Permit A_2„. CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00855
DEVELOPMENT SERVICES DATE ISSUED: 11/1/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09318 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: Sign lighting for (2) signs on one circuit.
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 HIGHLIGHT SIGN CORP
BY THE MACERICH COMPANY PO BOX 23667
9585 SW WASHINGTON SQUARE RD TIGARD, OR 97281 -3667
TIGARD, OR 97223
Phone: Phone: 503 - 620 -8205
FEES • Reg #: LIC 104599
SUP 3
Description Date Amount
ELE 37-660 - 660CLS
[ELPRMT] ELC Permit 11/1/2005 $53.40
[TAX] 8% State Surcharge 11/1/2005 $4.27 REQUIRED ITEMS AND REPORTS
Total $57.67
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 iss - • •-, or if work is
suspe : - . or • = an 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the • :; • 1 ility Notification Center. Those
rule are set forth in OA •52-0: - 010 . hrough OAR 952 - 001 -0100. You may obtain copies of • - - rules or direct questions to t
50 - 246 -6699 , r 1 -800 -332 :344.
Iss ed By: , I / _ fJ Permittee Sig . ure: ■Norld �^
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 Application
Date received: Off 06 Permit no.: ,,,, - _, roil
,•) , , City of Tigard Project/appl. no.: E date:
City of Tigard Address: 13125 SW Hall i W Et Date issued: MT . h Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 NOV _- q 0O5 Case file no.: Payment type:
V G
Land use approval:
. • TYPE OF PERMIT •
❑ 1 & 2 family dwelling or accessory )1/Commercial /industrial ❑ Multi - family ❑ Tenant improvement
OXNew construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
• JOB SITE INFORMATION
•
Job address: 1 ws L a. . ore., Bldg. no.: Suite no.: or b• Tax map /tax lot/account no.:
Lot: Block: ISubdivision:
Project name: PAFI� VAS I Description and location of work on premises: IM'S+' S( iF
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: Fee Max
Business name: t l 6444' 6 vi �� � 1 ' , � . — Description . Qty. (ea.) Total no. insp
F, � New residential - single or multi- family per
Address: }r dwelling unit. Includes attached garage.
City: 11�rk„ ei I State: ZIP: 2,7 Service included:
1000 sq ft. or less 4
Phone �� , �.'�'� F ax: I E -mail: ' ;ll
CCB no.: fjt Sa I Elec. bus. lic. no: '� T ®e, IA Each additional 500 sq ft. or portion thereof
Limited energy, residential 2
City /metro lic. no.: t ey ,-) C I Limited energy, non- residential 2
/ 0 3I1Z,T�0c Each manufactured home or modular dwelling
Signature of supervising electrician (required) bate Service and/or feeder 2
r 4. t v� License no: ' Services orfeeders – installation,
Sup. elect name (print):,
(Ad r alteration or relocation:
PROPERTY OWNER / 200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only I
Owner installation: The installation is being made on property I on Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
•
Owner's signature: Date: 401 to600amps 2
ENGINEER Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
Phone: Fax: E-mail: of service or feeder fee, first branch circuit: 2
Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service orfeedernot included):
❑ Service over 225 amps- commercial O Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps - rating of 1&2 ❑ Hazardous location Each signor outline lighting l _ 2
family dwellings ❑ Building over 10,000 square feet four or Signal circutt(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2
❑ Building over three stories ❑ Feeders, 400 amps or more *Description:
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lightingplan ❑ Other: Per inspection I I I I
Submit sets of plans with any of the above. Investigation fee A
The above are not applicable to temporary construction service. Other G�
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ iC3 • `�
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at %) $ J
Credit card number: / / within 180 days after it has been State surcharge (8 %) $ , 'I - .94
Expires accepted as complete. TOTAL $ 5�
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440 -4615 (6/00 /COM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
p Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: . Items Cost Total Check Type of Work Involved:
Residential - per unit
1000 sq. ft or less $145.15 4 n Audio and Stereo Systems
Each additional 500 sq ft. or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75 00
Each Manufd Home or Modular ❑ Garage Door Opener
Dwelling Service or Feeder $90.90 2
Services or Feeders n Heating, Ventilation and Air ' onditioning System'
Installation . -r• •r relocation
200 amps or less $80.30 2 El amps to 400 amps $106.85 2 Vacuum Systems'
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 ❑ Other
Over 1000 amps or volts $454 65 2 — '
Reconnect only '.66 85 2
Temporary Services or Feeders TYPE OF WO - INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each sy - m $75.00
200 amps or less $66 85 2 (SEE OAR 9 ;- 260 -260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Typ of Work Involved:
Over 600 amps to 1000 volts,
see "b" above. • Audio and Stereo Systems
Branch Circuits
New, alteration or extension per panel Boiler Controls
a) The fee for branch circuits
with purchase of service or n Clock Systems
feeder fee.
Each branch circuit $6 65 2 Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service n Fire Alarm Installation .
or feeder fee.
First branch circuit $46.85
Each additional branch circuit $6 65 ❑ AC
Miscellaneous ❑ lnstru gestation
(Service or feeder not included)
Each pump or irrigation circle $53.40 ❑
Each sign or outline lighting $53.40 Intercom - d Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75 0' ❑ Landscape Irn'ation Control
Minor Labels (10) $125.to
Each additional inspection over ❑ Medical
the allowable in any of the above
Per inspection $62.50 ❑ Nurse Calls
Per hour $62.50
In Plant $73.75 ❑ Outdoor Landscape Light I g"
Fees: . ❑ Protective Signaling
Enter total of above fees $ n Other
8% State Surcharge $ Number of Syst • s
25% Plan Review Fee
See "Plan Review" section o $ * No licenses are required Licenses are required for other installations
front of application.
Fees:
Total Balance Due $
Enter total of above fees " $
0 Trust Account # 8% State Surcharge $
Total Balance Due $ \
All New Commercial Buildings require 2 sets of plans. \\
i:\dsts \forms \elc- fees.doc 08/30/01
• CF TIGARD •
BUILDING DIVISION PERMIT #: ELC2005- 00855
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/1/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 '
INSPECTION WORKSHEET FOR DATE: 11/3/2005 TIME: 7:06AN1 PAGE: 63
SITE ADDRESS: 09318 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: CHICO'S
DESCRIPTION: Sign lighting for (2) signs on one circuit.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: HIGHLIGHT SIGN CORP PHONE #: 503- 620 -8205
Inspection Request Scheduled For: Date: 11/3/2005 Pour Time:
Code # • - ! - cription C • firm • Contact # Message
199 Electrical final 020202 -01 503 - 620.8205 N
Corrections /Comments /Instructions:
T `A►'S Vao_vs rt C-OV' ils S i ti (s) 11' "' ' S
a 1 �ct.�65 one Lys
PASS ❑ PARTIAL APPROVAL ❑ CANCEL _ ❑ NO ACCESS
❑ FAIL _ CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED
Inspector: ei, N ()6 uC Date: tk ' J' O3 Phone #: (503) 718-1A`go'