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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2009-00569 ia 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/27/2009 Parcel: 1 S 1260000300 Jurisdiction: TIGARD Site address: 9595 SW WASHINGTON SQUARE DR B12 Subdivision: Lot: 0 Project: True Religion Blue Jeans Project Description: (1) branch circuit for TI. Owner: FEES PPR WASHINGTON SQUARE LLC Quantity Description Date Amount 2235 FARADAY AVE STE #O CARLSBAD, CA 92008 1 crt Branch Circuits 10/27/2009 $56.18 wo/Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 10/27/2009 $6.74 Electrical Contractor: KEC ELELCTRIC INC 1281 NE 25TH AVE # K HILLSBORO, OR 97124 PHONE: 503-439-0904 FAX: 503-640-3838 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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 OAR 952-001-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 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: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. Oct 23 2009 12:05 KECELECTRICC 5036403838 p.l CEY Y ED Electrical Permit Application q q ry~jfi(j n C City of Tigard OCT 2 U Lt1UJ Received Permit No.: Date/3 027 O ~~o2O© ~7 13125 Sur Hall Blvd., Tigard,OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.10TY OF TIGAM Date/B : Other Pe-0,4 ~p®I - d d/~_9 Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By r ® See Page 2 for Internet: www.tlgatd Or.gOV Notified/Method Supplemental Information t l4ti'fll .11IL s s try l } tl {~11it AtV r i. -.~u ru..~. i4tf l R! r.-"-'- ❑ New construction ® Addition/altembon/replacement Please shed- all that apply (submit 2 sets of plans wlitems checked belmv): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ ,yOther: where the available fault current ❑ Marinas and boatyards. r 11 t1E (t"(}x exceeds 10,000 amps at 150 volts or ❑ Floating buildings. w-..... av-: less to ground, or exceeds 14,000 ❑ Commercial-usc agricultural ❑ I- and 2-family dwelling Z Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi family ❑ Master builder ❑ Other Eire pump. ❑ Installation o5KVA ❑ d s st m. I1 E IIVk OIIA a 1J r~Iksll f Q~ A 11~I me gency system. anger separate) y derive y e ❑ Addition of new motor load of ❑ "A" "F, -2" "1-3 o Job no.: Job site addres SW Washington Square Road Six or P momore. occupancy- Job Six ore residential units, ❑ Recreational vehicle parks. City/State/ZIP: Tigard ❑ Heabb-care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal Suitelbldg.rapt n.:B2 13 Project name: rwa Rt f_t i annarat.. Serme'or feeder 600 amps or more . lino [3 . - : . Cross street/d irect to job site: 7i-uc le6zl C"j p Description Fee. Total New residential single- or multi-family dwelling unit. 46, 7 65791W-5 Includes attached garage. Subdivision: 1 Lot no.: 1,000 sq. R. or less 145.15 4 Tax map/parcel no.: Q ~ Ea. add'I 500 sq. ft. or portion 33.40 1 Limited energy, residential "r IlPC1»..E)1<,, wlC.i?3~14;'.~,,.... ~'l. .tin?•~~ withabove s ,ft. 75.00 2 Clean up demo electrical Limited energy, multi-family 75.00 2 p residential with above . ft. Services or feeders installation, alteration andlor relocation 200 amps or less 80.30 2 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 CitylState/ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) Fax: { ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 10030 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits - new, alteration or extension per panel Owner signature: Date: A. Fee for branch circuits with © ApPLI("A7 G ~GV;'+ above service or feeder fee, ! each branch circuit 6.65 2 Business name: B. Fee for branch circuits r Contact name: without service or feeder fee, 1 46.85 46.85 2 first branch circuit Address: Each add'] branch circuit 6.65 2 Miscellaneous service or feeder not included City/StatelZIP: Each manufactured or modular dwell in service and/or feeder 40'90 2 Phone: ( ) Fax:: ( ) Reconnect only 66.85 2 E-mail: Pump or irrigation circle 53.40 2 Sign orottline lighting 53.40 2 Signal name: KEC Electric, Inc circuit(s) or limited- energy panel, alteration or Address: 761 SFV Bailey Ave extension. Describe: Page 2 2 City/State.71P: Hillsboro, Or 97123 Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: (503) 439-0904 Fax: (503) 640-3838 Investigation per hour (I by min) 62.50 CCB Lie.: 99267 Electrical Lie.: 34-426C Suprv. Lie.: 44895 Industrial plant per hour 73.75 Suprv. Electrician signature, required: Subtotal. Print name: Kenneth E. Conway Date: 10/22109 Plan review (25% of permit fte~ State surcharge (12% of permit fiee7 ~rUl" Authorized! signature-, TOTAL PERMIT FEEL 52, Print name: Date: 'I'bis permit application expires if a permit is not obtained within 180 days afterit has been accepted as complete. Number of inspections allowed per permit. „ I:lBuildiry~PermisELC-PamltApp.dnc 2s/23!66 440-4616T(I I.roS/CO)VUWEB