Permit CITY OF TIGARD ELECTRICAL PERMIT
1111 - COMMUNITY DEVELOPMENT Permit#: ELC2015-00765
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/23/2015
Parcel: 1 S 1260000300
Jurisdiction: TIGARD
Site address: 9451 SW WASHINGTON SQUARE RD A16
Project: Vans Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: TI
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
Quantity Description Date Amount
1 ea Sign or Outline Lighting 09/23/2015 $67.84
Specifics:
1 ea 12%State Surcharge- 09/23/2015 $8.14
Electrical
Type of Use:
Class of Work:
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 issue,.e, or if work is suspended for more the 180
days. ATTE •`: • -••1 law requires you to follow the rules adopted by the Oregon Utility Notification/ enter. Those rules are set forth in OAR
952-001-00 0 through OAR 95 01"?r You may obtain a copy of the rules or direct questions to OUNC by calling 503. ..1987 or 1.800.33 .44.
S= / /
Issued Permittee Signature: /1. ►♦.. /1 tJ♦ ! s
OWNER INSTALLATION ONLY Or
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 ApplicaRCEIVEP FOR OFFICE USE ONLY
City of Tigard ' ""`d �•�Q�S--I� S•—
g � 2 3 2015 oau/By: y a 3 /5 F, Permit No.: ��
13125 SW Hall Blvd.,Tigard,OR Plan Review
Phone: 503.718.2439 Fax: 503.598.1960
Date/By: Other Permit:
Inspection Line: 503.639.4175(`ITV OF TIGARU °ated3/By. rata: ® Page 2 for
Internet: www.tigatd-or.gov l• Notified/Method: Supplemental Information
.I4[111/4111*DIVISION PLAN REVIEW
New construction Please check all that apply(submit j�sets of plans w/items checked below):
® ❑Addition/alteration/replacement
❑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 150 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.
f ❑Addition of new motor load of ❑"A","E',"l-2","l-3",
Job no.: Job site address. `, y a t/lc (�}/ r rd Six or or more. occupancy.
C1 �5 S W N v�7 V1 r ly 1�,1 t 1 d ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,OR 97223 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.:1 koz3 i Project name: Uq n S ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Dmeripdoa I Qty. I Fee. I 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
Ea.add'1500 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 75.00 2
Instal 1 circuit residential(with above sq.ft.)
Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
Name:See Attached 401 amps to 600 amps 200.34 2
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
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 snips to 599 amps 168.54 2
Branch circuits—new,alteration,or extension,per panel
Owner signature: Date: A.Fee for branch circuits with
e 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 2
Contact name:Garrett Gibson branch circuit
Each add'I branch circuit 7.42 2
Address:9160 SE 74d'Ave Miscellaneous(service or feeder not included)
City/State/ZIP:Portland,OR 97206 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Phone:(503)777-4555 Fax::(503)777-0220 Reconnect only 67.84 2
E-mail: ess /rye yy� Pump or irrigation circle 67.84 2
J ess It� t t/I►I'�4 Vl 'l Sign or outline lighting I. 67.84 a7 V./2
CONTRACY)R 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) 66.25/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('/2 hr min)
CCB Lic.: 63422 I Electrical Lic.: 26106CLS I Suprv.Lic.: 493Sig ELECTRICAL PERMIT FEES
Subtotal: 7, St
Suprv.Electrician signature,requi ,/
Plan review(25%of permit fee): - _�,/
Print name: Phil Steig 1 Date: 'I 0.3 State surcharge(12%of permit fee): $' Ft
TOTAL PERMIT FEE: -/ 5 9�
Authorized sign This permit application aspires if a permit is not obtained within 180
cc Vr�' days after it has been accepted as complete.
Print nam 1�SSl C !-V, QS Date: /a� * Number of inspections allowed per permit.
I:\Buildmg'Permits\ELC-PermitApp.doc 07/01/10 (440-4615T(ll/05/COMWWEB