Permit Ali .,ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00293
� ' "" DEVELOPMENT SERVICES DATE ISSUED: 5/24/2006
s`' °� I I 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 PARCEL: 1S12600 -00300
SITE ADDRESS: 09633 SW WASHINGTON SQUARE RD FC -4 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 RAMSAY SIGNS
BY THE MACERICH COMPANY 9160 SE 74TH AVE
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97206
TIGARD, OR 97223
Phone: 503 - 639 -8865 Contact #: PRI 777 -4555
FEES
Description Date Amount Reg #: ELE 26- 106CLS
[TAX] 8% State Surcharge 5/24/2006 $4.27 LIC 63422
[ELPRMT] ELC Permit 5/24/2006 $53.40 SUP 493SIG
Total $57.67 REQUIRED ITEMS AND REPORTS
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 OU Cat 503 - 246 -6699 or
1- 800 - 332 -2344. �-
Issued By: 4 -'- Permittee Signature: 000 'j p
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 4.rmit Appli t Ir gi - FOR OFFICE USE ONLY
City of l ig �. • Date/B Received Permit No .
13125 SW Hall Blvd., Tigard, OR 97223 y " / A / l ��
Plan Re �� � � . v �� vte
Phone. 503.639.4171 Fax 503.598.1960 MAY 2 21 �4i Date/By Other Per
Inspection Line: 503.639 4175 ``_ OF -'I I Permit:
' Date Ready /By: A ® See Page 2 for
In www.ci.hgard.or us CITY OF TI - Nohfied/Method • ({ Supplemental Information
TYp PLAN REVIEW
❑ New construction " Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: ['Service over 225 amps, comm'l ['Hazardous location
['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft,
CATEGORY OF CONSTRUCTION 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
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family ❑Master builder 0 Other:
['Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
Job no.: g -3 q 18 L/ Job site address:
9�J 3 DHealth-care facility ['Other: e.� ..r - _
City/State/ZIP: --- �� <A Submit 2 sets of plans with any of the above.
The above are not applicable to temporary construction service.
Suite/bldg./apt. P Project name: i �nr FEE* SCHEDULE
no.: 5 t=C d No 0'rxr:. � 1 ✓ i7L Description I Qty. I Fee. I Total I **
Cross street/directions to job site: ,' ` r � /! U New res single - or multi - family dwelling unit.
- °L4. Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I 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
dwelling, service and/or feeder 90.90 _ 2
- ti L4. ) 5 ce,� Services or feeders installation, alteration, and /or relocation
V U 200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160 60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
Phone: ( ) I Fax: ( ) relocation
200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 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: 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: 2 ri'tYt/. branch circuit
� B Fee for branch circuits
Contact name: a- art, 4 U->ti.< without service or feeder fee, 46.85 2
n each branch circuit
Address:
�1 i , U E 7 4{ Jt& Each add'l branch circuit 6.65 2
City /State /ZIP: C _t�L (9 . q 2 d O 4 Miscellaneous (service or feeder not included)
63) — Fax: : ( ) Pump or irrigation circle 53.40 2
Phone:
S 5 I 9 7 7 0 a Sign or outline lighting l 53.40 5g , lie; 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: tom-- ee...-0 a- .e --P—t,
Address: Each additional inspection over allowable in any of the above
Per inspection 62 50
City/State /ZIP: Investigation per hour (I hr min) 62 50
Phone: ( ) I Fax: ( ) Industrial plant per hour 73.75
1 ELECTRICAL PERMIT FEES*
CCB Lic.:ONO___ Electrical Lic. :(p 10,..t c
i . ,uprv. Lic.:g93c /C Subtotal 5- , q o
Suprv. Electrician signature, required: // / % . 1 Plan review (25% of permit fee) y a 7
s .-- --, ........._
Print name: Date: State surcharge (8% of permit fee)
TOTAL PERMIT FEE -/
. Authorized signature: / +
This permit application expires if a permit is not obtained t4' hi 8ll
'� `� / days after it has been accepted as complete
Print name: j l/ � l g Date. 5 > • Fee methodology set by Tn- County Building Industry Service Board
** Number of inspections per permit allowed
t nit
i \ Building \Pens\ELC- PermitApp doc 12/03 440- 4615T(10/02/COM /WEB