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Permit (2) 71 CITY OF TIGARD ELECTRICAL PERMIT o COMMUNITY DEVELOPMENT Permit#: ELC2023-00381 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 9/18/2023 Parcel: 1 S 135BA00102 Jurisdiction: Tigard Site address: 10154 SW WASHINGTON SQUARE RD Project: BioLife Plasma Services Subdivision: OAKBURG Lot: 9 Project Description: Electrical for TI:Lighting, refrigeration,and low voltage for audio, data,fire alarm,and HVAC systems. Contractor: JC ELECTRIC INC Owner: PPR SQUARE TOO LLC 8117 NE 13TH AVE BY MACERICH RET VANCOUVER, WA 98665 PO BOX 4085 SANTA MONICA, CA 90411 PHONE: 360-887-7889 PHONE: FAX: 360-887-5584 FEES Quantity Description Date Amount 1 ea Services or Feeders-401 to 08/28/2023 $200.34 Specifics: 600 amps Type of Use: COM 6 ea Temp Services or Feeders- 08/28/2023 $356.16 200 amps or less Class of Work: ALT 138 crt Branch Circuits w/Purchase 08/28/2023 $1,023.96 Type of Const: Service or Feeder Occupancy Grp: 4 ea Limited Energy 08/28/2023 $300.00 1 ea Plan Review Electricial 08/28/2023 $470.12 1 ea 12%State Surcharge- 08/28/2023 $225.66 Electrical Total $2,576.24 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: _ gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in 0 R 952-001-0010 throua A 52-001-0090. You m obtain a copy of the rules or direct auestions to OUNC by callina 50 32.1987 or 1.8 0.332.2344...-7 I Issued By: Ur Permittee Signature: �� OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale,lease or rent. OWNER'S SIGNATURE: Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR.ELEC'N Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Electrical Permit Applicatio ECEIVED FOR OFFICE USE ONLY Cite o Tigard Received / �t// `2 7� f� I . `J f JUN 2 1 2023 Dale/Bv. V .�t a"2f 'i' Pe Le.l-�od% ' OD-2," I I ^ 13125 SW Hall Rlvd. Tigard.OR 97223 Plan Revi• .� �� Phone: 503.718.2439 Fax 503.598.1960 Date/By: ZD Re , i�'x. '3- o D° 8$ TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date/By: Jrris Ef See Page 2 for 0 Internet- www.ligard-orgov BUILDING DIVISION Notified/Method: t�yl y j Supplemental Information : TYPE OF WORK •Rev-Nei)t-s4 PLAN REVIEW ❑New construction 0 Addition/alteration/replacement Please check all t at apply(submit 2 iris of plans vv.items checked): El Service or feeder 400 snips or mute ❑Building over three stories. 0 Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION ': - exceeds 10,000 amps at ISO volts or ❑Floating buildings. ❑ I-and 2-him i It dwell illg I]Commercial/industrial ❑ Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑ \iulti-lamil� ❑ Master builder ❑ Other: ❑Fire um _ pump ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ['Emergency system larger separately derived 0 Addition of new motor load of system. Job 1/: Job site address: 10154 SW Washington Square Rd IooHP orinore. ❑"A,�e", l-2", `1-3', City/State/ZIP: Tigard,OR 97223 0 Six or more residential units occupancy (� ❑Health-care facilities. ❑Recreational vehicle parks Suite/hldg./apt.4: Project name: 1�` L.-W �J C(ec, ❑Hazardous locations. ❑Supply voltage for more than t 1` V`�` 1- ®Bert ice or(ceder 600 amps or more_ 600 volts nominal. Cross street/directions to job site: I FEE SCHEDULE Description I Qty. I Each I Total New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less I -. 16854 1 ers , 4 Tax map/parcel# _: Ea.add'1 500 sq.ft.or portion I 33.92 I DESCRIPTION OF WORK Limited energy,residential �.— (with above sq-ft) 75 00 2 Commercial II for new medical facility tenant. Limited energy,multi-family 75.00 2 residential(with above sq.ft.) --- - Renewable Energy ❑ See Page 2 ❑ PROPERTY OWNER © TENANT Services or feeders installation,alteration,and/or relocation Name: BioLile Plasma Services 200 amps or less 100.70 2 Address: 10154 SW Washington Square Rd 201 amps to 400 amps 33.56 2 401 amps to 600 amps 1 200.34 200.34 2 City/State/ZIP: Tigard,OR 601 amps to 1,000 amps 301.04 2 Phone:( ) 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 6 59.36 351. 1` I intended for sale. lease,rent,or exchange,according to ORS 447,449,670,and 70]. 201 amps to 400 amps 125.08 2 Osi her signature: Date: 401 amps to 599 amps 16854 2 APPLICANT ©. CONTACT PERSON Branch circuits—new,alteration,or extension, er panel A.Fee for branch circuits with Business name: Faster Permits above service or feeder fee. 1 3 7.42 /ya3��2 -- each branch circuit i • Contact name: Bradley Vaughan B_Fee for branch circuits rrirhonr service or feeder fee,first Address: 2000 SW 1st Ave#420 branch circuit 56.18 188 2 City/Stale/ZIP: Portland,OR 97201 Each add`]branch circuit 7.42 7 42 2 503-RRO-3530Miscellaneous(service or feeder not included) Phone:( ) Fax: : ( ) Each manufactured or modular 67 84 2 dwelling_service and/or feeder Email: Bradley(:FasterPermits.Com Reconnect only 6784 2 CONTRACTOR Primp or irrigation circle 67.84 2 Business name: To Bid SQie an.J4/(P j:7 p,/,r p/ ,/1j-Il i it-hem Sign or outline lighting 1 67.84 67.84 2 liTilJWf/t w" r^%�/Y(.tilt wJ/ Signal circuit(s)or limited-energy �/ Address: panel.alteration.or extension. I2 See Page 2 300�2 Each additional inspection over allowable in any of the above Cite/State/ZIP: Additional inspection(I hr min) 66 25/hr Phone:( ) Fax:( ) Investigation(I hr min) 90.00/hr Industrial plant(I hr min) 78.18/hr Email: r Inspections for which no lee is 90.00/hr CCB Lic.:get /lit Electrical Lic-:sa A Suprv- Lic.:3 mulled specifically listed(14 hr min) u- lw ` i rS ELECPRiLAL PERMIT FEES Suprv. Electrician signature.required: See .�fn o Jt,,� q yip//�a/i4n Subtotal: / i 'rV,1b'o Print name: U-��'r`�C Date:W(✓ ❑Plan Review Required(25%of permit fee). 'VC+ 1 it r� '/ � .' State surcharge(12%of permit fee): , j,tif Authorized signature: l/ //GLLZ/ TOTAL PERMIT FEE: P��"'.Z This permit application expires if a permit is not o taa d within 180 Print name: Bradley Vaughan -I Date: 06/12/23 days after it has been accepted as complete. * Number of inspections allowed per pennu. I.'nuildiny Permits,ELC PennsAlrp EIK_ERE.doe Rev Silt 7%201i 440-461 STt I I,05iCOIMrwlin I Electrical Permit Application FOR OFFWF USI:ONLY City of Tigard Received • 13125SW NaIIRIvd.,Tigard,OR 97223 Date/B Permit"; ) C;2{) 3.Ot}351 Plan Review Phone: 503.718.2439 Fax. 503.598.1960 Dam/8 : Related Permit 8: Inspection Line: 503,639.4175 Ready Date/By- tarts 0 See Page 2 for Tl C'ARt) s Internet: wwwtigard-or.gov NotifiedMethod: Supplemental Information TYPE OF WORK PLAN REVIEW ❑New construction Addition/alteration/replacement Please check a0that appty(submit 1 sets of plans w:items checked); aIl Service or feeder 400 amps or more 0 Building over three stones, 0 Demolition El Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF,CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ❑ I-and 2-family dwelling ©CommerciaLindustrial ❑Accessory building less 10 ground,Or exceeds I4,000 ❑Commc¢ial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder ❑Other: Ohre pump. -,_•„,�, ❑Installation of 150 KVp or JOB SITE INFORMATION:AND.LOCATION ❑Emergency system. larger separately derived ❑Addition of new motor bad of system. Job 4: ' Job site address: 10154 SW Washington Square Rd 1OOHP or more. ❑"A".`E '1 z ,"l.3 , City/State/ZIP: Tigard,OR 97223 ❑Six or more residential occupancy. sidetd al unit. ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.4: Project name: ❑Hazardous locations 0 Supply voltage(or more than ^ ^— " --- ®Srnlce or feeder 600 amps Or MOM, Oavolu nominal. Cross street/directions to job site: FEE SCHEDULE oeunatba 1 Pty. I Each I Total I • New residential single-or multi-family dwelling unit. Subdivision: Lot 4: Includes attached garage. 1,000 sq.II.or less 1 168.54 168.54 4 Tax map/parcel N: Ea.add'I 500 sq.0 or portion 8 33.92 271.36 1 _ ' ;'DESCRIPTION'OF WORK. ' Limited energy,residential (with above sq.0.) 75.00 2 Commercial TI for new medical facility tenant, Limited energy,multi-family 75.00 2 residential(with above sq.0.) -•'""" - Renewable Energy 0 See Page 2 0 PROPERTY;OWNER 7T--' "® TENANT Services or feeders installation,alteration,and/or relocation Name: BioLife Plasma Services 200 amps or less 100.70 2 Address: 10154 SW Washington Square Rd 201 amps to 400 amps 133.56 2 401 amps to 600 amps 1 200.34 200.34 2 City/StateiZIP: Tigard,OR ,...�. 601 amps to 1,000 amps 301.04 2 Phone:( ) 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 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 ® APPLICANT EJ CONTACT PERSON Branch circuits-new,alteration,or extension,ear panel . ,_"„,,. - A.Fee for branch circuits with Business name: Faster Permits above service or feeder fee, 742 2 each branch circuit Contact name: Bradley Vaughan B.Fee for branch circuits without Address: 2000 SW l st Ave 4 420 service or feeder fee,first 1 56.18 56.18 2 — branch circuit CitwSiate/ZIP: Portland,OR 97201 Each add'I branch circuit 195 7.42 202 42 2 - 503-880-3530 Miscellaneous(service or feeder not included) Phone:( ) Fax:: ( ) Each manufactured or modular �- - dwelling,service and/or feeder 67.84 2 Email: Bradlev'g'FasterPermits-Com „...... Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: T„B:d e. A 'WC - Sign or outline lighting 1 67.84 67.84 2 gas Signal circuit(s)or limited-energy Address: C�I 1"} a 1316 ANIL, pane),alteration,or extension. 0 See Page 2 2 City'State ZIP: ti to nit�L c» Each additional inspection over allowable in any of the above Ytrl C to Additional inspection(1 hr min) 66.25/hr Phone:( 3� G7 \ :lc tit Fax:( ) Investigation(1 hr min) 90.00/hr Email: UQ44\1NA '[St) .Zl - Industrial plant(I hr min) 78.18. hr ,.- tiJ Inspections for which no fee is CCB Lie.: 111 �. Electrical Lic.. t Suprv.Lie.: i y,ry specifically listed{%hr min) 9D.00 hr `Y Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES __, Subtotal. Print name: Or •e liy Date: 09/05/23 ❑Ptan Review Required(25%of permit fee}: - .-"`" State surcharge 12%of r� 0 � I permit fee): Authorized signature: (/4 �Q`f / 8{i TOTAL PERMIT FEE: . This permit application expires If a permit is not obtained within 180 Print name: Bradley Vaughan [/ Date: 06/12r23 days after n has been accepted as complete. • Number of inspections allowed per permit. I BalldingPmniuYLC Permi,App ELR ERE.doc Rnv06'172015 4.10-45151n t 05.COAL WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description I QIR I Each I 'I'alnl I ' Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 00.70 2 501 to 15 kva 133.56 2 Audio and Stereo Systems* 1501 to25 kva 200.34 2 Wind generation systems in excess of 25 kva: n Burglar Alarm 25 01 to 50 kva 301.04 2 5001 to Io0 kva 55226 2 n Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 U Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr charged at an hourly(I hr min) Inspections for which no fee is 9000/hr speed icallp listed('/hr min) ELECTRICAL PERMIT FEES COMMERCIAL WORK ONLY: Subtotal(Enter on Page 1): Fee for each commercial system: S75.00 • (SEE OAR 918-309-0000) Number of inspections allowed per permit. Check Type of Work Involved: Ni Audio and Stereo Systems 7 Boiler Controls Li Clock Systems Q Data Telecommunication Installation n Fire Alarm Installation n HVAC n Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls n Outdoor Landscape Lighting* Protective Signaling n Other: Total number of commercial systems: 4 *No licenses are required. Licenses are required for all other installations ADuddinu\Permits\ELC_PermltApp_ELR_ERE.dae Rev 06/17/2015