Permit q CITY OF TIGARD ELECTRICAL PERMIT
' • COMMUNITY DEVELOPMENT Permit#: ELC2015-00363
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/14/2015
Parcel: 1 S 135BA00102
Jurisdiction: TIGARD
Site address: 10206 SW WASHINGTON SQUARE RD
Project: Ulta Beauty Subdivision: OAKBURG Lot: 9
Project Description: (2)sign lightings
Contractor: VANCOUVER SIGN COMPANY INC Owner: PPR SQUARE TOO 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
2 ea Sign or Outline Lighting 05/14/2015 $135.68
Specifics:
1 ea 12%State Surcharge- 05/14/2015 $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 - -. •- 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. • NTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-00 -0010 thr• gh OAR•••2 • 9 I You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1. 00.33 344.
Is.ued By: j, /i_ L� `rte Permittee Signature: /� 1'1/
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 FOR OFFICE USE ONLY
City of Tigard Rte`d �/e/ /`j I �1) Permit No.: Z I /0/5• 13125 SW Hall Blvd.,Tigarrlr + l i/E D pt�Review /`— " ��
a Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit. /11� 06(�
T I C;n K D Inspection Line: 503.639.4175 MAY 14 2015 Date Ready/By: lurk: lid See Page 2 for St eajepug
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
PLAN REVIEW
❑New construction ❑A 1 o Please check all that apply(submit 2 sets of plans w/items checked below):
❑Service or feeder 400 amps or more ❑Building over three stories.
El Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
ATEGORY OF CONOWFIONIIIki exceeds 10.000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ I-and 2-family dwelling ❑ Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑Other: ❑Fire pump. ❑Installation of150KVAor
JOB SITE INFORMATION AND LOCATION ' ❑Emergency system larger separately derived system.
El Addition of new motor load of ❑"A" "E" "1-2" "1-3"
1O ZO p t 100HP or more. occupancy.
Job no.: Job site address: (P
5W (Oa£\;t1Tovl 52, fy}, ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: PO f 1GIY1� n R J ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: I Project name: U).r0. ❑Service or feeder 600 amps or more.
3 l
, t _
Cross street/directions to job site: Description Qty. `` Fee. Total •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 I
Tax map/parcel no.: Limited energy,residential 75.00
IIIIMIMMIIIMIIIIIIIIIIIII
(with above sq.ft.) -
I 1 /� Limited energy,multi-family 7500
Z AIM I LA. wad CC 11 c5 10p S residential(with above sq.ft.)
Lm �n�e Renewable Energy _ ❑ See Page 2
Services or feeders installation,alteration,and/or relocation .
❑ PROPERTY OWNER J 0' TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: (Sit Q. 401 amps to 600 amps 200.34 2
Address: 107,0(a, S� IIA)aSn(na.�All1 cc/ Rd 601 amps to 1,000 amps 301.04 2
J (, Over 1,000 amps or volts 552.26 2
City/State/ZIP: P I ,J
A1'� r'l, Os; Temporary services or feeders installation,alteration,and/or
Phone:( ) I Fax:( ) relocation
• 200 amps or less 59.36 I
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
® APitieV, t1t1 '! � A.Fee for branch circuits with
above service or feeder fee,
7.42
Business name: Vancouver Sign each branch circuit
B.Fee for branch circuits without
Contact name:Reid Storm service or feeder fee,first 56.18 -
branch circuit
Address:2600 NE Andresen Rd#50 Each add'l branch circuit 7.42 2
City/State/ZIP:Vancouver WA 98661
Miscellaneous(service or feeder not included)
_ Each manufactured or modular
67.84 -
Phone:(360)693-4773 I Fax::(360)693-2747 dwelling,service and/or feeder
Reconnect only 67.84 --
E mail:reids@ vansignco.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting a) 67.84 /3 6-.4 2
Business name:Vancouver Sign Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address:2600 NE ANdresen Rd#50 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:Vancouver WA 98661 {) Investigation(1 hr min) 66.25/hr -
Phone:(360)693-4773 I Fax:(360)693-2747 lu1 r l Industrial plant(1 hr min) 78.18/hr
-
�`� Inspections for which no fee is
90.00/hr
CCB Lic.: 63951 Electrical Li : 37-46CLS Suprv.Liic. �'S((( specifically listed(1/2 hr min)
/„,..• LECTRICAL PERMIT FE)
Suprv.Electrician signature,required' �J/ Subtotal: /j a'Q
Print name L -'A LL.k S C Date: �j Plan review(25°b of permit fee):
��
State surcharge(12%of permit fee): /e'.a S _
Authorized signature: /2 "y" TOTAL PERMIT FEE: _ l57• 94.
n et�' 0 r This permit application expires if a permit is not within 180
Print name: Reid Storm A l Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(II/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
10206 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2015-00363
Jeff Grove
Violation Summary:
Inspector Contractor