Permit CITY OF TIGARD ELECTRICAL PERMIT
"1 117 COMMUNITY DEVELOPMENT Permit#: ELC2015-00133
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/03/2015
Parcel: 1 S 135 BA00100
Jurisdiction: Tigard
Site address: 10205 SW WASHINGTON SQUARE RD
Project: Thirsty Lion Subdivision: SPRUCE VILLAGE Lot: 5
Project Description: Sign lighting for(1)sign.
Contractor: RAMSAY SIGNS INC Owner: PPR SQUARE TOO LLC
9160 SE 74TH AVE PO BOX 847
PORTLAND, OR 97206 CARLSBAD, CA 92018
PHONE: 503-777-4555 PHONE:
FAX: 503-777-0220
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 03/03/2015 $67.84
Specifics:
1 ea 12%State Surcharge- 03/03/2015 $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 a ance with -..roved 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. ATT TION: Oregon la re. _-s you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001- 10 thro gh OAR 952-00 •690. You • ay obtain a copy of the rules or direct questions to OUNC by calling 503.2.1987 or 1.800.332. 3`44..
Issue By: �� / Ir y 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' 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.
Electrical Permit Application FOR OFFICE USE ONLY
City �'1�1
of Tigard �) l EIVEP Received l Permit No.:11111 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review -
a Phone: 503.718.2439 Fax: 503.598.1960 Pig : Other Permit:
I l n it I Inspection Line: 503.639.4175 g Date Ready/By: ® See Page 2 for
Internet: www.tigard-or.gov MAR 3 2��5 Notified/Method: Supplemental Information
TYPE OF WAY OFTI(;Akl) PLAN REVIEW
®New construction ❑Addition/alt Please check all that apply(submit 2 sets of plans w/items checked below):
Demolition 510 ❑Service or feeder 400 amps or more ❑Building over three stories.
❑ ❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling g Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder El Other: ❑Fire pump. ❑Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E","1-2","1-3",
Job no.: Job site address: ,a a(3'3 IA) \JOS' 1f(N-�h S Six or or more. occupancy.
S 1 7• - ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,OR 97223 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name:m1 {f) L,o n 0 Service or feeder 600 amps or more.
—i FEE SCHEDULE
S Cross street/directions to job site: `,IA; elrttn 00171 rd Description I Qty. I Fee. I Total 1 *_
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'/500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential
75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
1' Limited energy,multi-family 75.00 2
S'\q Y l c 'cc Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
relocation
Phone:( ) Fax:( ) 200 amps or less 59.36 I
201 amps to 400 amps 125.08 2
Owner installation:This installation is being made on property that I own which is not
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Branch circuits—new,alteration,or extension,per panel
Owner signature: Date: A.Fee for branch circuits with
® APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, 7 42 2
each branch circuit
Business name:Ramsay Signs Inc B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Contact name:Garrett Gibson branch circuit
Each add'l branch circuit 7.42 2
Address:9160 SE 74th Ave Miscellaneous(service or feeder not included)
City/State/ZIP:Portland,OR 97206 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Phone:(503)777-4555 Fax: :(503)777-0220 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail:GarrettG @RamsaySigns.com Sign or outline lighting ; 67.84 (,7.Ir y 2
CONTRACTOR Signal circuit(s)or limited-energy
Business name:Ramsay Signs Inc panel,alteration,or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address:9160 SE 74th Ave Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:Portland,OR 97206 Investigation(I hr min) 66.25/hr
Industrial plant(1 hr min) 78.18/hr
Phone:(503)777-4555 Fax:(503)777-0220 Inspections for which no fee is 90.00/hr
specifically listed('h hr min)
CCB Lic.: 63422 Electrical Lic.: 26106CLS Suprv.Lic.: 4935ig ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: 2/ a/ Subtotal: (p7.pi
Plan review(25%of permit fee):
Print name: Phil Steige i/( r7 Date:3/2 State surcharge(12%of permit fee): 0
I l ,��Iri TOTAL PERMIT FEE: f
Authorized signature``(M y 'LUJ/ This permit application expires if a permit is not obtained within 180
r1 f�1( days after it has been accepted as complete.
Print name: S S I L VI /GS�� Date a ' Number of inspections allowed per permit.
I:\Building\Permits\ELC-PermitApp.doc 07/01/10 440-4615T(I I/05/COM/WEB
„ CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
1111 COMMUNITY DEVELOPMENT Permit#: ELR2015-00133
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/19/2015
Parcel: 1 S135BA00102
Jurisdiction: Tigard
Site address: 10206 SW WASHINGTON SQUARE RD
Project: Ulta Subdivision: OAKBURG Lot: 9
Project Description: Burglar alarm.
Contractor: SIMPLE SECURITY Owner: PPR SQUARE TOO LLC
PO BOX 80577 PO BOX 847
PORTLAND, OR 97280 CARLSBAD, CA 92018
PHONE: 503-574-2254 PHONE:
FAX: 503-245-2998
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/19/2015 $75.001
12%State Surcharge-Electrical 05/19/2015 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 0 Fire Alarm: 0
HVAC: 0 Instrumentation: 0
Intercom/Paging: 0 Landscape/Irrigation: 0
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
Security Alarm: 1 Other: 0 Total $84.00
Other Desc: 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 0•' 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 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:
nn CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date: ! a 17, Z.4 (
•
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.
Electrical Permit ApplicationR EC E I V E D iY)li 0,.. i l ,l- O\l.1
City of Tigard Date ed vol- `,9 /,s 4.14 Permit#: CL/!P0/...<-40/33
13125 SW Hall Blvd.,Tigard,OR 97223 MAY 1 9 2015 Plan Review �iw
I ' Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit# P��s /
Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date/By: Juris//-�1� El See Page 2 for
I I`' \1?I' Internet: www.tigard-or.gov ILDING DIVISIO Notified/Method: Supplemental Information
❑New construction Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
El Demolition El Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current ❑Marinas and boatyards.
exceeds 10,000 amps at 150 volts or ❑Floating buildings.
❑ 1-and 2-family dwelling -Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
i I : l . , , ❑Emergency system. larger separately derived
Job#: Job site address: !!,^, ❑Addition of new motor load of system.
�,0 Z 0 W (.J 4-5 i1 "5 S a uc✓-e ( 100HP or more. ❑"A","E","l-2" "l-3»
City/State/ZIP: 2 ❑Six or more residential units. occupancy.
ty 7 l a✓ (.Z Z 3 Health-care ❑Recreational vehicle parks.
❑ ealth-caze facilities.
Suite/bldg./apt.#: I Project name: ❑Hazardous locations. ❑Supply voltage for more than
U � � ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site , 1 : } I;, ,, ->t.
Description Qty. Each Total
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.add'I 500 sq.ft.or portion 33.92 1
Limited energy,residential 75.00 2
(with above
B 0,r) if L 412,1 Limited ft.)
energy,,multi-family ti-family 75.00 2
residential(with above sq.ft.)
. . m ks.
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
Address:
201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) I Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: _ Date: 401 amps to 599 amps 168.54 I 2
Branch circuits-new,alteration,or extension, er panel -
A.Fee for branch circuits with
Business name: above service or feeder fee, 7 42 2
each branch circuit
Contact name: B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: branch circuit
City/State/ZIP: Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) I Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
Business name: S I (Q 5 E.cu v-, -}.,` l C Sign or outline lighting 67.84 2
� 1 / Signal circuit(s)or limited-energy See Page 2 2
Address: /, 0 r f'GI... g 0 (� 7 Z panel,alteration,or extension.
g
City/State/ZIP: ro,r-/,,�I gyp,/) 17-2-8.0 Each additional inspection over allowable in any of the above
'''.7* -. Additional inspection(1 hr min) 66.25/hr
Phone:(5 o zj ) 5 ,.../ -2_2_5.41 Fax:60)2 )"2(5- `,-9'' Investigation(1 hr min) 66.25/hr
Email: Tj Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: l 74( Electrical Lic.3 y-:6 03ea Suprv.Lic.:L f q t t specifically listed %:hr min
Suprv.Electrician signature,required: 011111 Subtotal:
Print name: p 604 /vl 7 Date: I 7y,�y Z, y ❑Plan Review Required(25%of permit fee):
/ State surcharge(12%of permit fee):
Authorized signature: ,63
TOTAL PERMIT FEE: AD t/
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\Building\Permits\ELC_PemtitApp_ELR_ERE.doc Rev 04/21/2014 440-4615T(I 1/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined: $75.00
Description I Qty. I Each I Total I
Renewable Renewaable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
El Burglar Alarm 25.01 to 50 kva 301.04 2
50,01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
n Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed 4 hr min
COMMERCIAL WORK ONLY:
Fee for each commercial system: $75.00 Subtotal(Enter on Page I):
y " Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
Fl Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
El Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
0 Other: -ce/2.6l 2 19-1.../972P-1
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I.\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014