Permit (10) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2017-00416
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/06/2017
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9591 SW WASHINGTON SQUARE RD B10
Project: Victoria's Secret Subdivision: None Lot: None
Project Description: Sign lighting for(2)interior wall 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
Specifics: 2 ea Sign or Outline Lighting 06/06/2017 $135.68
1 ea 12%State Surcharge- 06/06/2017 $16.28
Type of Use: COM Electrical
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 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. ATTENTI.': e -gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-001t hrough OAR •52-00 '09. You may obtain a copy of the rules or direct questions to OUNC by calling I_ -p.1987 or 1.800.332.2344.
Issued :y: �L1�� _ Permittee Signature: -%'lr/,'f/sre
i
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: / /7
LICENSE NO. eoc(0 3-,
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 Applicati I1ECEIVEP FOR OFFICE USE ONLY
City of Tigard DatefB d 6,15111M11Permit#: 4.4,96/7/� / ,
- R 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review v��
• Phone: 503.718.2439 Fax: 503.598.19/4a 6 2017 Related Permit#:
SU Datem
t I G A R D Inspection Line: 503.639.4175 Ready Date/By: Juris: VI See Page 2 for
Internet www ugard or gov Notified/Method
Supplemental Information
❑New construction ❑Addition/.tit M.,' ;1.---- . Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
['Demolition ❑Other:
where the available fault current ❑Marinas and boatyards.
,. exceeds 10.000 amps at 150 volts or ❑Floating buildings.
❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
0 Multi family ❑Master builder ❑Other: ❑Fire pump.
Installation of15O KVA or
❑Emergency system. larger separately derived
El Addition of new motor load of system.
Job#: Job site address9585-SW Washington Sq Rd 100HP or more. ❑"A","E","t 2",°'t-s",
City/State/ZIP:Portland,OR 97233 959/ ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#:B-10 Project name:Victoria's Secret ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more 600 volts nominal
Cross street/directions to job site:
Description ,Qty. Each Total, _ *_,''
New residential single-or multi-family dwelling unit.
Subdivision: 1 Lot#: Includes attached garage.
Tax map/parcel#:
1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
above sq. 75.00 2
Install(2)sign circuits. (with ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy
El See Page 2
` ' � *''-- - Services or feeders installation,alteration,and/or relocation
Name:Victoria's Secret 200 amps or less 100.70 2
Address:9585 SW Washington Sq Rd Unit B-10 201 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
t' : '1: '''':;-r':';:':1':
'' e r i' Branch circuits—new,alteration,or extension,per panel
�'°` �' ,» '` ° ' " A.Fee for branch circuits with
Business name: Vancouver Sign Group above service or feeder fee, 7A2 2
each branch circuit
Contact name: Chris Brown B.Fee for branch circuits without
Address:2600 NE Andresen Rd Ste 50 service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP:Vancouver WA,98661 Each add'1 branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone: (360)693-4773 Fax: : (360)693-2747 Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: `.0i Al ' CO A . Reconnect only 67.84 2
67.84 2
Business name:Vancouver Sign Group Sign or outline lighting 2 67.84 X55444
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(1 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-.. 64,7 s.ecifically listed(i/z hr mm)
', :'L : .,. a...v..,,,,,, `�� m2,:,, t*mac'"L-:,-,,,...t.k ... °' i.'`,"d. ..
Suprv.Electrician signature,required: Subtotal: 5—,67q.
Print name: Adam Wallis Date: 0 Plan Review Required(25%of permit fee): r-----
c State surcharge(12%of permit fee): Cc,.Ac 4"
../(7.1.4
Authorized signature: TOTAL PERMIT FEE: /6/.90
rThis permit application expires if a permit is not obtained within 180
Print name: Chris Brown Date: 4/6z 6( days after it has been accepted as complete.
( Number of inspections allowed per permit.
I:A Building\Permits\EL.C_PermitApp_ELR_ERE,doc Rev 06/17/2015 440-4615T(I l/05/COM/WBB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9591 SW WASHINGTON SQUARE RD B10,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2017-00416
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor