Permit _ g
; i�``t` �� -` ELECTRICAL PERMIT
1 1 4 CITY OF TIGARD
PERMIT #: ELC2008 -00043
COMMUNITY DEVELOPMENT DATE ISSUED: 1/23/2008
TIGARD. 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S12600
SITE ADDRESS: 09645 SW WASHINGTON SQUARE RD FC08 ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
PROJECT: GYRO EXPRESS
Project Description: (1) sign lighting.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: 1
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
WASHINGTON SQUARE LLC MULTI -LIGHT SIGN CO.
BY THE MACERICH COMPANY 809 NE LOMBARD ST
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97211
TIGARD, OR 97223
Phone: Contact #: PRI 503 - 281 -3083
FAX 503 - 280 -9624
FEES
Description Date Amount Reg #: ELE 26 -90CLS
IELPRM'li ELC Permit 1/23/2008 $53.40 LIC 64107
[TAXI 12% State Surchar 1/23/2008 $6.40 SUP 343S1G
Total $59.80 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952- 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: ` p Permittee Signature: )" 4
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'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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 Applicatio E CEW E p . . .' l "OR OFF IC.F i1S1. ONLY..
Received p I
City of 'Tigard ._i.A iN 2 3 2008 Date/By: / fr /O p 86 Permit No �? .00
I I I ° 1 3125 SW Hall Blvd., Tigard, OR 9722 Plan Revie
9 ` ` W GARD Other Permit:
Phone: 503.639.4171 Fax: 503.598.1 hTY ®F C DateBy:
G A R D Inspection Line: 503.639.4175 !3UILDiJG DWIS ION Date Ready/By: Loris: l See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
. TYPE OF WO •
_ ' R •
_ ,.PLAN REVIEW
❑ New construction Z Addition /aheratio /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current . ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling E Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
dOB .SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
. . ❑ Addition of new motor load of ❑ "A" "E" "I -2" "I -3
Job no.: Job site address: 9645 SW Washington Square Road IOO or or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: Store Name Change ❑ Service or feeder 600 amps or more.
FEE SCHEDULE -
Cross street/directions to job site: Summit Food Court, Washington Square Mal Description 1 Qty. 1 Fee. 1 Total 1
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION.OF WORK , - •
. (with above sq. ft.)
Limited energy, multi - family 75.00 2
Replace an existing luminated store sign with another luminated sign residential (with above sq. ft.)
(Store Name Change) Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
. :• , ❑ PROPERTY OWNER . ® TENANT . 201 amps to 400 amps 106.85 2
Name: The Jersey Restaurant Group, LLC 401 amps to 600 amps 160.60 2
601 amps to L000 amps 240.60 2
Address: 9645 SW Washington Square Road Over 1,000 amps or volts 454.65 2
City /State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (503)968 -8033 Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel _
Owner signature: A Date: A. Fee for branch circuits with
. ®'APPLICANT. • ❑ CONTACT PERSON • . above service or feeder fee,
each branch circuit 6.65 2
Business name: Gyro Express B. Fee for branch circuits
without service or feeder fee,
Contact name: Abdul -S. Hashimee 46.85 2
first branch circuit
Address: 9645 SW Washington Square Road Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Tigard, OR 97223 Each manufactured or modular
90.90 2
503 968 -8033 Fax: dwelling, service and /or feeder
Phone:
(503) ( ) . Reconnect only 66.85 2
E -mail: Engshukorl @aol.com Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Mu `T , ._ L i / 4- s f c „m co Sig ga circuit(s) or limited -
�, energy panel, alteration, or
Address: O Q A.-c. Lo mRA ?b S'1 extension. Describe: Paget 2
City /State /ZIP: 10 KT 11\ x 1 b Q K. Ot'l Z. 1 1. Each additional inspection over allowable in any of the above
/ Z U� t Per inspection 62.50
Phone: ( �3) ....0 - 3o S 3 Fax: ( ) Investigation per hour ( hr min) 62.50
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 63, ele2
Print name: Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee): (�. ..-/d •
`/ signature: 7 11 `c d g /// � �� r�� D TOTAL PERMIT FEE: . g o
X Print name: A 8 D t_J� This permit application expires if a permit is not obtained within 180
U L . c , i4 ivci } m c a Date: I /Z3' '� days after it has been accepted as complete.
02/25/2008 12:04 5032809624 MULTILIT PAGE 01
4 CITY OF TIGARD
COMMUNITY DEVELOPMENT
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
Electrical Signature Form
IMPORTANT PERMIT NOTICE
MULTI -LIGHT SIGN CO.
809 NE LOMBARD ST
PORTLAND, OR 97211
Permit #: ELC2008 - 00043
Date Issued:
Parcel: 1512600 -00300
Site Address: 09645 SW WASHINGTON SQUARE RD FC08
Subdivision: WASHINGTON SQUARE
Lot:
Jurisdiction: TIG
Zoning: C -
Project Name: GYRO EXPRESS
Description: (1) sign lighting.
Your company has been indicated as the electrical contractor for the permit referenced above, In order for the electrical
permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from
your company sign below and return this Electrical Signature Form prior to the start of the work. Please mail the form to:
City of Tigard, Building Division, 13125 SW Hall Blvd., Tigard, OR 97223, or you may fax the form to: 503.624,3681,
If you have any questions please call 503.718.2433,
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
WASHINGTON SQUARE LLC MULTI -LIGHT SIGN CO.
BY THE MACERICH COMPANY 809 NE LOMBARD ST
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97211
TIGARD, OR 97223
Phone #: Phone it 503 - 281 - 3083
Reg #: ELE 26 -90CLS
LIC 64107
SUP 343S1G
AN 1 IGNATURE 1S REQUIRED ON THIS FORM
X �^
kr 1 -e
Signature of S. •ervi -'ng ectrician Name (rinted) SUP LIC #