Permit �• / `w CITY OF TIGARD , ELECTRICAL PERMIT
r PERMIT #: ELC2005 -00351
DEVELOPMENT SERVICES DATE ISSUED: 5/25/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09642 SW WASHINGTON SQUARE RD G -12 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 435SIG
Description Date Amount ELE 20 255CLS
[ELPRMT] ELC Permit 5/25/2005 $53.40
[TAX] 8% State Surcharge 5/25/2005 $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: 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'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 FOR OFFICE USE ONLY
City of Tigard rc� �, rr. fi c� / , Received 5 a 6e) Permit No ( e. DS 00 351
13125 SW Hall Blvd., Tigard, OR 97223 IZ - - `- r . _, Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 41,1 l � `� Date/By. Other Permit
Inspection Line: 503.639.4175 ;may y r.' Date Ready/By Jugs - IZI See Page 2 for
Internet: www ci.tigard.or.us C G _ - � Notified/Method �J LSD Supplemental Information
TYPE {aF(OK _ PLAN REVIEW
y P lease check all that apply:
❑ New construction ❑ A�LtZi�t ®�/r pp y
❑ Demolition XJ Other: V 19 ;'7 ❑Service over 225 amps, comm'l Hazardous location
L ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft ,
CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling 01 Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder ❑Other: ❑Building over three stories OFeeders, 400 amps or more
['Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ['Egress/lighting plan RV park
„ l �VGW ji // s1 �„ �, Jy o s � ❑Health -care facility ['Other:
Job no.: a7o� I Job site address: 955 5VU I(. J( /
J Submit 2 sets of plans with any of the above.
City/State/ZIP: / / Ai Yom. lh�� The above are not applicable to temporary construction service.
Suite/bldg. /apt no.: / Z I Project name: r' -e, FEE" SCHEDULE ..
Description I Qty Fee. Total
Cross street/directions to job site: j i ) fl ti/9) �h CSi New residential single- or multi - family dwelling unit.
Includes attached garage.
/ n ne r , c / - 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
!
//(9•5 / % J/ A `C ; 6 f _ 4 / p/ 5/5 4 . dwelling, service and/or feeder 90.90 2
` / VGtit Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
El PROPERTY OWNER I ( 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: ily-g-5 1 h y � ( u J ,_, L46 f 9 Over 1,000 a mps or volts 454 65 2
�� I ..26.7)3 � `?' Reconnect ry o nly I 66.85 I 2
City/State /ZIP: � ` `r Temporary services or feeders installation, alteration, and /or
Phone: ( ) I F ax: ( ) relocation
200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps L00.30 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: /4 ( / A._---- Date: Branch circuits — new, alteration, or extension, per panel
APPLICANT - - 1 ❑ 'CONTACT PERSON ' A Fee for branch circuits with
service or feeder fee, each 6 65 2
Business name: es*4 C_,5"), h fr- / I n % 6 • branch circuit
B Fee for branch circuits
Contact name: (J 5' � / without service or feeder fee, 46.85 2
/do,/ 1 1 each branch circuit
Address:
/.3 F" ��/�� T Each add'I branch circuit 6.65 2
City/State /ZIP: p , toe_ 17220 Miscellaneous (service or feeder not included)
Phone: (5 5L1� /0p I ( )L A11 Pump or irrigation circle 53.40 2
Fax:: l/
Sign or outline lighting t 53 40 1 o 2
E -mail: u057e....6 c eS _ _ (04,x- , Cry) Signal circuit(s) or limited -
CO CRe+l6JLOR energy panel, alteration, or
� extension. Describe: Page 2 2
Business name: t9 -/ J ( 1 ' qy) 4 o frit{ l (h CQ .
Address: v /t i 7e `��% 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 ( ) Industrial plant per hour 73 75
�b 7 0 I ', i - { 4 ELECTRICAL PERMIT Subtotal FEES. `C -
CCB Lic.: Electrical Li , i r Su p (�/p rv. Lic.: �S! Subtotal
Suprv. Electrician signature, required' a ,'; S Plan review (25% of permit fee)
Print name: i f ��� Date: 5``05 State surcharge (8% of permit fee 11-,017_,
�- t� ( G TOTAL PERMIT FEE 7 .
Authorized signatu li ' 11111111P This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: ; 1e....6 AV er Date: 6- 1 6 : 5---- • Fee methodology set by Tn- County Building Industry Service Board
[ •' Number of inspections per permit allowed
i \Buitding\Prnnits\ELC- PennitApp die 12/03 440- 4615T(l0 /02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005-00351 .
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 5/25/2006
Phone: (503) 639 -4171 _alt
Inspection Requests (24 Hrs.): (503) 639 -4175 __ °'L,I... .
INSPECTION WORKSHEET FOR DATE: 8/4 /2005 TIME: 7 : 08AM PAGE: 91
SITE ADDRESS: 09642 SW WASHINGTON SQUARE RD G -12 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: CACHE �---+
DES - PTION: Sign lighting.,
OWN , • WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: S & A SIGN & AWNING PHONE #: 541 - 485.5546
Inspection Request Schedu -d For: Date: 8/4/2005 Pour Time:
Code # • • ectio ■ : ri • ion - : - ' Contact # Message
199 - - .ctrical final 0127 -01 541- 4855546 Y
Corrections /Com - - lnstr ons: . Q1 / 1 — ,5 3.0 C2-n
+ 1 .
N0Ro61 Vv 1r 60si6
- TewailJ 11 ) N6S-
�■1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
• f z it J Inspector: Date: 9._ G Pho #: (50 3) 71 S
8