Permit (99) „14 CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2017-00646
[CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/30/2017
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9632 SW WASHINGTON SQUARE RD G09
Project: Bath&Body Works Subdivision: None Lot: None
Project Description: Sign lighting for(7)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
7 ea Sign or Outline Lighting 08/30/2017 $474.88
Specifics:
1 ea 12%State Surcharge- 08/30/2017 $56.99
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $531.87
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 follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 9 1-0090. You ml btain a cop of the rules direct questions to OUNC by calling 503 . 987 or 1`800.33 44.
Issued By: f� �� 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
City of Tigard Received
!IN 'I. Date/B _ lv . i
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: Juris: ® See Page 2 for
T I G A R D Internet: www.tigard-or.gov Notified/Method: Supplemental Information
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❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑ Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current 0 Marinas and boatyards.
f ` h sy¢+ s exceeds 10.000 amps at 150 volts or 0 Floating buildings.
El 1-and 2-family dwelling ®Commercial/industrial CI Accessory building
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
❑¢ �,. A4,r,.ci y... r a,.:{.sa..,4 .�v s „z users '' 3_.�...., �.. t.. .#sv. ..w.3,.. _ ,:,,:.. t,uuxN .:L��'.,.}>,
❑EAmdoncof system.
otor load of larger s.e aratel
derived
Job#: Job site address:$5$SSW Washington Sq Rd 100HP or more. ❑"A","E",°'1-2",°°t-3",
City/State/ZIP:Portland,OR 97223 476'3), ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#:G-09 Project name:Bath and Body Works ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:
Description Qty. �.EachTotal �*
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#:
Ea.add'l 500 sq.ft.or portion 33.92 1
(with above sq.ft.) 75.00 2
Install(7)sign circuits. Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
x Renewable Energy 0 See Page 2
. �s • ,.r,=.-... ..4 ,_' .., ,m4., .. .., • Services or feeders installation,alteration,and/or relocation
Name:Bath and Body Works 200 amps or less 100.70 2
Address:9585 SW Washington Sq 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: (360)693-4773 Fax: (360)693-2747 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
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
Address:2600 NE Andresen Rd Ste 50service or feeder fee,first 56.18 2
branch circuit
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
Email: Cbrown@vansignco.com dwelling,service and/or feeder
Reconnect only 67.84 2
1, ` k; ws � ,.u' Pump or irrigation circle 67.84 2
Business name: Vancouver Sign Group Sign or outline lighting 67.84 2
Address:2600 NE Andresen Rd Ste 50 Signal circuits)or limited-energy ❑ See Page 2 2
panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP:Vancouver,WA 98661 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 whlch no fee is 90.00/hr
CCB Lic.: 63951 Electrical } 3 46€ S-.-__ Suprv.Lic.: 648SIG listed(t/z hr min)
Suprv.Electrician signature,required: /' Subtotal: Zlo{
Print name: Adam Wallis Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): S 6 ,ct
Authorized signature: TOTAL PERMIT FEE: t } '
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. S 3 6
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