Permit (12) CITY OF TIGARD ELECTRICAL PERMIT
1111 31. COMMUNITY DEVELOPMENT Permit#: ELC2017-00198
ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/21/2017
[ � g Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9522 SW WASHINGTON SQUARE RD H07
Project: Pink Victoria's Secret Subdivision: None Lot: None
Project Description: Sign lighting for(5)signs.
Contractor: VANCOUVER SIGN COMPANY INC Owner: PPR WASHINGTON SQUARE 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
5 ea Sign or Outline Lighting 03/21/2017 $339.20
Specifics:
1 ea 12%State Surcharge- 03/21/2017 $40.70
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $379.90
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 s are set forth in OAR
952-001-0010 through R 952-001-0090. Yo btain a cop the rules or direct questions to OUNC by calling 50 . .1•87 or 1.800.3 44.
Issued By: ' 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 '
f� FOR OFFICE USE ONLY
City of Tigard FYI V, 14 ,, Received .
•
Date/B : ��,pl /L1 I,
.14 il 13125 SW Hall Blvd.,Tigard,OR 973` Plan Review ' 1
Phone: 503.718.2439 Fax: 503.598.1960 >(','1( Related Permit#: 7. / p -e t t
Date/B 0
Inspection Line: 503.639.4175 q0..' 14 Ready Date/By: NNW ® See Page 2 for
T I G A R D Internet: www.tigard-or.gov ,a ,- Notified/Method: Supplemental Information
TYPE OF WO Vii. F film;... V PLAN REVIEW
®New construction 0 Addition/alteratlopir��ent.'' Please check all that apply(submit 2 sets of plans w/items checked):
£ \' ,l' ❑Service or feeder 400 amps or more ❑Building over three stories.
0 Demolition 0 Other: r where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑Floating buildings.
0 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14.000 0 Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family ❑Master builder ❑Other: 0 Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
0 Addition of new motor load of system.
Job#: Job site address:9585 SW Washington Square rd IOOHP or more. ❑"A","E",°°1-2",°`1-3",
City/State/ZIP:Portland,OR 97223 ElSix or more residential units. occupancy.
El Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: 1806 I Project name:PINK El Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: 1S1260000300 Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
Install(5)sign circuits Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
0 PROPERTY OWNER I @ TENANT Services or feeders installation,alteration,and/or relocation
Name:PINK 200 amps or less 100.70 2
Address:9585 SW Washington Square Rd 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Portland,OR 97223 601 amps to 1,000 amps 301.04 2
Phone: ( ) I Fax:( ) 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
@ APPLICANT /1 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Vancouver Sign Group above service or feeder fee,
7.42 2
each branch circuit
Contact name: Chris Brown B.Fee for branch circuits without
s• Address:2600 NE Andresen Rd Ste 50 branch circuit t feeder fee,first
56.18 2
City/State/ZIP:Vancouver,WA 98661 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone: (360)693-4773 Fax: :(360)693-2747 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:CBrown@vansignco.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Vancouver Sign Group Sign or outline lighting 5 67.84 3,3 q, 2
Address:2600 NE Andresen Rd Ste 50
Signal circuit(s)or limited-energy
❑ See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Vancouver,WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:(360)693-4773 Fax:(360)693-2747 Investigation(1 hr min) 90.00/hr
Email:CBrown@vansignco.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 63951 Electrical Lic.: 37-46CLS Suprv.Lic.: 648SIG specifically listed(t/hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: 339.20
Print name: Adam Wallis Date: ❑Plan Review Required(25%of permit fee):
_ State surcharge(12%of permit fee): �A-7r'er---40.'W
.y ,
Authorized signature: TOTAL PERMIT FEE: ft:
�
This permit application expires if a permit is not obtained within 180
Print name: Chris Brown Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I_ABuilding\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(1I/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9522 SW WASHINGTON SQUARE RD H07,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2017-00198
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor