Permit s � CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00548
DEVELOPMENT SERVICES DATE ISSUED: 8/3/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09410 SW WASHINGTON SQUARE RD K -11 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: Sign lighting. -
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 ES & A SIGN &AWNING
BY THE MACERICH COMPANY 1210 OAK PATCH RD
9585 SW WASHINGTON SQUARE RD EUGENE, OR 97402
TIGARD, OR 97223
Phone: Phone: 541 - 485 -5546
FEES Reg #: LIC 145755
SUP 2
Description Date Amount
ELE 2o - 255CLS
[ELPRMT] ELC Permit 8/3/2005 $53.40
[TAX] 8% State Surcharge 8/3/2005 $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 issuance, or if work is
suspended for more than 180 days. ATTENTION' Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503 - 246 -6699 or 1 -8 332 -2
Issued By: �c:.v Permittee Signature: nei et...7044
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.
+ 1
`Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard L Date/By: ev ' 3 Perm Nok 3- 1(
13125 SW Hall Blvd., Tigard, OR 97223 if 0
Plan Revie /O �aa� '�
Phone 503.639 4171 Fax. 503.598.196( v A„,, ),,,: „ Date/By. Other Permit
Inspection Line: 503.639 4175 D 1.!.. Date Ready/By. 0 See Page 2 for
Internet www.ci.tigard.or.us Notified/Method 776, Supplemental Information
TYPE OF WORK PLAN REVIEW -
❑ New construction ❑ Addition/alteration/replacement Please check all that apply.
['Service over 225 amps, comm'l ['Hazardous location
❑ Demolition 0 Other: 6/9)
['Service over 320 amps - rating ❑Bulldog over 10,000 sq fl.,
CATEGORY OF ONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi - family Master builder ❑Other: ❑Building over three stories ['Feeders, 400 amps or more
['Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lightmg plan RV park
3 � a ,4/ � ,.1 It I I � h � n / / ❑Health -care facility ['Other
Job no.: Job site address: / ! W UV ! r. G{
Q Submit 2 sets of plans with any of the above.
City/State /ZIP: TI A - C F ' 7Z �3 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: L s�,o, FEE* SCHEDULE ` `
`�" -I Description I Qty. I Fee I Total I '"
Cross street/directions to job site: Wo.51(platy, �/ � �,J t I New residential single - or multi- family dwelling unit.
` � J { Includes attached garage.
1,000 sq ft. or less 145 15 ' 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft or portion 33 40 1
Limited energy, residential 75 00 2
Tax map /parcel no.:
Limited energy, non - residential 75 00 2
DESCRIPTION OF WORK Each manufactured or modular
.�j� i a dwelling, service and/or feeder 90 90 2
`m_S I GLII r' lI w� i� r /sli► C-�l- - / I �// 1 0) sly v) • Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
❑ PROPERTY OWNER. - ig TENANT
401 amps to 600 amps 160.60 2
Name: L 0 .� A I 'A WI n IZ i' I �-f,, 601 amps to 1,000 amps 240.60 2
Address:
/
� I t�✓V ( Y ` ( R_ Over 1,000 amps or volts 454 65 2
e 1 '^ 7 � � Reconnect only 66.85 2
City/State /ZIP: / T 9 44 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( )
200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 1.00.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133 75 2
Owner signature: /2 ( t__ ' Date: Branch circuits - new, alteration, or extension, per panel
APPLICANT - I ❑ CONTACT PERSON A Fee for branch circuits with
service or feeder fee, each 6 65 2
Business name: 5 6 i in si_. o v / , 1 ^ C . branch circuit
�� (Q ( tie.„,r / B. Fee for branch ar Contact name: L/ fee without service or feeder fee,
` I each branch circuit 46 85 2
Address: l Uo ( iv� y ;� C5
Each add'l branch circuit 6 65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
(q, )J � 7 � q �� , ) /� �l d�
Pump or irrigation circle 53 40 2
Phone: ...0 7� �! (
0V Fax: : 5) 3 Sign or outline lighting 1 53 40 53. 1Q 2
E -mail: PG i_csQ «SS nS • eDi Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: (5I JY? 4.6. o ��/ / Ca--")
Address: `/ Each additional inspection over allowable in any of the above
Per inspection 62.50
City/ State/ZIP: Investigation per hour (1 hr min) 62.50
Phone: ( ) Fax: I Industnal plant per hour 73 75
ELECTRICAL PERMIT FEES* -
CCB Lic.: /b34'70 Electrical Lis !'I , Suprv. Lic.: 6 &6s/0 Subtotal 110
4
Suprv. Electrician signature, required: a' %,
State surcharge (8% -`. Plan review (25% of permit fee)
�,�p of permit fee) .a
Print name: -jet f 0r) Date: 7 .2.- 0 5
TOTAL PERMIT FEE `52,
Authorized sig i 1 AIM
. _AIM— This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print namir Air �/.14 Si. Date: ` • Fee methodology set by Tn- County Building Industry Service Board
Number of inspections per permit allowed
i \ Building \Pertnits\ELC- PermitApp.doc 12/03 440- 4615T(10/02/COM/WEB
1
CY,OF TIGARD , -
BUILDING DIVISION PERMIT #: ELC2005 -00648
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/3/2005
Phone: (503) 639- 4171pl�
Inspection Requests (24 Hrs.): (503) 639 -4175 °:_..
INSPECTION WORKSHEET FOR DATE: W24/2006 TIME: 7 :08AM PAGE: 69
SITE ADDRESS: 09410 SW WASHINGTON SQUARE RD K -11 CLASS OF WORK:
SUBDIVISION: WASHINGTON,SQUARE LOT #: TYPE OF USE:
PROJECT NAME: LEGO \�
DESCRIPTION: Sign lighting: \.
OWNER: WASHINGTON SQUARE C, PHONE #:
CONTRACTOR: ES & A SIGN & AWNING PHONE #: 541- 485 -5546
Inspection Request Scheduled For: D' te: 8/2412005 Pour Time:
Code # • • - : - - • s - scription Cork # Contact # Message
199 Electrical final 01414541 541 - 486 -6546 N
Corrections /Commen s ns ruc ions:
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•
•
1APASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ___ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
p 1 -9 1 4L 4 LLIL
Inspector: � � � l—,� Date L4 0.5 Phone #: (503) 718 -