Permit CITY OF TIGARD ELECTRICAL PERMIT
,111111
COMMUNITY DEVELOPMENT Permit#: ELC2017-00089
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/08/2017
[ta'i Parcel: 1S135BA00100
Jurisdiction: Tigard
Site address: 10205 SW WASHINGTON SQUARE RD
Project: Thirsty Lion Subdivision: None Lot: None
Project Description: Sign lighting for a new storefront sign.
Contractor: RUDNICK ELECTRIC SIGNS LLC Owner: PPR SQUARE TOO LLC
1625 WASHINGTON ST PO BOX 847
OREGON CITY, OR 97045 CARLSBAD, CA 92018
PHONE: 503-655-2610 PHONE:
FAX: 503-980-7919
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 02/09/2017 $67.84
Specifics:
1 ea 12%State Surcharge- 02/09/2017 $8.14
Electrical
Type of Use: COM
Class of Work: ALT
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 issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are -t forth in OAR
952-001-0010 through 952-001-0090. Yo • copy- -— les or direct questions to OUNC by calling 50 ►1.87 or 1.800.332.23•
Issued By: 2 7],--ZA-- - 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.
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
Cl ofTigard Received
`J g y� Date/By: et 17 Permit#: a c 7-- �1
ill . . 13125 SW Hall Blvd.,Tigard,OR 9722 O /
�' � Plan Review
Phone: 503.718.2439 Fax: 503.598.1'.1Related Permit#: */7' ;1^3/
Date/By:
T I GA RD Inspection Line: 503.639.4175 p '7'04\7 Ready Date/By: 7uris: ® See Page 2 for
Internet: www.tigard-or.gov 1.EB J Notified/Method: Supplemental Information
. ::"L f 0. :_ ' I" .;; *7, )4:17.414:44::: '17144i14. ,Vis„: �'
New construction Z' i1 g"1'-" Please check all that apply submit 2 sets of plans w/items
El Addition/alteratio . PP y( P checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
' '` exceeds 10,000 amps at 150 volts or 0 Floating buildings.
I:11-and 2-family dwelling 74 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family • Master builder 0 Other: 0 Fireum .
p p 0 Installation of 150 KVA or
> '• 1 1 i ❑Emergency system. larger separately derived
Job#: Job site address: to 7 � (6L �` ❑Additioo of ore.motor load of system.
C 100HP or more. ❑"A","E","1-2","1-3",
❑Six or more residential units. occupancy
City/State/ZIP: c,(�" ❑Recreational vehicle arks.
` 0Health-care facilities. P
Suite/bldg./apt.#: Project name: ❑Hazardous locations. 0 Supply voltage for more than
��` 0 ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: 4 I I
Description Qty Each" I:.. Total .1...:.*
New residential single-or multi-family dwelling unit.
Subdivision: I Lot 4: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel 4:
Ea.add'l 500 sq.ft.or portion 33.92 1
>.` ": g Limited energy,residential 75.00 2
-th (with above sq.ft.)
(L) laE' ��� Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
p- I Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
�� .
Name: ` 6. , - 200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
_ ' 401 amps to 600 amps 200.34 2
City/State/ZIP: .CE Gleak� .. J/� 601 amps to 1,000 amps 301.04 2
Phone:( ) v J�MMFFaax:(( ) CC Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
l � ,_ Ci • _ 0-" Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: .-?.vA \ `S' c� above service or feeder fee, 7 42 2
t,.-1<,,:,--- each branch circuit
Contact name: R, tia,io B.Fee for branch circuits without
orccmlccdEnc_,fnst_ __ -- -
Address: . ,cI
��Z --- ..44.....v, c , 56.18 2 branch circuit
City/State/ZIP: ' Each add'l branch circuit 7.42 2
�''64-'4 --. Miscellaneous(service or feeder not included)
Phone:(GCS) to - �A tb Fax: :( ) Eddwacehl mngan,usefarvcticu
ereadnodr/omr ofedeudlearr
67.84
.84 2
Email: 4. l(y,1t-aek e- t,C.S1 eC_„... Reconnect only 67.84 2
k444., 444
l 4:44434.04:444:44:4:4,1
t. °'" ` `' Pump or irrigation circle 67.84 2
Business name: ZON-41j Cj .JOE' 1 S't 0 � Sign or outline lighting , 67.84 (01-.V- 2
Address:' ��^ � �� Signal circuit(s)or limited-energy ❑ See Page 2 2
\�j+ ZS- �( i. panel,alteration,or extension.
/� m� qt��j�'� Each additional inspection over allowable in any of the above
City/State/ZIP: C >�2 > op_ lv`-" 6 Additional inspection(1 hr min) 66.25/hr
Phone:(�S )1Q15'S`.— a;►.� Fax:( ) Investigation(1 hr min) 90.00/hr
Email: <'' '-g--. Industrial plant(1 hr min) 78.18/hr
ekt`'�.0.;t_CC ''v r (--I''^` Inspections for which no fee is 90.00/hr
CCB Lie.: to � Electrical Lie.: (_ Suprv.Lic.: �5 ( � s.ecificall listed CA hr min)
Suprv.Electrician signature,required:
p Subtotal: , L-1.
Print name: C ( ,r Date: c t 6 . /L� ❑Plan Review Required(25%of permit fee):
��Jb>�' _ l State surcharge(12%of permit fee):
Authorized signature:rt:s'y' —'� TOTAL PERMIT FEE:
( This permit application expires if a permit is not obtained within 180
Print name: .- fin ` l. Date: 6.7_,(67,_ / l * days after it has been accepted as complete.
J `wNumber of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10205 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2017-00089
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor