Permit CITY OF TI(�AD
ELECTRICAL PERMIT
< COMMUNITY DEVELOPMENT Permit-#: ELC2010 00329
•
TI
13125 SW Hall Blvd., Tigard OR'97223 503:639.4171 Date Issued: 07 /01/2010
G'ARD
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9412 SW WASHINGTON SQUARE RD K10
Subdivision: Lot: 0
Project: Crazy 8
Project Description: Sign lighting.
Owner: FEES
PPR WASHINGTON SQUARE LLC Quantity Description Date Amount
2235 FARADAY AVE STE #O
CARLSBAD, CA 92008 1 ea Sign or Outline Lighting 07/01/2010 $67.84
1 ea 12% State Surcharge - 07/01/2010 $8.14
PHONE: Electrical
Contractor:
VANCOUVER SIGN COMPANY INC
2600 NE ANDERSEN RD #50
VANCOUVER, WA 98661
PHONE: 360- 693 -4773
FAX: 360- 693 -2747
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 OA; 952- 001 -0100. You may obtain a c• • • - .'rect questions to OUNC by calling 503.246.•699 or 1.x00.332. 44.
Issued B i ��� Permittee Signature: 1
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.
CaII 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 Application /' FOR oF US Y „ w � w
� �" � `�
City of Tigard V Received
Date /B Permit No.:
1 * ¢ " °' ° 13125 SW 1 Hall Blvd., Tigard, OR `97223 ` � Plan Review / I T, (-i L� C(� �3 (
i $
p l Ph one: 503.639.4171 Fax: 503.598.1960 `U� , Date /B : Other Permit: i g ♦ i ,. X00 4
T Inspection Line: 503.639.4175 7 G � N. � � .a Ready /By: ® See Page 2for
X. ,x ; m Internet: www u aigard -or goy CO' QS `` ,t , ,lpybtrtt e d /Meth Supplemental Information
t S
. ,; TYPE : OF WORK - � _ f
, � = PLAN REVIEW ' '-
El New construction ❑ Addition/alteration /r lacement 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.
; a ' exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
' ,> CATEGORY , OF CONSTRUCTION ,., " - < _ ,
less to ground., or exceeds 14.000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ' Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
a ❑Emergency system. larger separately derived system.
?. . "
JOB SITE :'INFORMATION Alm LOCATION P " t ;,g ❑ Addition of new motor load of ❑ "A ", ` E ", "I 2 ", `1 -3 ",
Job no.: Job site address: 9 y _ $l,J (,J- -h.ir� torl, 100 or more. occupancy.
( 0 - ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: 1 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous, locations. 600 volts nominal.
Suite /bldg. /apt. no.: 1,6, o Project name: G co,z u $ ❑ Service or feeder 600 amps or more.
` ; a FEE SCHEDULE `. "''_
Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 *
q V \ New residential single- or multi - family dwelling unit.
�t1�5h,1 A y(111, i t.t e - Mai ) 0 1 Includes attached garage.
Subdivision: J j � Lot no.: / I,000.sq. ft. or Tess 168.54 4
Ea. ,add'1'500 sq. ft. or portion 33.92 1
Tax map /parcel no Lt mited energy, id res ential
. `r , DE$CRIP�TION�,OF' WORD( , - m : , (with above sq. ft.)
67.84 2
Limited energy, multi- family
I r esidential ( with above sq. ft.) 67.84 2
111 uilVt,l r1pt,-l'8�,� , 51 q IR, -
J Services or feeders installation, alteration, and/or relocation
200 amps`or less 100.70 2
% " II °PRO PERTY. OWNER . My I ,;� . V1 * TENANT . ,� 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
�i 1'C4•Z 601 amps to 1,000 amps 301.04 2
Address: /GU Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
R yl Z 51 /3 vl toy 6 RI, � /� - 1 C� p
City /State /ZIP: ZZ v r.
( i Ct aR q _ 3 relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
P
O' 4P – _- ' , - K. CONTACR,PERSON .. ;• above service or feeder fee, 7 42 2
each branch circuit
Businessname: V'zut,GU 6t. U1✓ (' $ I Gt 0 B. Fee for branch circuits
Contact name: d t o � rn �J without branch or feeder fee,
g t ; 5 first branch circuit 56.18 2
Address: Z 4' Each'add'I branch circuit 7.42 2
ddress:
(0 0 A) e- A rl.dxa5 e r1` RA, SO Miscellaneous (service or feeder not included)
City /State /ZIP: v 0 ULde,'C 1)1/4),, t 1, ( t Each manufactured or modular 67 84 2
t�Q! dwelling, service and/or feeder
Phone: (; 3( o 0) ( 3 L(773 Fax:: (Z/ ( • LA Reconnect only 67.84 2_
Email f lc ,`401(L�,(7t GO Pump or irrigation circle . 67.84 2
; .iC ONTRACTOR< _ °, . ::`. Sign lighting 7
,
�_• �_. � . _ -a Sl nor outlineli httn ()) 67.84 � 2
Business name: C Signal circuit(s) or limited-
v&rtjC O L&\J � J1 energy panel, alteration, or
Address:
zoo NE Ai tis eseet. Rol. #5U extension. Describe: Page 2 2
City /State /ZIP: VeLYtco uv ex' IAA iq g 6e I Each additional inspection over allowable in any of the above
Per inspection 66.25
Ph : (36,0)05 1/77 y Z Fax: (34,0) ( 3"Z7 Investigation per hour (1 hr min) 66.25
G �� 5 1 v ctr
CB Lic.: - u Li'
p �13�t4- rv. c. Industrial plant per hour 78.18
6. � ical Lic.: 37 - y�G -
'. ° 'max iMeTRICAL; PERMIT »}FEES ' _. ' ° `' k '
Suprv. Electrician signature, required: 6�, / Subtotal: 6-7 ��
Print nam L S Date: Plan review (25% of permit fee): 1
C/ State surcharge (12% of permit. fee): 'Ill
Authorized signature: TOTAL PERMIT FEE: ---75-, qk
Print name: This permit application expires if a permit is not obtained within 180
P� Stogy Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
C \Building \Permits \ELC- PermitApp.doc 10/01/09 4411- 4615T(I1/05/COM /WEB