Permit CITY OF TIGARD ELECTRICAL PERMIT
14 0 CO MMUNITY DEVELOPMENT Permit #: ELC2010 00538
1 G A R i? 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/05/2010
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Parcel: 1 S135BA00100
Jurisdiction: Tigard
Site address: 10205 SW WASHINGTON SQUARE RD
Subdivision: WASHINGTON SQUARE TOO Lot: 0
Project: Thirsty Lion
Project Description: Sign lighting for (2) signs.
Owner: FEES
PPR SQUARE TOO LLC Quantity Description Date Amount
BY THOMSON PROPERTY TAX SERVICES,
2235 FARADAY AVE STE #0 2 ea Sign or Outline Lighting 10/05/2010 $135.68
PHONE: 1 ea 12% State Surcharge - 10/05/2010 $16.28
Electrical
Contractor:
HANNAH SIGN SYSTEMS LLC
5101 SE 17TH AVE
PORTLAND, OR 97202
PHONE: 503 - 946 -8373
FAX: 503 - 206 -4900
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $151.96
Required Items and Reports (Conditions)
This p it is issued s ••-ct to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Code =nd all other applicable law. All work will
be d a in accordance with -ppro • • •tans. This permit will expire if work is not started within 180 days of issuan - or if work is suspended for more the 180
day . ATTENTION: Oregon . requi -. •u to follow the rules adopted by the Oregon Utility Notification C ter. Those rules are set forth in OAR
952 001 -0010 through OAR 952 '61-0100 You ay obtain a copy of the rules or direct questions to OUNC by calling 503. • 6.6.99 or 1.800.332.2344.
Is ed By: ` d i /" �� Permittee Signature:
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 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.
56 ColCc2 r- 0 _
Electrical Permit Applicati ECE VED roR or„-,,„: ush: ONLY
Received y
City of Tigard Date /B : Iv �� Permit No.: 4 JO —OCJ
a 13125 SW Hall Blvd., Tigard, OR 97223c P 2010 Plan Review
;,
C Phone: 503.639.4171 Fax: 503.598.196V Date /By: Other Permit:
T 1 G A K D Inspection Line: 503.639.4175 Date Ready /By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: 1 Supplemental Information
TYPE th'ti- Matti\ IENGINEERI` ' PLAN REVIEW
® New construction ❑ Addition /alteration /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 ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A", °E", I -2". ' I -3",
Job no.: Job site address: 10205 SW Washington Square Rd I or more. occupancy.
❑ Six ix or 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.
m
Suite/bldg. /apt. no.: Project nae; TM ion Y ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Greenbufg \ Description 1 Qy. 1 Fee. 1 Total 1 •
v.+
• , \\ New residential single- or multi - family dwelling unit.
\` �`�
Subdivision: L ot no.: Includes attached garage.
`' 1,000 sq. ft. or less 168.54 4
�� }� R �`�
i `^' 4 / Ea. add'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: �`' pt Q, 01 b ; Limited energy, residential 67.84 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi -family
Channel letters on a raceway residential (with above sq. 6.) 67.84 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY O R ® TENANT 201 amps to 400 amps 133.56 2
Name: Concept Entertainment Group 40) amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: 839 SE Belmont St Over 1,000 amps or volts 552.26 2
City /State/ZIP: Portland, OR 97214 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)222 -4174 Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that 1 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
® APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 742 2
Business name: Hannah Sign Systems, LLC. B. Fee for branch circuits
Contact name: Dave Lanphere without service or feeder fee,
p first branch circuit 56.18 2
Address: 5101 SE 17th Ave Each add'I branch circuit 7.42 _ 2
Miscellaneous (service or feeder not included) _
A City /State/ZIP: Portland, OR 97202 Each manufactured or modular 67.84 2
dwelling, service and/or feeder
4
Phone: (503) 946.8373 Fax: (503) 206.4900 Reconnect only 67.84 2
E -mail: davel @hannahsignsystems.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting
I.- 67.84 I7 5, L 4 2
Business name: Hannah Sign Systems, LLC. Signal circuit(s) or limited -
energy panel, alteration, or
Address: 5101 SE 17th Ave extension. Describe: Page 2 2
City /State/ZIP: Portland, OR 97202 Each additional inspection over allowable in any of the above
Per inspection 66.25
Phone: (503) 946.8373 Fax: (503) 206.4900 Investigation per hour (1 hr min) 66.25
CCB Lic.: 188772 Electrical Lic.: CLS 11, Suprv. Lic.: 676 SIG t Industrial plant per hour 78.18
1 �l 10 it �1 ELECTRICAL PERMIT FEES
Suprv. Electrician s i g� � e, re ti Subtotal: 35, /J
—
Print name: David Demuth . /8/10 Plan review (25 % of permit fee):
/ State surcharge (12% of permit fee): �I.
Authorized signature: j am/ TOTAL PERMIT FEE: / / r 96
vvv ��` This permit application expires if a permit is not twined within 180
Print name: Dave Lanphere Date: 9/8/10 days after it has been accepted as co plete.
`• Number of inspections allowed per permit.
I:\ Building \Pennits \ELC- PermitApp.doc 10 /01 /09 440- 4615T(III05 /COM/WEB