Permit •
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2013-00467
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/07/2013
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9491 SW WASHINGTON SQUARE RD A04
Project: Zumiez Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: Sign lighting to storefront sign.
Contractor: QUICKSILVER NEON AND SIGNS LLC Owner: PPR WASHINGTON SQUARE LLC
2325 NW 154TH PL. PO BOX 847
BEAVERTON, OR 97006 CARLSBAD,CA 92018
PHONE: 503-626-7020 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 08/07/2013 $67.84
Specifics:
1 ea 12%State Surcharge- 08/07/2013 $8.14
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $75.98
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B iii/�% Permittee Signature: Ji/. _ -L
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date:
LICENSE NO. -
Call 503.639.4175 by 7:00 a.m.for the next available Inspection date.
This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each Inspection.
quicksilver neon and sign 503-626-7020 p.2
Electrical Permit Application ® FOR OFFICE USE ONLY
City of Tigard Deg 5-t Permit No.: --GL ,1. -�O`f(v 7
13125 SW Hall Blvd.,Tigard, i t t 2 `� L
t- � Plan Review
11 Phone: 503.7182439 Fax: c' rt �?J DatdB : Other Permit:if / do/ 06,1a
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: 53 See Page 2 for
Internet: www.tigard-or.gov ��\G ..(\���'° \ Notilied/Method: Supplemental Information
TYPE OF WORK nlr \\\3A PLAN PLAN REVIEW
❑New construction XAddition/alterat.(jr. .1°•.$! Please check all that apply(submit 2 sets of plans wlitems checked below):
❑Demolition ❑Other. &,,1 ❑wher Service or!'ceder le fault amps re more 0 Building over three stories.
where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONS UCTION exceeds 10,000 amps at 150 volts or ❑Floating uildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ I-and 2-family dwelling ViCommerciatindustrial ❑Accessory building amps for all other installations. buildint,.
❑Multi-family ❑Master builder ❑Other. ❑Fire pump. ❑Installation of 150 KVA or
❑Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑Addition of new motor load of ❑"�", E","l-2","l-3",
Job no.: I Job site address: ` ?�SA./4/4-5/7114/41Z)4.---C2?AO IOOHP or more. occupancy.
❑Six or more residential units. ❑Recreational vehicle Darks.
City/State/ZIP: T7474zJ> / r R_EZrl1AI y7z -3 ❑Health-care facilities. ❑Supply voltage for mom than
❑Hazardous locations. 600%nits nominal
Suite/bldg./apt.no.: I Project name:Z///v/E Z- ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross streeudirections to job site: Decriptlon I Oh,- I tee. I Total I •
New residential single-or multi-family dwelling unit.
Includes attached garage.
-Subdivision:- -- Lot no.: 1,000 sq.ft.or less 168.54 4•
Ea add'I 500 sq.ft or portion 33.92
Tax map/parcel n0.: Limited energy,residential 75.00 2
DESCRIPTION OF WORK (with above sq-ft.)
r� Limited energy,multi-family 75.00 2
71?--/A1)4�y a7041•4-6-77e) '✓ 72 z:-4"--/� /LGL°I/�40/Z 5 residential(with above sq.ft.)
/ Renewable Energy ❑ See Page 2
.. 7Z .e7 T 72-OAA/ 5-ii 4/ Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER TENANT 200 amps or less 10050 2
X 201 amps to 400 amps 133.56 2
Name: �L1 ,•.&-----� 401 amps to 600 amps 200.34 2
Address: 9V 1/ S[U'it../4-S MA/SGT A-1). 601 amps to 1.000 amps 301.04 2
/ 4 7ZZT
Over services volts 552.26 2
Ci /State/ZIP: 'rf -`0/Z 6-7/2_ ---4-o.
/ 3 Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation
200 amps or less 5996 1
Owner installation:This installation is being made on property that I own which is not 201 amps to400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits-new,alteration,or extension,per panel
,21...APPLICANT I ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name:4-,7///G,e-C/GI/2L_A/4-0A/ X1./� 574 5/J /-./�L each branch circuit
B.Fee for branch circuits without
Contact name.: !�1//fi i51,l=/Sv Al service or feeder fee,first
7� branch circuit 56.1 B 2
Address: Z. ZC �r /S% T• / • " Each add'!branch circuit I I 7.42 2
City/State/ZIP: 1/.4:72,/?-•-t/ /:2/1_ 77C->U Each m aoeous(service or feeder not included)
Each manufactured or modular
Phone:(�LC) fUZ4,-�O 2-b Fax: :( )
dwelling,service and/or feeder 67.84 2
lteconnect only 67.84 I 2
E-mail: �(/2-!/ lf-.1✓.0.t/¢.� �,O// • CG/47 Pump or irrigation circle 67.84 1 2
CONTRACTOR Sign or outline lighting 67.84 (7 1 2
Business name: iri)e. l�,L4B//_-1/ �,�,r/ yj�rJ sj/r r/f ��L Signal circuit(s)or limited-energy / See
panel,alteration,or extension. Page 2 2
Address: 2 3 25-,k,r e.4.1. %5-z74 744 ,L-- Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 6625/hr
City/State/ZIP: /5i 31 fry_(}t/ C)/t___ 9-7 '29 Investigation(1 hr min) 66251 hr
Phone:( 53) 4,Z4_ 79 ? I Fax:( ) ,/Industrialplant(1 hr min) 76.[&hr
/ ✓ Inspections for which no fee a 90.00/hr
CCB Lic.:/'S'�/1" Electrical Lic.:GL 5,c Sutorv.Lic.:752....5/9, ( specifically listed(:5 hr min)
111/11) �1r II. �� t+g ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:
1f�'.--S--/--
J- ?-Y� �L tJtis-i Subtotal:
/2,4,/%/ TL/t1 d �--/ Plan review(25%of permit fee):
Print name: ✓} Date:
State surcharge(I 2%ofpennit fee): r�,//
Authorized signature: A TOTAL PERMIT FEE: '?? ,1 A/
This permit application expires if a permit is not obtained within 180
Print name: t/j1 j .,16.q W.)64/ Date:
g'S i days after it Was been accepted as complete
• Numbcr of iriapcctions allowed per permit.
1-\Building\Permits1ELC_PemntApp_ELR_ERE.doc Re,051210015 44e-461ST(IIl0SICOMIWEB