Permit Support Document a CITY OF TIGARD t ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT "'FAN, Permit#: ELC2015 00152
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/12/2015
Parcel: 151260000300
Jurisdiction: TIGARD
Site address: 9706 SW WASHINGTON SQUARE RD F09
Project: Kiehl's Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: Interior wall signs.*mount only*. 4/215,reprinted to add 2nd sign lighting&correct job site address from 9585 SW
Washington Sq Rd to 9706 SW Washington Sq Rd.4/8/15,reprinted to correct parcel and owner information.
Contractor: SECURITY SIGNS INC Owner: PPR WASHINGTON SQUARE LLC
2424 SE HOLGATE BLVD PO BOX 847
PORTLAND,OR 97202 CARLSBAD, CA 92018
PHONE: 503-546-7114 PHONE:
FAX: 503-230-1861
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 04/02/2015 $135.68
Specifics:
1 ea 12%State Surcharge- 04/02/2015 $16.28
Electrical
Type of Use: COM
Class of Work: NEW
Type of Const:
Occupancy Grp:
Total $151.96
Required Items and Reports(Conditions)
This permit is issu he regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in rdance with appro 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. AT NTION: Oregon law req i =- •u to follow the rules adopted by the Oregon Utility.. • - • enter. Those rules are set forth in OAR
952-001- 10 throu•h OAR 952-001-00• . You - ••tain a copy of the rules or direct questions to OUNC by call -`. •87 or 1.800.3324344.
// / f 47 �� "
Issue By: Permittee Sig • • C .—s " c e��
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.
311CITY OF TIGARD ELECTRICAL PERMIT
! s COMMUNITY DEVELOPMENT Permit#: ELC2015-00152
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/12/2015
Parcel: 1115
Jurisdiction: Tigard
Site address: 9706 SW WASHINGTON SQUARE RD F09
Project: Kiehl's Subdivision: Lot:
Project Description: Interior wall signs.*mount only'. 4/215,reprinted to add 2nd sign lighting&correct job site address from 9585 SW
YVashington Sq Rd to 9706 SW Washinytgn Sq Rd.
Contractor: SECURITY SIGNS INC Owner:
2424 SE HOLGATE BLVD
PORTLAND, OR 97202
PHONE: 503-546-7114 PHONE:
FAX: 503-230-1861
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 04/02/2015 $135.68
Specifics:
1 ea 12%State Surcharge- 04/02/2015 $16.28
Electrical
Type of Use: COM
Class of Work: NEW
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 acc• •- - ..roved 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. ATTE. ION: Oregon law :quires - to follow the rules adopted by the Oregon Utility Notification - ter. Those rules are set forth in OAR
952-001-00 0 thro :h OAR 952-001-01,• ou a •twin a copy of the rules or direct questions to OUNC by calli • . .1987 or 1.800,332.2344.
Issued :y: " - ' 'e-4--ltd Permittee Signatt
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 Applicat4. L ( ,0 * $ =, , roit OI Fi r l NSF.O\I.1
City of Tigard Received
Dat ail y i i 5 .. Permit No.: EX'090/5-�/5 ,
• 13125 SW Hall Blvd.,Tigard,OR 91 1 5 Plan Review
likl Phone: 503.639.4171 Fax: 503.59 19 0 Date/B : Other Permit:
TIGAIt13
Inspection Line: 503.639.4175 Date Ready/By: lent: fa See Page 2 for
Internet: www.tigard-or.gov 4. 9 l (!L _ ;",.A K k' Notified/Method: Supplemental Information
•
TYPLr bit N , j+31:1.A t i PLAN REVIEW
❑New construction ®Addition/alteration/replacement Please check all that apply(submit a 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 ISO 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 INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A "E',"1-2","1-3",
Job no.: Job site address: (64(1.1401 t00HP or more. occupancy.
S ❑Six or more residential units. ❑Recreational vehicle parks.
Clty/Sta[e/ZIP: �j?(�( ❑Health-care facilities. ❑Supply voltage for more than
lltal+7tz! ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: Y e ` ['Service or feeder 600 sumps or more.
`�. ` FEE SCHEDULE
Cross street/directions to job site: Description I Qty. l Fee. 1 Total I •
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'l 500 sq.ft.or portion 33.92 1
Limited energy,residential 67.84 2
DESCRIPTION OF WQRK (with above sq.ft.)
1. /,� Limited energy,multi-family 67 84 2
• � /� �� T V residential(with above sq.ft) _
�J:��1<�\1w`r Services or feeders installationzalteration,and/or relocation
*Mount Only"` L) 'et21-/)/— 200 amps or less 100.70 2
.9 PROPERTY OWNER I ❑ 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
Phone:( ) I 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
T Branch circuits—new,_alteratio>,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:Security Signs B.Fee for branch circuits without
service or feeder fee,fast 56.18 2
Contact name:Melissa Hayden branch circuit
Each add'I branch circuit 7.42 _ 2
Address:2424 SE Holgate Blvd Miscellaneous(service or feeder not included)
Each manufactured or modular
City/State/ZIP:Portland,OR 97202 dwelling,service and/or feeder 67.84 2
Phone:(503)546.7114 I Fax::(503)230.1861 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail:Melissa @SecuritySigns.com
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s)or limited-energy
panel,alteration,or extension. Page 2 2
Business name:Security Signs Each additional inspection over allowable in any of the above
Address:2424 SE Holgate Blvd Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:Portland,OR 97202 Investigation(1 hr min) 66.25/hr
_ Industrial plant(1 hr min) 78.18/hr
Phone:(503)546.7114 I Fax:(503)230.1861 Inspections for which no fee is
specifically listed(lh hr min) 90.0W hr
CCB Lic.: 122809 I Electrical Lic.: 26560CLS I Suprv.Lic.: 383SIG 'EL ECI'RICALitpERMJT FEES —
Suprv.Electrician signature,required: Subtotal:
Plan review(25%of permit fee):
Print name: Marc Linguist I Date: State surcharge(12%of permit fee):
TOTAL PERMIT FEE:
permit Authorized signature: This application expires if a permit is not obtained within 180
Print name: Melissa Hay n Date: • Number of days after it has been accepted as complete.
inspections allowed per permit.
.... ..___,..__'__ ........-,. een.ncr,nrncrnummn
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9706 SW WASHINGTON SQUARE RD F09,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2015-00152
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor