Permit (4) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2023-00676
T 6Gf.JD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/29/2023
Parcel: 1 S135BA00101
Jurisdiction: Tigard
Site address: 10125 SW WASHINGTON SQUARE RD
Project: ODOT,SW Greenburg and Hwy 217,#9 Subdivision: OAKBURG Lot: 32
Project Description: Install(4)100A feeder and(6)branch circuits for lighting service cabinet. NOT AT THIS ADDRESS:Located in the
ROW at SW Greenburg and Hwy 217.
Contractor: MILL PLAIN ELECTRIC INC Owner: PPR SQUARE TOO LLC
6115 NE 88TH ST BY JAGUAR LAND ROVER PORTLAND
VANCOUVER, WA 98665 10125 SW WASHINGTON SQUARE RD
PORTLAND, OR 97223
PHONE: 503-574-7265 PHONE:
FAX:
FEES
Quantity Description Date Amount
Specifics:
4 ea Services or Feeders-200 11/15/2023 $402.80
amps or less
Type of Use: COM 4 crt Branch Circuits w/Purchase 11/15/2023 $29.68
Service or Feeder
Class of Work: NEW 2 crt Branch Circuits wo/Purchase 11/15/2023 $63.60
Type of Const: Service or Feeder
Occupancy Grp: 1 ea 12%State Surcharge- 11/15/2023 $59.53
Electrical
Total $555.61
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 to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 throua obtain a copy of the rules or direct auestions to OUNC by callina 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: 4 app
(e c<' vZ1.1.
7
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 ApplicatiRECEIVED FOR OFF ICE I ISE ONI,1 4r 9
City of Tigard
li°
V 1 2023 RzciBiveyd: (1 i .3.3 ..* .,p. ,, i... .).
e .c ..3 _131,5 SW Hall Blvd.,Tigard,OR 972h.) Plan Review ': ll Phone: 503.718.2439 Fax: 503.598.1960 Date/By: .'"--..--‘.---.-.'' Related Permit#:
T
Inspection Line: 503.639.4175 CITY OF TIGARD Ready .Datc/By: .. Juris: fa See Page 2 for
I G A R 1)
Notilied/Method: ldrt ta3 Supplemental Information
Internet: www.tigard-or.gov BUILDING DIVISION
JYPE OF WORK 411 r4 eqPIPPIPLAN REVIEW
0 New construction IffAdditionialteration/replacement Please check all that apply(submit 1 sets of plans w/items checked):
0
0 Service or feeder 400 amps or more C)Building over three stories.
Demolition Other:0
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground,or exceeds 14,000 0 Commercial-use agricultural
Eli-and 2-family dwelling 12<ommercial/industrial 0 Accessory building
amps for all other installations. buildings.
D Multi-family 0 master builder El Other: 0 Fire pump. 0 Installation of ISO KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: 0 Addon of new motor load of system,1 1 0-b Li<, Job site address: %1orrev-5,q_ctk Qv\(see ‘7.t1,,,,p) 100HP or more.
City/State/ZIP: 1-Vck,Vietwl 0?--i ce..
• 61-12:7—: D Six or more residential units. 0occupancy.
0 Ilealth-care fil acities. Recreational vehicle parks.#: Project name:6 q• vx%Dort3 ‘ClOvor 0 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: 1 int e r5..e_cit an of
FEE SCHEDULE
Description 1 Qtr. 1 Each I Total I •
Cirety-001/4) f2-ek ar•64 Of2:2-t-1 New residential single-or multi-family dwelling unit.
Subdivision: Lot#: includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.addl 500 sq.R.or portion 33.92 I DESCRIPTION OF WORK .
Limited energy,residential
75.00 2
(with above sq.fl.)kl.‘ "- fat VI 1° 0\ n 02 tA) too Ick s3m.cL Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
gree,r1\OU'r6 k?C)A"
Renewable Energy 0 See Page 2
RTIROPERTY OWNER 0 TENANT
Services or feeders installation,alteration,and/or relocation
Name: 0 Dcyl"
200 amps or less Li 100.70 40 9.,7) 2
Address: SS S Ca,prr0 I S—V Ni 0 M, Id_ 201 amps to 400 amps , 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Sa 1 JE wi. op._ 91 SO i 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
Er.tPPLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
-T
A.Fee for branch circuits with
Business name: t../V\\\ ?km v-k C[.eettrl(.., above service or feeder fee, y
7.42 2A.C.1 2
each branch circuit
Contact name: fry V \a\yin-L., B.Fee for branch circuits without
service or feeder fee,first I 56.18 5CQ AI 2
Address: Co 00C) 1..)E-- Wetn Sk ,bloket A
tinuich circuit
City/State/ZIP: Vaylca_hfstr--1 (NIA- (17 c -s Each add'l branch circuit I 7.42 1-141- 2
Miscellaneous(service or feeder not included)
Phone:(.7 ( 0 IS-114 --1 7_to.' Fax: :(3(5D) S-I‘A Dots(4, azhilimang7faciradndioro ffriodi ularr
67.84 2
d
Email: ?erfleti't S ( Im_p —C I•CC-tYl.c._. CO 141 Reconnect only 67.84 2
CONTRACTOR
Pump or irrigation circle 67.84 2
Business name: I\A-‘t I 71.(xlvek E.kectric, Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
0 See Page 2 2
Address: (D D()0 NE. 2.17?"tt'' k-- C21k.9, A panel.alteration,or extension.
Each additional inspection over allowable In any of the above
City/State/ZIP: VanCotikrev- (..A.)109 CI %Co(06 Additional inspection(I hr min) 66.25/hr
Phone:(3‘,00) Si LA ---1 240 c..7 Fax:(3‘20 ) SI Li oCCS ko Investigation(1 hr ruin) 90.00/hr
(QIJ
Industrial plant(I hr min) 78.18/hr
Email: ysty.-yvcik 3 . vyl p ... t\tC.1-1,-1 c...,. (0 vvi
Inspections for which no fee is
CCB Lic.:(0100 )_k Electrical Lic.: 3^7....too Suprv.Lic.:iso. • ,,
specifically listed(54 hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:
Subtotal: Li ciko.01K
,.,1--re---
Print name: c_rst-,...k-- 1.4,00a3ks Date: i v %ot 11-3 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee); Sct.SS
Authorized signature: ..--tit0.44"4.
A,,,,, TOTAL PERMIT FEE: 55s.(0%
I This permit adppilseartiloniterasires ifnaaccpeeprmIt isisnoctoronbptitneed within 180
I Print name: vkvlok VITAk pvLE I Date: 10)11 I 175
• Number of inspections allowed per permit.1:1Buikling1Permits\ELC jennitApp_ELR_ERE.doe Rev 06/17/2015 440-4615T(11/05/COMAVEB