Permit CITY OF TIGARD ELECTRICAL PERMIT
1111 q
- COMMUNITY DEVELOPMENT Permit#: ELC2014-00201
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/28/2014
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9508 SW WASHINGTON SQUARE RD J01
Project: Pandora Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: Sign lighting for(2)interior signs
Contractor: QUICKSILVER NEON AND SIGNS LLC Owner: PPR WASHINGTON SQUARE LLC
2325 NW 154TH PL PO BOX 847
BEAVERTON, OR 97006 CARLSBAD,CA 92018
PHONE: 503-626-7020 PHONE:
FAX:
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 04/28/2014 $135.68
Specifics:
1 ea 12%State Surcharge- 04/28/2014 $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 /suspended for more the 180
days. ATTEN %•: • -.on law requires you to follow the rules adopted by the Oregon Utility Notification Can -r. Tho 'rules are set forth in OAR
952-001-00 •through OAR ' 2-66 '090 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1••7 0 1 .80, 2.2344.
Issue. By: 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.
Cali 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 Applica (�C1'![D Reo��a lull I11 I I( I I ' l O\I 1
City of Tigard 1,J1�. �l 1 Date/B : 5m�� PermitNo.:Else, ,, ate
13125 SW Hall Blvd.,Tigard,OR 97 ;'s p 2 8 2014 Plan Review
a Phone: 503.718.2439 Fax: 503.598.•(t0` Date/B ; Other Permit:
I I i .,,,,I 1 Inspection Line: 503.639.4175
CITY (gyp 'l Date Ready/By: 0 See Page 2 for
Internet: www.tigard-or.gov Q1j)1 TMOr �I1art1�I^J Notified/Method: Supplemental Information
TYPE OF1tIG N`+1Si"t PLAN REVIEW
0 New construction Please check all that apply(submit 2 sets of plans w/items checked below):
®Addition/alteration/replacement
El Service or feeder 400 amps or more ❑Building over three stones.
❑Demolition 0 Other:
where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
❑ 1-and 2-family dwelling less to ground,or exceeds 14,000 ❑Commercial-use agricultural
y g ®CommerciaUindustrial ❑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 ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E","i-2","1-3",
Job no.: Job site address: qp7$ S„A), (,(/4,f tf ri....ja.,,v S 100HP or more. occupancy.
0 Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: Pe5/2--77->TA✓/) • e72 —7-e-d,✓ `i 7j ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: DI 41- ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
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'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
/A/S 9 4-4-->9 77 OW (2 Z- ( ) S/'�/2.0-- 2.cwr residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
-cc.-/4 Ai.S Services or feeders installation,alteration,and/or relocation
XL PROPERTY OWNER I ❑ TENANT 200 amps or less 100.70 2
Name: 201 amps to 400 amps 133.56 2
/t'74 C. 7 _/�� 401 amps to 600 amps 200.34 2
Address: 9ccSW _rry yh//i/7)4/.S-4d, /Le, 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: `�j1*.i'i Cr/L 7(c,,k/ 9 7LZ
Temporary services or feeders installation,alteration,and/or
Phone:(J2) 6...17 .-- 6,c) 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 I ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name l/ge4l�je.. 24/jgv._o 4.-C4..4..-1 L1.-C___ each branch circuit
B.Fee for branch circuits without
Contact name: t//".,,e• ,3pw,r'OA /v service or feeder fee,first 56.18 2
Address: �; A>/.4c_-e._ branch circuit
�si3 Z.���/t / Each add'I branch circuit 7.42 I 2
Miscellaneous(service or feeder not included)
City/State/ZIP: 0 ------20 1../ -1z---72 Q/L 9 7410 G Each manufactured or modular
Phone:( ) 624- -7Q 2.-c) Fax::( ) dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
E-mail: av/6.4,1-/<-i/2-7et Ts "V r/ 9')Q#-„,•Cvrt
Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting ,2 67.84 /5c.(F g 2
Business name:cfPirLC.y-e/z. .v4/4 4_42 ;4A/ i--Z—C._ Signal circuit(s)or limited-energy ot See
panel,alteration,or extension. Page 2 2
Address: 2..32._S--.4 Lv) /Ci/?!7::,./, Each additional inspection over allowable in any of the above _
City/State/ZIP:, Sp✓c�,�.x/ t .a Z ate/ 97(2)�, Additional inspection(1 hr min) 66.25/hr
Investigation(1 hr min) 66.25/hr
Phone:(c&j) 62-(0 - 7o 2 Fax:( ) Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.:/-gr/jam Electrical Lit , uprv.Lic.:.57/777 specifically listed(%z hr min) 90.00/hr ELECTRICAL PERMIT FEES _
Suprv.Electrician signature,required: Subtotal: / 5
Print name: Al I//, yr...- 0,4 Date:y- Z S--7 fri Plan review(25%of permit fee): -----
State surcharge(12%of permit fee): /(4), ?•g
Authorized signature: TOTAL PERMIT FEE: I S • %4
I✓/� `3 _ This permit application expires if a permit is not obtained within 180
Print name: i.t �'v ti Date. L1 days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\Building\Permits\ELC_PemitApp_ELR_ERE.doc Rev 0521/20/3 440-4615T(11/05/COM/WEB
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9508 SW WASHINGTON SQUARE RD J01,
TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00201
Jeff Grove
Violation Summary:
Inspector Contractor