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Permit CITY OF TIGARD ELECTRICAL PERMIT MI 2 ' COMMUNITY DEVELOPMENT Permit#: ELC2022-00389 Date Issued: 7/7/2022 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S115BA00100 Jurisdiction: Tigard Site address: 16200 SW PACIFIC HWY M Project: Trader Joe's Subdivision: None Lot: None Project Description: Electrician work related to shell modifications and Trader Joe's tenant improvement. Contractor: FRAHLER ELECTRIC COMPANY Owner: TECOLOTE RESOURCES INC 11860 SW GREENBURG RD KELLY'S LEGACY LLC ET AL TIGARD, OR 97223 BY HESLIN HOLDINGS INC 23421 SOUTH POINTE DR STE 270 LAGUNA HILLS, CA 92653 PHONE: 503-639-4627 PHONE: FAX: 503-639-4673 FEES Quantity Description Date Amount 1 ea Limited Energy 07/07/2022 $75.00 Specifics: 6 ea Services or Feeders-200 07/07/2022 $604.20 amps or less Type of Use: COM 2 ea Services or Feeders-401 to 07/07/2022 $400.68 Class of Work: ALT 600 amps Type of Const: 157 crt Branch Circuits w/Purchase 07/07/2022 $1,164.94 Occupancy Grp: Service or Feeder 1 ea Plan Review Electricial 07/07/2022 $561.21 1 ea 12%State Surcharge- 07/07/2022 $269.38 Electrical Total $3,075.41 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 . issuan if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility No •• C- -Those rules are set forth in OAR 952-001-0010 throuah 0 952-001-0090. You.mav_obtain a coo the rules or direct questions to OUNC by calli4�/ .2�.: .r 1.800.332.2344. Issued By: �_ �r Permittee Signatu ` ff 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 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. ECEIVE : Electrical Permit Application JUN ?U22 FOR OFFICE USE ONLY City of Tigard Received U'l2) 2 EtL202-2-Lb3 j Date/B Perm". 111 • Ph one S50 Hall Blvd.,Tigard,OR 98 19� Ij.,�OF 1 IGARLJ Plan Review� // 81* Phone: 503.718.2439 Fax 503.e98 19150 Date/By: (/(!/ �2 4 Related Permit M. Inspection Line: 503.639.4175 lUILDING DIVISI Ready Dal e78yf kris ®See Page2 foe 1 1 t'\.i.I 1 Internet: d-or www.ti an 8 gov 'fie elhod: Gi t _ - Supplemental Information TYPE OF WORK i PLAN REVIEW ❑New construction Addition/alteration/replacement Please check all that apply(submit J sets of plans w/items checked). IB Service or feeder 400 amps or more 0 Building over three stories ❑Demolition ❑Other: _ where the available fault current 0 Marinas and boatyards CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. 0 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. 0 Multi-family 0 Master builder ❑Other. 0 Fire pump. ❑installation of ISO KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system larger separately derived Job#: Job site address:// ❑Addition of new motor load of system Z 00 s P t'v ic i,f t r_ HW j I OOHP or more. ❑"A""E","I 2", 13" City/State/ZIP: 7 f-' � ore 9 z.ci 7 z Li 0 Six or more residential units occupancy. 7 - ❑Health-care facilities ❑Recreational vehicle parks Suite/bldg./apt.#: Project name: -7"N tiQr- Io e - ❑Hazardous locations 0 Supply voltage for more than 0 Service or feeder 600 amps or more 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total I • New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. Tax map/parcel#: Z� /�S 6 D 1,000 sq.ft.or less 168.54 4 - map/pa l/ Ea add'I 500 sq R or portion 33.92 DESCRIPTION OF WO-RIC/ Limited energy,residential 1 1 4 G.� To e el / Limited energy,(with above ft.) 75.00 2 e clr Goi/ 7 , T multi-family 75.00 2 residential(with above sq.ft.) - - — Renewable Energy 0 See Page 2 0 PROPERTY OWNER J ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: e$/r i 11v/r�/n� C -r n c, t 200 amps or less 6 100.70 ,j02fr 2)2 A / (7 l I �J I Address: Z 3 L?/�/ S'v tl f-les ealeA/ )r, v/ ? 7 7 Q 201 amps to 400 amps 133.56 2 1 Y Z. 401 amps to 600 amps � 200.34 y�Qt�j g'2 City/State/ZIP: /',,.v n�„‘ f.f-;//5 I l A 9z.6-S 3 601 amps to 1,000 amps 301.04 2 Phone:(n/9) ,7 7 yy4'Q Fax:(ryy y) (� ,C7/ / 6 O Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I 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 2 VI APPLICANT J 0 COMM rERsr►1Q Branch circuits-new,alteration or extension,--per panel - --- A.Fee for branch circuits with Business name: _5c rs.s 1 0-I- AA'e Ot t,-1 -1- '1" --- above service or feeder fee, SJZ 7 42 �/6 •9 I each branch circuit �� Contact name: *'441` ,yetis)© -T- B.Fee for branch circuits without - first 56 18 2 \ Address: ��ip I S �� .�° U t - service or feeder fee,branch circuit City/State/ZIP: I c 2J GO.._ I Each add')branch circuit 7.42 2 Phone:(5,3)�"20 S1 I Fax::( ) Miscellaneous(service or feeder not included) ' Each manufactured or modular Email:C / dwelling,service and/or feeder 67 84 2 J-1Q4.E�� M #Ste>eit�•�?c5 pc ,Goal^ Reconnect only 67.84 2 CONTRACTOR/ Pump or irrigation circle 67.84 2 Business name: / r� t�r C je Ci Sign or outline lighting 67 84 2 Address: ! /� Signal circuit(s)or limited-energy g 75,Ua 2 �1 86 0 1� 6ci e n b arc Qom . _ panel,alteration,or extension. Set Page 2 City/State/ZIP: 7-' w 0 D �i L Z c.:2 Each additional inspection over allowable in any of the above L ! Additional inspection(I hr min) 66 25/tit Phone:(3Go) ?/ //Jr/ Fax:( ) Investigation(I hr min) 90-00/hr Email: z bye r_S 0 r ok AA r,.e/Q c7G t. GUI Industrial plant(I hr min) 78 I0/hr / Inspections for which no fee is 90 001 hr CCB Lic.:/9 7/7 z Electrical Lic.:6 g' Suprv.Lic.: j(� 5 specifically listed(h hr min) is, Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES !6�i Subtotal: 1 9/D, a Re - Print name:� 1���I eft,C!t e ate: 63» _ Z ❑Plan Review Required(25%of permit fee) y77] '7 s� State surcharge(12%of permit fee) Z.S6 l 6 3 Authorized signature: TOTAL PERMIT FEE. 1�6 7s, ZS This permit application expires if a permit is not obtained within 180 �rint name: Date: s ,4 I days after it has been accepted as complete. ----- • Number of inspections allowed per permit I lauilding\Permits\ELC PermnApp_ELR_ERE doe Rev 06/17/2015 4404615T(11AIS/CO61/WEB