Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00286
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/26/2011
Parcel: 151260000300
Jurisdiction: TIGARD
Site address: 9591 SW WASHINGTON SQUARE RD B10
Project: Victoria's Secret Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project Description: Sign lighting for (2) signs.
Contractor: MEYER SIGN CO OF OREGON Owner: PPR WASHINGTON SQUARE LLC
15205 SW 74TH AVE 2235 FARADAY AVE STE #0
TIGARD, OR 97224 CARLSBAD, CA 92008
PHONE: 503 - 620 -8200 PHONE:
FAX: 503 - 620 -7074
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 05/26/2011 $135.68
Specifics:
1 ea 12% State Surcharge - 05/26/2011 $16.28
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $151.96
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 enter. T se rules are set forth in OAR
952- 001 -0010 through OAR 952 - 001 -0090. You my obtain a copy o - ru es o direct questions to OUNC by calling 503. .19 or 1. .33 .2344.
i
Issued By: 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 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.
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard _ C� \� Date /Bv: Received
7�j, ,y/ •
y� i<t► �1
II
° 13125 SW Hall Blvd.. Tigard. OR 9 � 6
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. 2 : ' - Phone: 503.718.2439 Fax: 503.598.1960 4 .,;,...k 0 Other Permit: EFABIEMIIM
TIGARD ,t Inspection Line: 503.639.4175 `� • �G```�0° Date Ready /By: ions: El See Page 2 for
Internet: www.tigard- or.gov ,� 0' <llv Notified /Method: CO Supplemental Information
1, rl Y
TYPE OF WOR .1 v PLAN REVIEW
❑ New construction Addition /alterationneplacement 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 El 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
JOB SITE INFORMATI N AND LOCATION ❑ mergon system. larger separately
derived 1-". system
❑ Addition of new motor load of ❑ "A ", "E ". "I -2 ". "I -3 ".
I00HI' or more. occupancy.
Job no.: Job site address �4- S( 1 � ❑ R ecreational vehicle parks.
�'� � ❑Six or more residential units. arks. I
City/State/ZIP: /� 7 El Health-care facilities. ID Supply voltage for more than ,IA SQ QCQ �� !/L 0 of ❑ Hazardous locations 600 volts nominal.
Suite /bldg. /apt. no.: bio Project ►, I x� [— ,' � C PGrr+ Ell Service or feeder 600 amps or more.
A l ��' t 7 FEE SCHEDULE
Cross street/directions to job site: /A ��j Description I Qlv. I Fee. I Total I *
�(V//''�� New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less . 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 I
Tax map /parcel no.:
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy. multi - family
C Or CAM /rAi S (t - kkliV3 f 6 -) s'^� N�
75.00 and/or ✓ residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
X PROPEWTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: �/� �, ' n / � � �.
&r 't:�T �\ 1Gf(�( \[ - I c. ( / .Q (. 601 amps to 1,000 amps 301.04 2
Address: (mil it, l f l S 'V) # .9'6.° I Over 1.000 amps or volts 552.26 0
W J Temporary services or feeders installation, alteration, and /or
City /State /ZIP: x 4u .e . e . L Qiptko relocation
Phone: (s -) --' _ Fax: ( 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
401 amps to 599 amps 168.54 2
intended for sale. lease. - enL or exchange, according to ORS 447.449, 670, and 701.
rr Branch circuits - new, alteration, or extension, per panel
Owner signature: I D. A. Fee for branch circuits with
APPLICANT ❑ CONTACT PERSON above service or feeder fee 7.42 2
J` each branch circuit
Business name: % B. Fee for branch circuits rvi(hrnu ,
service or feeder fee, first •
•
Contact name: C e l j z . Cackikl branch circuit 56.18 2
Each add'I branch circuit 7.42 2
Address: ( 5 0I , ' 5u) 9 cA 4-L. t h \o -t_ Miscellaneous (service or feeder not included)
City /State /ZiP: <f'�' C CY q3 7:1A4 Each manufactured or modular 67 84 2
�� ` dwelling, service and/or feeder
Phone) '�a 4 g7,(30 Fax:: (6;52) C213 . - q t \ Reconnect only 67.84 2
Pump or irrigation circle 67.84
E - mail: Sc. (t,- f IAA_ f/- S � Co
( C'(` � Sign or outline lighting 6 l t �t j "'4, g 2
C Signal circuit(s) or limited- energy
Business name: (
56,out / panel, alteration, or extension. Page 2 2
f .. Each additional inspection over allowable in any of the above
Address: Additional inspection (1 hr min) 66.25/ hr
investigation (I hr min) 66.25/ hr
City/State /ZIP: Industrial plant (I hr min) 78.18/ hr
Phone: ( ) Fax: ( ) Inspections for which no fee is
90.00/ hr
specifically listed ('h hr min)
CCB Lic.: C_tO ( Electrical Lic.: 20 G. (Spry. Lic.: [`/�C t 6 ELECTRICAL PERMIT FEES
• Jl Subtotal: (.9( Suprv. Electrician signature, required: - _'_^
Plan review (25% of permit fee):
Print name: �j , �, (� s � Illate: C - 2 �.' ( State surcharge (I2% of permit fee): P(4 r
- 1' W `C TOTAL PERMIT FEE: `57 61 (
Authorized signature: �, This permit application expires if a permit is not obtained within180
r�
k
��` days after it has been accepted as complete.
Print name: Ca <,c CA, Oate:c . Z (,— 1 k * Number of inspections allowed per permit.
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