Permit (70) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2017-00616
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/17/2017
T f g Parcel: 1S126CB00500
Jurisdiction: Tigard
Site address: 9300 SW WASHINGTON SQUARE RD
Project: Macy's Subdivision: None Lot: None
Project Description: Retro fit sign lighting for(5)existing wall signs,2 interior&3 exterior.
Contractor: RUDNICK ELECTRIC SIGNS LLC Owner: MACY'S DEPARTMENT STORES INC
1400 S TOWNSHIP RD ATTN: TAX DEPARTMENT
CANBY, OR 97013 7 WEST SEVENTH ST
CINCINNATI, OH 45202
PHONE: 503-263-3600 PHONE:
FAX: 503-263-4617
FEES
Quantity Description Date Amount
5 ea Sign or Outline Lighting 08/17/2017 $339.20
Specifics:
1 ea 12%State Surcharge- 08/17/2017 $40.70
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $379.90
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 _. _- 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. ENTION: Oreg. la. -quires you to follow the rules adopted by the Oregon Utility Notification Center. Those r -s are set forth in OAR
952-0' -0010 through OAR 9'•-001-0190 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232. 87 or 1.800.3 .2344.
I-suedBy: • / /' / 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: g /7/7
LICENSE NO. 7 S/.
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 of Tigard RECEIVE Received �S��,� Permit No.: EL C,. 6I/� ,l•
- PlanDateR
14 '� 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit:
Inspection Line: 503.639.4175 AUG 2017 Surfs. H See Page 2 for
TIGARD oeeMeInternet: www.tigard-or.gov oSupplemental Information ormation
. Please
m -checked Please check all that apply(submit 2 sets of plans w/items checked below):
El New construction 0 AddltlOri/al It�n F� i l+ 0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: �° a where the available fault current 0 Marinas and boatyards.
£ exceeds 10,000 amps at 150 volts or Floating buildings.
y; ,*,,
, , ,. =` z :45.7,',',,e'''1-''. : - less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑ I-and 2-family dwelling M Commercial/industrial 0 Accessory building amps for all other installations. buildings.
❑Multi family 0
Master builder ❑Other: ❑Fire pump. 0 Installation of 75 KVA or
� 4 �, 0 Emergency system. larger separately derived system.
' "°
3` 1 # 8 a l 0 Addition of new motor load of ❑"A","E","1-2","1-3",
t r f s
IOOHP or more. occupancy.
Job no.: Job site address: 9340 SW 14 ask j N9 Ivy S9 14' ❑Six or more residential units. 0 Recreational vehicle parks.
ty -riga
I, OR 7223 0 Health-care 0 Supply voltage for more than
City/State/ZIP: d600 volts nominal.
0 Hazardous locations.
Suite/bldg./apt.no.: Project name: M a Cy Ns 0 Service or feeder 600 amps or more
, i 1
Cross street/directions to job site: oas 1 i•Ki}va 5114a Ye Ma!I Description 1 Qty. Fee. Total *
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'l 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential 75.00 2
p. i �11 ' + > I.MrilifIgik- 'I (with above sq.ft.). 1 i ., ' ' ?t,'14'•, r ,.,. '''''',:_'
. 1. Limited energy,multi-family
Q 4;40 S residential(with above sq.ft.) 75.00 2
S a A ' r Services or feeders installation,alteration,and/or relocation
G. Si 1/15 I'll /e d 2 gni 4 al.r i 3 a J,E.i air 200 amps or less 100.70 2
'411—
. P ---i"44:11 ,5441‘41 ACC* t ,t ' 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
City/State/ZIP: relocation
Phone: ( ) Fax: 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation:This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. Branch circuits—new,alteration,or extension,per panel
Owner signature: Date: A.Fee for branch circuits with
, a, above service or feeder fee,
7.42 2
4 i' ` t� 't : "Ii*""! i , ,j,,_:I, : ` •
, . > R t41 ` each branch circuit
Business name: 'Ru d fin C k ler 7I i e J .Q1'1 _ , 6 B.Fee for branch circuits without
Iris, service or feeder fee,first 56.18 2
Contact name: s7e,y, ye Rudnick branch circuit
1 Eachadd'lbranchcircuit 7.42 2
Address: /i 00 5. Towns/1;p Wei Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
City/State/ZIP: ca ky4 o R 97 013 dwelling,service and/or feeder _
Phone: Fax:
('S03 )26 3 -Lf 617 Reconnect only 67.84 2
(S03>263-3600 Pump or irrigation circle 67.84 2
E-mail: Steve rud Ki k e leefr cs P N.s. GOYY1 Sign or outline lighting , 5 67.84 ,35,.AO 2
,. r z a ro a-" z`Cx '^' cg's ";'t `. —
ar' i _. .`' LA s ,4 *s.. ,:`, : , `` r ,. . .. Signal circuit(s)or limited-energy
panel,alteration,or extension. Page 2 2
Business name: S.a m e as Cll_bOve Each additional inspection over allowable in any of the above
Address: Additional inspection(1 hr min) 66.25/hr
Investigation(1 hr min) 66.25/hr
City/State/ZIP: Industrial plant(1 hr min) 78.18/hr
�%1 Ins ections for which no fee is
Phone: ) Fax:( 14}0 p�� p 90.00/hr
( �Friel �A specificall listed(%hr mm)
CCB Lic.: 1g65'81 Electrical Lic.:C Ls 7 Suprv.Lic.:7(0.sib i. 1 ,_ $, > , a! (
/ �_ Subtotal: �j 9.
Suprv.Electrician signature,required: !/ ,, '� Plan review(25%of permit fee): —r
Print name: t�
(+1-tVCo1 ift,e 1htC1/4 Date: g(-17_,7 State surcharge(12%of permit fee): t/o•?D
TOTAL PERMIT FEE: 3 79.10
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: * Number of inspections allowed per permit.
I:\Building\Permits\ELC-PermitApp.doc 07/01/10 440-4615T(11/05/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ A• udio and Stereo Systems*
❑ B• urglar Alarm
❑ Garage Door Opener*
❑ Heating,Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
Fee for each commercial $75.00
system
(SEE OAR 918-309-0000)
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
X Other $I 9n
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I.\Building\Permits\ELC-PermitApp.doc 07/01/10
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9300 SW WASHINGTON SQUARE RD, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2017-00616
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor