Permit (95) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2019-00095
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/19/2019
T l i. It.f g Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9302 SW WASHINGTON SQUARE RD V05
Project: Casper Subdivision: None Lot: None
Project Description: Connecting(1)internally illuminated wall cabinet to existing electrical.
Contractor: MEYER SIGN CO OF OREGON Owner: PPR WASHINGTON SQUARE LLC
15205 SW 74TH AVE PO BOX 847
TIGARD, OR 97224 CARLSBAD, CA 92018
PHONE: 503-620-8200 PHONE:
FAX: 503-620-7074
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 02/19/2019 $67.84
Specifics: 1 ea 12%State Surcharge- 02/19/2019 $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. Special 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 issuance/or if work is suspended for more the 180
days. ATTENTION: Oregon law requiresAi, to follow the rules adopted by the Oregon Utility N ification C rater. T se rules are��✓✓set f9rth in OAR
952-001-0010 through OA/-001-00•3. Yo2 ay obtain a y of the rule r direct questions to OUNC by ing 503.23 987 or 1. 0.332. 4
r lll���
Issued By: //� Permittee Signature: /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:
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 OFFIC'F l'SE ()NIA.
IL g City of TIgard FEB 9 2019 Date/Received i� � ��, . �- ��
.A�
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 - -'N Ready Date/By: Avis: ® See Page 2 for
'I 1 C;A R 1) Internet: www.tigard-or.gov Notified/Method: Supplemental Information
EOFWOO ..
PLAN REVIEW
0 New construction ;;;;Z: VT..,
Please check all that apply(submit 2 sets of plans w/items checked).
❑Service or feeder 400 amps or more ❑Building over three stories.
0 Demolition 0 Other: where the available fault current ❑Marinas and boatyards.
:.;! CATS+" RY O 1N+� 1- ,`:' exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 1-and 2-family dwelling Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
-
JOB srrEIrwoR1HA'1'IIoN:AIVI3 1 A.LioN W/414 ; ❑Emergency system.
Ve2larger separately derived
s stem.
❑Additioo of orw motor load of ❑<<y
Job#: Job site address: /FTG 1 V A l��. looHP or more.
//��
❑Six or more residential units. occupancy.
City/State/ZIP: g/1.474-6.10) DA- 'O ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bld /apt.#: Pro ect name: n ❑Hazardous locations. 0 Supply voltage for more than
g• p J /g ��
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: :i FEE SC E ,E :" ._
Description I Qty. 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#: Ea.add'l 500 sq.ft.or portion 33.92 1
'. DESCRIPTION"OF` o t[C` :, r- Limited energy,residential 75.00 2
N.dt-LT
Ind' Y A-/1 //iM id 11-11-0 cl/ - (with above sq.ft.)
ILimited energy,multi-family
residential(with above sq.ft.) 75.00 2
�'�f nl 6'7' � ��i SnAa•6 �l�i��r—• R bl Ener ❑ See Pa e 2
r, y enewa a gy g
'.: .'' R Q ' ' N/� Services or feeders installation,alteration,and/or relocation
Name: / lifibiJ1 / V Id 0d ilo- I•/.i . 200 amps or less 100.70 2
Address:
Q• /J&X gig,/7 201 amps to 400 amps 133.56 2
ty �r tD�/ 9�/ 401 ampspto 1,600 amps 200.34 2
City/State/ZIP: './`�,rJ ( y'r � 601 amps to 1,000 amps 301.04 2
Phone:( ) 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
( :14a4
Branch circuits-new,alteration,or extension,per panel
` ` ; r I, "' t �� tr^ w E A.Fee for branch circuits with
Business name: #,X jN t zr , ,,Aerese� above service or feeder fee, 7.42 2
(� each branch circuit
Contact name: / (e°/L / B.Fee for branch circuits without
p
F service or feeder fee,first 56.18 2
Address: /5?,6 j 7 ,-
• branch circuit
City/State/ZIP: 17a)-11 Each add']branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(17/ ) 5 2 - (Qat/ Fax: :( ei/uk Each manufactured or modular 67.84 2
Email: /eknAk-r...c
e ,7„...,,,,...6„,cd (i i/uk dwelling,service and or feeder
Reconnect only 67.84
Pump or irrigation circle 67.84 2
Business name: / i '/ 1. f 6 1 I' U�6Oki Sign or outline lighting i 67.84 2
(,� Signal circuits)orlimited-energy
Address: j5"765 (1- I i panel,alteration,or extension. ❑ See Page 2 2
City/State/ZIP: 6R l lit... 112 - Each additionalpinsection over allowable in any of the above
Additional inspection(1 hr min 66.25/hr
Phone:(IP) 732. - 30s21 Fax:( ) Investigation(1 hr min) 90.00/hr
Email: p/ /xuA,rs t rvlk,L--1 f j v,j 60. Ge AAIndustrial plant(1 hr min) 78.18/hr
lC
Inspections for which no fee is
CCB Lie.: e It/ Electrical Lic.)6.,/96 I .uprv.LK.: ft/ j76. specifically listed('h hr min) 90.00/hr
1 LlE+E" ciAVInt II .Ii S
Suprv.Electrician si atur equ' e� 19° Subtotal:
Print name: Q , x� Date: ❑Plan Review Required(25%of permit fee):
l State surcharge(12/o ofpermit
�' g ° fee):
Authorized signatuZl. TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name- / t� ir/ 0, -/17 I Date: a / Pf ` days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Peimits\ELC_PermitApp ELR_ERE.doo Rev 06/17/20,15 44-4615T( 1/05/COA4/WEB