Permit ,� CITY OF TIGARD ELECTRICAL PERMIT
• COMMUNITY DEVELOPMENT Permit#: ELC2014-00589
T[G ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/13/2014
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9426 SW WASHINGTON SQUARE RD K04
Project: Journey's Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: (2)sign lightings
Contractor: RAMSAY SIGNS INC Owner: PPR WASHINGTON SQUARE LLC
9160 SE 74TH AVE PO BOX 847
PORTLAND,OR 97206 CARLSBAD,CA 92018
PHONE: 503-777-4555 PHONE:
FAX: 503-777-0220
FEES
1. Quantity Description Date Amount
2 ea Sign or Outline Lighting 10/13/2014 $135.68
Specifics:
2 ea 12%State Surcharge- 10/13/2014 $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 accord: ce 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. ATT- • ION: Oreg• law -•uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-r 010 through OAR 95 r.1-00'0 You may obtain- copy of the rules or direct questions to OUNC by calling 50A32.1987 or 1.800.33 .2344.
Issue. =y: /t i� Permittee Signature: � t.��/���N��
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 ApplicaRECEI VED FOR OFFICE USE ONLY
City of Tigard Received /A -easy?
Tigard, �3 l ' // ,/ Permit No.: j�/
13125 SW Hall Blvd.,Ti OR 9 T 3 C.:'~ Plan Review
'"
% Plan Review
Phone: 503.718.2439 Fax: 503 ����� Date/By: Other Permit:
I; Inspection Line: 503.639.4175 Cif K HL) Date Ready/By: luris: B See Page 2 for
Internet: www.tigard-or.gov BU11DI(i'n n 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):
❑Demolition ❑Other:
0 Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1- 2-family dwelling less to ground,or exceeds 14,000 ❑Commercial-use agricultural
y g ®Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 75 KVA or
JOB SITE INFORMATION AM) LOCATION D Emergency system. larger separately derived system.
D Addition of new motor load of ❑"A" "E""1-2""1-3"
r _ Six or or o more residential Recreational
Job no.: Job site address:(ALA"LIVf'1 Sw � � 0 Six or more residential units. ❑R vehicle parks.
City/State/ZIP:Tigard,OR 97223 Sj( , D Health-care facilities. ❑Supply voltage for more than
a ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: L—134 Project name:C �u['� I t5
0 Service or feeder 600 amps or more.
�+-+ "`'� FEE SCHEDULE
Cross street/directions to job site: vQc t\ q'�-p( Sq 1l] c�1 ' Description I Qty. Fee Total I"1 v New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq.ft.or less 168.54 4
Tax map/parcel no.: Ea.add'I 500 sq.ft.or portion 33.92 I
Limited energy,residential
DESCRIPTION OF WORK (with above sq.ft.) 75.00 2
1 YI S-t-�t 1 Limited energy,multi-family 75.00 2
Q r ht -r,� o r SI gY�5 residential(with above sq.ft.) -
Services or feeders installation,alteration,and/or relocation _
200 amps or less 100.70 2
❑ PROPERTY OWNER 1 ❑ TENANT 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
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
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 168.54 2
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
® APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42
2
each branch circuit
Business name:Ramsay Signs Inc B.Fee for branch circuits without
service or feeder fee,first 56.18
Contact name: 3\S 5 lcQ S'mac branch circuit 2
Each add'l branch circuit 7.42 2
Address:9160 SE 74th Ave Miscellaneous(service or feeder not included)
City/State/ZIP:Portland,OR 97206 Each manufactured or modular Ci
ty dwelling,service and/or feeder 67.84 2
Phone:(503)777-4555 I Fax::(503)777-0220 Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s)or limited-energy
Business name:Ramsay Signs Inc panel,alteration,or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address:9160 SE 74th Ave Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:Portland,OR 97206 Investigation(1 hr min) 6625/hr
Industrial plant(1 hr min) 78.18/hr
Phone:(503)777-4555 I Fax:(503)777-0220 Inspections for which no fee is 90,00/hr
specifically listed('/s hr min)
CCB Lic.: 63422 I Electrical Lic.: 26106CLS Suprv.Lic.: 493Sig ELECTRICAL PERMIT FEES �tof
Suprv.Electrician signature,requir-• .0/.1.;-:.e."2/..Aar- Suit fee): /37'
� Plan review(25%of permit fee): ,_�
Print name: Phil Steiger r'ate:,O _\)D-- 1(,..' State surcharge(12%of permit fee): /4,,a
���f,r J�,,,,,�,/� TOTAL PERMIT FEE: 151. ?#
Authorized signature: Y 'j�rUJ� This permit application expires If a permit is not obtained within 180
Print name: ( J( 5t,l CA '�.0Srna S Date: 10—i3^1 y days after it has been accepted as complete.
Number of inspections allowed per permit.
I:1 Building\Peimits\ELC-PemitApp.doc 07/01/10 440-4615T(1l/05/COM/WEB