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Permit C ITY OF T I GA R D ELECTRICAL PERMIT PERMIT #: ELC2004 -00107 �i1� DEVELOPMENT SERVICES DATE ISSUED: 3/5/04 {` -° 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S12600-00300 SITE ADDRESS: 09653 SW WASHINGTON SQUARE RD SUBDIVISION: Oo4' HINGTON SQUARE ZONING: C BLOCK: LOT : JURISDICTION: TIG Project Description: Installation of (1) 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: PPR WASHINGTON SQUARE LLC GRAPHIC AWNING + SIGN BY THE MACERICH COMPANY GRAPHIC ILLUMINATED AWNINGS IN 9585 SW WASHINGTON SQ. RD. PO BOX 301038 PORTLAND, OR 97223 PORTLAND, OR 97294 Phone: Phone: 256 - 3938 Reg #: LIC 63616 ELE 26- 758CLS FEES SUP 304S1G Description Date Amount Required Inspections [ELPRMT] ELC Permit 3/5/04 $53.40 [TAX] 8% State Surcharge 3/5/04 $4.28 Rough -in Elect'I Final Total $57.68 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 mo - - • • . ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set fo• in OAR 952 - 001 -s. 0 through OA' : • - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246-6699 or - 800 - 332 -2344. Issued By: ::_.._ ' I L LI ► Permit 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 639 -4175 by 7:00pm for an inspection the next business day Electrical Application FOR OFFICE USE ONLY City Off' Tigard Received 13125 SW Hall Blvd., Tigard, OR 97223 Plan R % ' PermttNo - �` l �/G Plan Review Phone: 503.639.4171 Fax. 503 598.1960 i iw,,'m''"'d' Date/B Other Pernut Inspection Line: 503 639.4175 I i_ Date Ready/By Inns El See Page 2 for Internet www.ci tigard.or Notified/Method Supplemental Information '1::::1-7',::::", ,. : -h ,TYPE' OF WORK" . ::'.:'. ;:'`i.; s!,'- - C : - --.' 6 ,:::7' . '; ::PLAN'REVIEW - - ❑ New construction ❑ Addition/alteration/replacement Please check all that apply ❑ Demolition Other: EService over 225 amps, comm'l 0 Hazardous location _ ❑Service over 320 amps - rating ❑Butldng over 10,000 sq. ft , . - , tit - OF CONSTRUCTION- ' 4' of ,; - ;" 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 stones ❑Feeders, 400 amps or more ❑ Multi family ❑Master builder ❑ Other: f , 0 Occupant load over 99 persons ❑Manufactured structures or " - - - JOB S ITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park Job no.: 4„ 1 1 Job site address: 9 t 5 2 S ' w � S t � �. v ❑Health -care facility ❑Other w J Submit 2 sets of plans with any of the above City /State /ZIP: i 1 G vkit_iN I , J e 2 1 , . - S 62 a.4.-.2-it - tt M 4 The above are not applicable to temporary construction service Suite/bldg. /apt. no.: Projectname:, //� . : :,:, ,t.•FE'E`;SCHEDilLE` -_ '" r. - I L T V fig- 1 et° Z Description I Qty. I Fee. Total Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft or less 145 15 4 Subdivision: Lot no.: Ea add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75 00 2 Limited energy, non - residential 75.00 2 ;.: . ` _ : ' DESCRIPTION; OF WORK _ , _ .. Each manufactured or modular dwelling, service and /or feeder 90 90 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80 30 2 " r, .: ., tr PROPERTY OWNER , . ❑ TENANT r - 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 ';Y : -kAPPLICANT- __, .1 l II CONTACT;PERSON A. Fee for branch circuits with service or Business name: C 044,0 NA( ant - '- S 16 A . branch circuit eder fee, each 6 65 2 -, te.�,PN t � Contact name: B Fee for branch circuits C� L�A,j 1� yt,/ti tom 6j-- without service or feeder fee, each branch circuit 46 85 2 Address: R 0, g, y 0 3 c Each add'1 branch circuit 6 65 2 City/State/ZIP: e olLTL 0 2 i7 4- Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone (550 2 ' & I Fax : (563) ZS 5 2 - Sign or outline lighting i 53.40 2 E - mail: Signal circuit(s) or limited- ''..:, ,-. -, : _ A' _ , CONTRACTOR, energy panel, alteration, or °" extension Descnbe Page 2 2 Business name: 6� L ''t LPt 11 "` 03E- Ni t( . •4. S t � ys.J �k � !1� ' (� Each additional inspection over allowable in any of the above Address: P 0 ' V Per inspection 62 50 City/State /ZIP: ?3p, A t.O , D/L— 9-72-Ci 4_ Investigation per hour (i hr nun) 62 50 Phone: (SQ p er : ( Industrial plant per hour 73.75 Ci3K ° o5) 2sb s3� t I I O U �� .y 4 , : , - , ELECTRICAL- ,PERMIT FEES*• : :::.: CCB Lic.: (ts � 6 ' Electrical �ic.: t�s� Suprv Lic a In C Subtotal , ' (� �� y Suprv. Electrician signature, required: ''� — Plan review (25% of permit fee) Print name: J Ey� j 2 t.- 7 0 '�� Date: `— ©y State surcharge (8% of permit fee) P-5/ TOAL PERMIT FEE � Kihin471.850 Authorized signature: This permit application exp if a permit is not obtained i days after it has been accepted as complete Print name: p M �j� �, ate: �' 4 — ' C • Fee methodology set by Tn- County Building Industry Service Board .."71 d ▪ Number of inspections per pemut allowed. i\ Building \Permits\ELC- PernutApp doc 12/03 440- 46i5T(10 /02/COM/WEB Electrical Permit Application - City of Tigard , _ Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: • Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ • Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i �Buildmg\Pemtits\CLC- PemdtApp doc 04/03 CITY OF TIGARD 24 -Hour _-`-- BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 - 4171 MST BUP Received qt. -U A Date Requested g�� AM PM BUP Location q (P 5 3 WA - . • Suite MEC Contact Person Ph (_)) Z 5 3 3 4 PLM Contractor 24. BUILDING ✓ Tenant/Owner , .ii�....:1 EL C u( >lC9 Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear St '► p M 8� Framing ��'�f' et ^ NV `p�) lI CJ o Insulation ‘� a Drywall Nailing ' '� St �� ' A Firewall Fire Sprinkler ,, ` Fire Alarm Q� N 51�{ ry - ..:. :,_ . , ..:.�/ • S' , Susp'd Ceiling U 1 Roof l i 5 N ■ 5 ON d� (f" Other: O V Final N� 5i C' a • PASS PART FAIL v PLUMBING A� Post & Beam `�" Under Slab IA --c --1L Rough -In Water Service — Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL Service Rough -In Q /UG /Slab �, ` 1) Low Voltage F - 'Ian' u 4 NIJ NIL? PART N'. .6s:�-. Q; El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. � SI ❑ Please call for reinspection RE: 0 Unable to inspect — no access Fire Supply Line ADA LA f Gj (\11(6 1 Approach/Sidewalk Date ` - In spector ���- l •G Ext Other: Final - DO NOT REMOVE this Inspection record from the job site. PASS PART - FAIL