Permit ''''':':'-'''='''; CITY OF TIGARD
ELECTRICAL PERMIT
IN a COMMUNITY DEVELOPMENT Permit #: ELC2010 00046
',.TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 01/27/2010
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9702 SW WASHINGTON SQUARE DR F10
Subdivision: Lot: 0
Project: Sprint
Project Description: Add /alter (6) branch circuits for TI.
Owner: FEES
PPR WASHINGTON SQUARE LLC Quantity Description Date Amount
2235 FARADAY AVE STE #O
CARLSBAD, CA 92008 6 crt Branch Circuits 01/27/2010 $93.28
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 01/27/2010 $11.19
Electrical
Contractor:
KEC ELECTRIC INC
761 SW BAILEY AVE
HILLSBORO, OR 97123
PHONE: 503 - 439 -0904
FAX: 503- 640 -3838
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $104.47
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 thrqugh i OAR 952 -001 -0100, You may obtain a cop of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: 10. 11 ,1 1 \ ( 1 Permittee Signature:
w -- -- — - ... ..� -
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' c j (jam Date:
V c V im'
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.
T • Jan 27 2010 13: 12 KCrtIVD 5036403838 p. 1
• Electrical Permit Application �y xi, ' :� ' ° : �• s e . I (.3,11Z ' - .' ,IC 1 ' tos ' I t1\,l,i ..1,44'.. E.,
Received r/�� /
City of Tigard JA RD Date/By: ermit No O O IJ vG �
" 13125 SW Hall Blvd., Tigard, OR 9724 - TIG,� Plan Review
j ° Phone: 503.639.4171 Fax: 503.59€ v
U t ther Per ap��d �
[I +1
Inspection Line: 503.639.4175 gUILDiN :
:�� DIV1S Date Rea /B
G F: h ) Y: ' r ® See Page 2 for
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Internet: ww.tigard -orgov No tified&Method: e
Supplemental [nto
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❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories,
❑ Demolition ❑ Other: where the available fault current ❑ M and boatyards.
4 i � - T �, a'r {{1{ ,c' v'7�L' a'f ' ti � `*' 3'is 1 ' t - s; +0r t•4 , ` t ` a:_ exceeds 10,000 amps at 150 volts or F buildings
s y ¢ . ii t. IC o- NC[: JJ 1 r � i -. i P ❑ g s
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.? II L'��'� i n i stv, • , less to ground, or exceeds I4,000 ❑ Canmereial -use agricultural
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
i r ; n t rear t hat 4 - ire _ t i t l ❑ Emergency system, larger separately derived system.
t :; Ft l i t • t .S "tr ta ., i�i`'' ,n .,46 . vzil A u 113:11i41 i ❑ Add of new motor load of ❑ "A ' 6" l_2 , "1 3'
Job no.: Job site addres SW Washington Square Road 100HP or more, occupancy.
❑ Six or more residential units. 0 Recreational vehicle parks.
City /State/ZIP: Tigard 9 i ❑ Health -care facilities. ❑ Supply voltage for mom than
❑Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: F10 Project name: Sprint TI ❑ Service or feeder 600 amps ormore.
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Cross street/directions to job site: Description Qty Fee. Total "
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no,: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1 I
Tax map/parcel no.: Limited energy, residential
. a t Y (rttrn7lis t
t'irrrirt x . e .; ti].t N k ~ l71 a a ti 75.00 2
r : r ^ # rs. a r'St :. i 'tie t iiit W ra di .- � ferr .....'v. _,A! F :'+r" _..� titida (with above sq. ft) -
r space for Sprint Tl Limited energy, multi - family
remodel s residential (with above sq. ft)
75.00 2
P P
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 1 2
r °.• y ta �� = ��
lkl a " phi -! ,.r -a : 1 s t r li WE � t {g , " a � t ` � r 201 amps to 400 amps 106.85 2 i. Name: 401 amps to 600 amps 160.60 2 I
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts I 454.65 2 t
City/State/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 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 1 2
Branch circuits — new, alteration, or extension, per panel
Owner signature Date i
I
A. r w A. Fee for branch circuits with
‘..7 t , i ; : if .' '4± L ' A ' lw 'fis r,• G ;; 1 .... i . t. ,. 1 , ° M - ... . „ n ,i_ above service or feeder fee, 6.65 i 2
each branch circuit
Business name: 13. Fee for branch circuits (�
Contact name: without service or feeder fee, 2 �t,3
first branch circuit �° �'
Address: Each add'i branch circuit X5 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or nodular l I
dwellin,service and /or feeder 1 90.90 2
Phone: ( ) I i Fax: : ( ) Reconnect only 66.85 2
E- mail: g Pump or irrigation circle 53.40 2
`' x w - y ""`Y `'� g , ° , �'t .11:`we. :y ERMAW I � . outline lighting 53 .40 2
✓ y" }, . 3 yr, , .,. ��rt,..31<`.�I[ 0diiu�:tat�.� n Y -
Sign or
Business frame: KEC Electric, Inc Signal circuit(s) or limited -
energy panel, alteration, or
Address: 761 SW Bailey Ave extension. Describe: Page 2
City /State/ZIP: 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 (1 in min) 62.50 1
CCB Lic.: 99267 Electrical Lic.: 34 -426C Suprv. Lic.: • • 89S Industrial plant per hour t r }]73.75
__.. i .Ail: :tl." a� iW�..�� .�'il .'.GF , 4 At�r' ;. _ :, 711' .' -!r;ri
Suprv. Electrician signature, required: / . r.t,
P g fl / / /2 7 /40 0 Subtotal: : r 10
Print name: Kenneth E. Conway Date: Plan review (25% of permit fee): Q 3
State surcharge (12% of permit fe,e): , (11Aq
Authorized signature: TOTAL PERMIT FEE.
This permit application expires if a permit is not obtained within 180
Print name. Date: days after it has been accepted as complete. ( �
Number of inspections allowed per permit. lo� "l
Mau ilding\ Permits 'ELC-Pervri tApp.doc 05123.'06 440- 46157(11/05/C EB
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