Permit (167) CITY OF TIGARD ELECTRICAL PERMIT
I' • COMMUNITY DEVELOPMENT Permit#: ELC2019-00208
T 1( A R f7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/03/2019
Parcel: 1S135BA00102
Jurisdiction: Tigard
Site address: 10140 SW WASHINGTON SQUARE RD
Project: Tefinition Subdivision: OAKBURG Lot: 9
Project Description: Sign lighting
Contractor: JERRY M YOUNGER Owner: PPR SQUARE TOO LLC
840 NE VILLAGE SQUIRE AVE PO BOX 847
GRESHAM, OR 97030 CARLSBAD, CA 92018
PHONE: 503-380-4774
PHONE: 503-253-9406
FAX: 503-253-9407
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 04/02/2019 $67.84
Specifics:
1 ea 12%State Surcharge- 04/02/2019 $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 y• to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001- 90. V. ay obtain a •py of the -•r direct questions to OUNC by calling 503.23 1987 or 1.800.332.2344.
_tl(PC-(7-7(-7 ---1.
Issued ���� �♦ •. Permittee Signature: //L '
By:
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.
1
Electrical Permit ApplicationE .T 1, l,,s�: FOR OFFICE 1 SE ONE
Received �f P
City of Tigard /tv 2 0 2019 Dale13 : /s�i
IN • 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review Related Permit#:
g
• Phone: 503.718.2439 Fax: 503.598. GO- Date/13
Inspection Line: 503.639.4175 g t ? Ready Date/By: forts: 63 See Page 2 for
IlC ARO p BLIiL ,..N Notified/Method: Supplemental information
Internet wwtiv hgazd or gov o �- � C.t
., z ,. ? `.Xr z. '. 7<%'a 4;:;• ii.i,,,.' ,u t .el.a.,;¢'str, i ' u'�',,,, _e:1 Ri , ',&a. a", '': 0.a i @ ,-..`... ,, r 'w' §ltit�..,.,., i.
Please check all that apply(submit 2 sets of plans'wnems checked):
0 New construction 0 Addition/alteration/replacement 0 Service or-feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
. .. >,,
o- it'
A i'` ° s r 'a. exceeds 10,000 amps at 150 volts or 0 Floating buildings.
- t Viµ, „s.,.aq
less to ground,or exceeds 14,000 0 Commercial-use agricultural
I-and 2-family dwelling N Cotnmercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi family ■ Master builder 0 Other: 0 Fire pump. installation of 150 KVA
,- , +... 0 Emergency system. 0 larger separately derived or
" „„ � sl � v,a?.€_ ..a�4. ?,(.,. ;"',az«a, '' ' loadof
, ; r>��=-�� .,,x.,.. � .�.,�. - s stem.
a •. - __ //�� ..{. r O Addition of new motor Y
Job#: Job site address: (..-•(4 0 9uj IA)fwx,�i�rt I.— ?.� ❑100HP or more. 0"A","E", "1-3",
2 Six or more residential units. occupancy
City/State/ZIP: r',�-d t C) �� p ❑Health-care facilities. 0 Recreational vehicle parks.
v ❑Hazardous locations. 0 Supply voltage for more than
Suite/bldg./apt.#: I Project name: r 600 volts nominal
0 Service or feeder 600 amps or more.
Cross street/directions to job site: ay �� z7i2:4 • iir -�_t;„,:raTAV
�
Q-A
. �1 Description Qtv. Each I Total I-
YW CTV A5. 2 , New residential single-or multi-family dwelling unit.
LTV
Subdivision: I Lot#: Includes attached garage.1,000 sq.ft.or less 168.54 4
Tax map/parcel#: _Ea.add'1500 sq.ft.or portion 33.92 1
i` tt s} s t a,- Limited energy,residential 2
'c, , ..,,.. �, e �., , r 75.00
(with above sq.ft.)
u) .e Sr-
I e,�
u �^ Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
,P Renewable Energy 0 See Page 2
�� !' "''.--4044:'''''';',,,4" ) r,, ••,,s,, Services or feeders installation,alteration,and/or relocation
. ,.� ,< ,.. ll 1 100.70 2
Name: kgitr, a�t,l Ct,1�is a ' 200 amps or less
201 amps to 400 amps 133.56 2
Address: Ci b se- cc.“) a�-eui S i i,-' -Q. 401 amps to 600 amps 200.34 2
City/State/ZIP: `?i���-d r (5 R 0 l7"'a,�3 601 amps to 1,000 amps 301.04 2
l Fax_ i ^ Over 1,000 amps or volts 552.26 2
Phone:( �h�) tr G s(s((q ( ) fJ/ 7 Temporary services or feeders installation,alteration,and/or
Email: IA ct 1�twt• 'AAA/C-1(4'R( ( M 4'ce rt'cA 'l/x relocation
200 or less 59.36 1
Owner installation:This installation is being made on property that I own which is not �
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. . 201 amps to 400 amps 125.08 2
Date 401 amps to 599 amps 168.54 2
Owner signature mBranch circuits-new,alteration,.or extension,per panel
H,,;� - r C:4-
; � V a _ -.:�x A xt. A.Fee for branch circuits with
_ above service or feeder fee, 7.42 2
Business name: jY (,(,G
' �Q (/�iC7 �(Z each branch circuit
Contact name: "���a B.1�� B.Fee for branch circuits without
V (� / service or feeder fee,first 56.18 2
Address: g 1,.N s /32.te P,&' r branch circuit
t'C. 2 p Each• ella branch circuit 7.42 2
City/State/ZIP: D/L Gj Miscellaneous(service or feeder not included)
c.. ,/.%/ i Fax::( ) Each manufactured or modular 67.84 2
Phone:(fps) ; C q _ l Nr dwelling,service and/or feeder
Email: C' et� 1 '4:!--_ g Fd C1 (_.1TY1/( _Reconnect only 67.84 2
< Ali fir ��, y ,; . Pump or irrigation circle0 67.84 2
` ' ice: �,� g�, .. ... „ .��x�.
Business name: Sign or outline lighting 67.84 2
3 12,4,..r �[9 U t l - Signal circuit(s)or limited-energy
II See Page
/J 2 2
Address: v(to AJ U t (Lai,fL 1R_ 4_0 a, panel,alteration,or extension.
Each additional inspection over allowable in antOf the above
City/StatelZIP: � C>;d -Additional inspection(1 hr min) 66.25/hr
Phone:( (0.7), `Z/(0 tk/71 Fax:( ) t)/� Investigation(1 hr min) 90.00/hr
(( Industrial plant(1 hr min) 78.181 hr
Email: IJ j Inspections for which no fee is
o • s ificalt listed('fix hr mm 90 00/hr
CCB Lie.: Electrical Lie.: Suprv.Lie.: S' Nt gym,
Sup . lectricia si'V-tu`, eq :_•d: _ Subtotal: e0-7.v.i
Prin e: _®1` r 1 Date: _O Plan Review Required(25%of permit fee):
State;surcharge(12%of permit fee):
TOTAL PERMIT FEE:
Authorized Si!! e:� 2This permit application expires if a permit is not obtained within 180
Print name: ���R 1 CO8days after it has been accepted as complete.
• Number of inspections allowed per permit
I.\Building\Permits\ELC_PermitApp_ELR_ERE.d c Rev�{�f } Date:
06/1712015. 6151(11/0 B
Electrical Permit Application--City of Tigard
Page 2 Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
Fee for all residential systems combined: $75.00 neacriinion Qty. I Each Total I
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance-0040) 552.26 2
❑ Heating,Ventilation and Air Conditioning with OAR tion918-30systems
Solar generation in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
,specificall listed 'A hi:111,T),
Fee for each commercial system: $75.00 Subtotalllowed per permit t. Page l):
(SEE OAR 918-309-0000) ' Number of inspections allowed permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
n Intercom and Paging Systemw_
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
h\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015