
CONTRACTOR • Sig or outline lighting I 67.84 41. t 2
Business name: 9 ( r 'gnat circuit(s)or limited-energy See
�- r♦•ia� ` 'Q�� of O�(7,„ J panel.alteration,or extension. Page 2 2■Address: f).O Q p-Q Each additional inspection over allowable in any of the above
LJ[�Jr U Q Additional inspection(I hr min) 66.25/hr
City/State/ZIP: , , (,, CIA ., ow...._ "Z0.3 a... Investigation(I lit min) 66.25/hr
Phone:(Q3 �p`/_-'3` l_ 3 Fax: ( ) Industrial plant(I hr min) 78.18/hr
•O Inspections for which no fee is 90.00/hr
CCB Lie.: `Gt 4 Is s- Electrical Lie.: CLS �, Suprv.Lic.:3 _Sj G. specifically listed('/z hr min)
��--' _ ___ ELECTRICAL PERMIT FEES
Suprv. Electrician signatu ,leg fired_ Subtotal: 6i,Sr9
Print name: l� � --� Date: l��, j f3 Plan review(25%of permit fee):
SState surcharge(12%of permit fee):I
Authorized signature: TOTAL PERMIT FEE: -15 R8
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:\BuildingV Permits\Et-C_PcrmiiApp_I:LR_I:RE.Joc Rev(15/21/2013 440-4615T(11/05/C()1(.1/WEB
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10164 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
2014-02-13 00:00:00
ELC2013-00507
PASS - No C of O
Violation Summary:
Inspector Contractor