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Permit CITY OF TIGARD ELECTRICAL PERMIT 71 COMMUNITY DEVELOPMENT Permit #: ELC2010 -00428 Date Issued: 08/19/2010 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S1260000300 Jurisdiction: TIGARD Site address: 9651 SW WASHINGTON SQUARE RD FC10 Subdivision: WASHINGTON SQUARE MALL Lot: 0 Project: Taco Time Project Description: (1) 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 08/19/2010 $67.84 PHONE: 1 ea 12% State Surcharge - 08/19/2010 $8.14 Electrical Contractor: SECURITY SIGNS INC 2424 SE HOLGATE BLVD PORTLAND, OR 97202 PHONE: 503 - 546 -7114 FAX: 503 - 230 -1861 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. At 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 9 2 - 00. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: ,, ' / -- Permittee Signature: 7 Pz-r" e6 o j/\ / OWNER INSTALLATION ONLY v 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 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 -, . , , - - 1 • 1 ) 1 : t ,1.1• I (. 7f, &i.: 0 \ 1.1 City of Tigard Date/By. x//9/61 PermitNc.a C.20 /O pa yip • 13125 S W Ball Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Pax: 503,5981960 AUG 18 2010 Date/By: ate' Permit: T 1, _ r; a Inspection Line: 503.639.4175 Date Ready/By: krti B S P age 2 fo Internet: www.tigard or.gov Notified/Method; C1 Supplemental Information TI'1+L . r ,�' ; '` : ' : „ ";i: ° " " " � ; , �Rt�'(�,''�R ym:,;:�:;'!. •:..j. :,._'..:; ^::!:.: ❑ New construction ® Addition/alteration/replacement PNaw °heck all that apply (zubmft 2 setts of plans w /items checked below): ['Service ar feeder 400 amps or mote D Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. � at buildings. exceeds 10, t 130 votes or D Floating bu ' Ie66 to ground, or emueede 14,000 D Commcrcia] -ese agricultma] ❑ 1- and 2- family dwelling ►�: Commercial/industrial 0 Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: D Fire pump. ❑ installation of 75 iCVA or .. ., ... ys n ..,. ;: . : S)Pl!E;•: 1 . ... MA.'1OD r 1o4of ❑ Addition a sew mo separately derived s • . D « « X t « _ Job no.: Job site address: /„�j/ .1 /./ /- l i� O1 Occu vvrrvv(( < _L(/ ( , ( �1 L/ © six or more r BSident an 1� Recreational vehicle pain. City/State/ZIP: D Health -oa<'e facilities. 0 Supply voltage: for more than - In liaaardout locations. 600 volts nominal. Suite/bIdgiagt no.: Project name: I 1 a 1 � ,,,, 4 ❑ service or Rader 600 a more. Cross street/directions to job site: '�t C rt -45 Cam, ^asap tion ::' :` ' : '• : °.;:. , a3Cl 1 Ui3F.B.. ..; .. r:: ; .:. . ne tOM re �at �T New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: f Lot no„ 1,000 sq. R• arias 168.54 4 Tax map/parcel no.: Ea. add'l 500 sq. ft. or portion 33,92 1 Limited energy. dal 6784 2 ' .... ........ a ..'.. ......'. QhT;:QF,`:,WO1$ '' ., " ' ?' 1;• i;; I I . � ... ���,�. (wife abov �� . Limi ted eneTSy, mul e- Y 67.84 2 eJ , 1..n .. t 1 z i3 ) residential (with above sq. R ) 1 / Services or feeders installatio alteration, and/or relocation *Mount Only* lJ 200 amps or less 100.70 2 T9 �0t�BOPER i' !�'.;.; to 400 amps 133.56 2 , Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) f Fax: ( ) 200 amps or Less 59.36 V 1 Owner installation: 'Phis installation is being made on property that I own which is not 201 amps rn 440 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: hate: A. Pee for branch circuits with - :7" . f ear si APPIdC�,1y'�' : : i; .. ` : ` . t:` lT C2' t3Al `;' 7.4z . ' '.... Ye service . or each branch cf 2 Business name: Security Signs B. Pee for branch circuits within service or feeder fee, first 56.18 2 Contact name: Melissa Hayden branch circuit Each add'l branch circuit 7.42 2 Address: 2424 SE Holgate Blvd _ - _ Miscefaneons (service or feeder not included) City /State/ZIP: Portland, OR 97202 �" tt or modular 67.84 2 dwelling, service and/or feeder Phone: (503) 346.7114 f Fax: : (503) 230.1861 Reconnect anlY . 67.84 2 L -mail: McUesn ®Sectn-i i Pump or irrigation circle 67.84 2 Sign or outline lighting ` 67.84 • . � '..: 1 ' signal ClKttlt(8) or limited- enCrgy . Business name: Security Signs Pend. alteration, or extension. Pg 1s 2. 2 Each additional inspection over allowable in any of the above Address: 2424 SE Holgate Blvd Additional inspection (1 hr min) 6625/ hr City /State/ZIP; Portland, OR 97202 Inverstigation (1 hr min) 66.25/ hr Industrial plant (1 hr min) 78.18/ hr ylione: (503) 546.7114 Fax: (503) 230.1861 Inspections for which no fee is 90.DO/ ou W specciftcativ listed (1 hr min) CCB Lie,: 122809 1 Electrical Lie.: 26360CLS Suprv. Lic.: 383STO �;� d „ . Suprv. Electrician signature, required: 1. 1 .. .....2 . = Subtotal: 6 7,, P Y Plan review (25% of permit fee); Print name: Marc Linguist Date: State surcharge (12% of permit fee): (Pr/ y Authorized signature: , TOTAL PERMIT FEE: 73 9 - This permit application expires if Si permit is not obtained within 189 Print name: Melissa Hay n Date: days aver it has been accepted as complete. Number of inspections allowed per pent. L• eBBildin6PermitslEt .C- RKmiIAyp.doc 1001109 440- 4615T(11/onICOM/wEa ZO z1:V1 OZOZ 81 End Z98TO�Z2OS:x 3U1 sable 64t.ln3as