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Permit (83) CITY OF TIGARD ELECTRICAL PERMIT 4Permit#: ELC2019-00052 COMMUNITY DEVELOPMENT Date Issued: 02/07/2019 TI C A R.t-r 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S1260000300 Jurisdiction: Tigard Site address: 9339 SW WASHINGTON SQUARE RD T11 Project: Amerisleep Subdivision: None Lot: None Project Description: Sign lighting for exterior channel letter set for TI. Contractor: Owner: PPR WASHINGTON SQUARE LLC PO BOX 847 CARLSBAD, CA 92018 PHONE: PHONE: FAX: FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 02/07/2019 $67.84 Specifics: 1 ea 12%State Surcharge- 02/07/2019 $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 set forth in OAR 952-001-0010 through OAR/.2-001-' •0. You -y obtain a••py of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344, frvi Issued By: Iii 1.1/dd.eid e . 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 Date FOR OFFICE USE ONLY City of Tigard JAN 2 i 9 Received A ��` y' t.- lig '� 13125 SW Hall Blvd.,Tigard,OR 973 Review Plan Review . 0�,�/ ` G Phone: 503.639.4171 Fax: 503.5yq�i tI ''' DateB : rr.; /I. �� Ltl� .ad�ti :'114,-:t:,...� DateRead/B 0See Page 2for T I G ARD Inspection Line: 503.639.4175 �� Ready/By: Supplemental Information Internet: www.tigard-or.gov Notified/Method: PP Please check all that apply(submit 2 sets of plans w/items checked below). 0 New construction 0 Addition/alteration/replacement ❑Service or feeder 400 amps or more ❑Building over three stories. O Demolition 0 Other: where the available fault current ❑Marinas and boatyards. exceeds 10,000 amps at 150 volts or ❑Floating buildings. . - . - W • - -" less to ground,or exceeds 14,000 ❑Commercial-use agricultural O 1-and 2-family dwelling ❑ Commercial/industrial 0 Accessory building amps for all other installations. buildings. Multi-family 0 Master builder 0 Other ❑ 0 EFire merpump y system. Installation eparat ly derived system. i t i '`1 } ''_.. !i ❑Addition of new motor load of ❑"A","E","1-2","1-3", 2q 100HP or more. occupancy. Job no.: Job site address: 9'3 J I az (..) lO S\` `j y\ 0 Six or more residential units. 0 Recreational vehicle parks. 9.--t-2.7_ `"'"-- Q '"-- r(3* ❑Health-care facilities. El Supply voltage for more than City/State/ZIP. (cry.d op, 1"�'��3 600 volts nominal. ❑Hazardous locations Suite/bldg./apt.no.: Qy�.it` l Project name: AYye,t(\S�C ❑Service or feeder 600 amps or more. Cross street/directions to job site: ‘j\.6 `F?- 1 vYV\ WI, Description ..Qty 3 Fee i°tat � New residential single-or multi-family dwelling unit. l's\'�%cO'1\ ,Y'- `._.X.3-`\` Includes attached garage. Subdivision: 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 Limited (with above sq.multi-family energy,multi 75.00 2 j`p\q • PJV'„\p if'`\©, l,� Y\' residential(with above sq.ft.) L{ `V '��e�C��`"`�� Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: .,i y('\t,l/"\6t `ttQ ,\A C Q, 601 amps to 1,000 amps 301.04 2 Address:g3Sq 'SL,.. Ll. `��� Vof f `� Over 1,000 amps or volts 552.26 2 C1Temporary services or feeders installation,alteration,and/or City/State/ZIP:1-1T,c(�) 0 CIN q-‘7_12.7-0relocation JJ Phone:( ) Fax: 200 amps or less 59.36 1 ( ) 201 amps to 400 amps 125.08 2 Owner installation:This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. Branch circuits new,alteration,or extension,per panel Owner signature: Date: A.Fee for branch circuits with t t. i above service or feeder fee, 7'42 2 each branch circuit Business name: r,C,IC- E(eci1L ‘ars LLC-, B.Fee for branch circuits without service or feeder fee,first 56.18 2 Contact name: C ,vp„xabranch circuit Each add'l branch circuit 7.42 2 Address: 1RW �E 1- ]`(1 �\9 918- Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 2 City/State/ZIP: C ' C)9..., q—\Q 1,� dwelling,service and/or feeder V , Fax: Reconnect only 67.84 2 Phone:(�03 )Z�?', .�. ( Pump or irrigation circle 67.84 2 E-mail: Ser ks t,.. s �"�� Y'tACkVII(,,[-'UeC�T�C t td '"a•Cory, Sign or outline lighting 4- 67.84 2 :$ 1 Q _ Signal circuit(s)or limited-energy s r �� e �.lC.l_kl-,c c . C SS L,V,v panel,additional n,l i sppension. Page 2 2 Business name: t, � Each additional ins ection over allowable in any of the above Address: 114 00 Se TO I_S\f.:S Q Additional inspection(1 hr min) 66.25/hr Investigation(1 hr min) 66.25/hr City/State/ZIP: C_0.N0nc q' (�1© Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is Phone:(60-?)5? Fax:( ) 90 00/hr ) Z�O�- s.ecificall listed 'A hr min) CCB Lie.:I Cd3B I Electrical Lic.: - �� Suprv.Lie.:�H'z -,..,,-,, ,,1-,,,.-,:,..„--„,.,,,i.,,,_-..,!. .,,:, h Subtotal: Suprv.Electrician signature,required: Plan review(25%of permit fee): Print name: e\yg.,y\ (1\ x-iy Date: 11'3, 12--C1Ck State surcharge(12%of permit fee). -- TOTAL PERMIT FEE: Authorized signature: � This permit application expires if a permit is not obtained within 180 1 \ (� days it hs ccetas complete. Print name: s h a Date: * Number of inspectionsafter alloawedbeen aper permpit.ed I:\Building\Permits\ELC-PermitApp. oc `7/01/10 440-4615T(11/05/COM/WEB City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9339 SW WASHINGTON SQUARE RD T11 , TIGARD, OR, 97223 Record Type: Record ID: Commercial - Electrical ELC2019-00052 Inspection Type: Inspector: 199 Electrical final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor