Permit iii CITY OF TIGARD ELECTRICAL PERMIT
o COMMUNITY DEVELOPMENT Permit #: ELC2009-00533
Date Issued: 10/08/2009
T I GARD 13125 SW Hall Blvd , Tigard OR 97223 503.639 4171 parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9538 SW WASHINGTON SQUARE RD H14
Subdivision: Lot: 0
Project: Orange Tree Yogurt
Project Description: TI. Install (1) 200 amp or less service, and add /alter (20) branch circuits
Owner: FEES
PPR WASHINGTON SQUARE LLC Quantity Description Date Amount
2235 FARADAY AVE STE #0
CARLSBAD, CA 92008 1 ea Services or Feeders - 200 10/08/2009 $100.70
amps or less
PHONE: 20 crt Branch Circuits w /Purchase 10/08/2009 $148 40
Service or Feeder
1 ea 12% State Surcharge - 10/08/2009 $29.89
Contractor: Electrical
FRAHLER ELECTRIC CO
11860 SW GREENBURG RD
TIGARD, OR 97223 ,
PHONE' 503 - 639 -4627
FAX: 503 - 639 -4673
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $278.99
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 throu h AR 952-001-0100 n You may a copy of the rules or direct questions to OUNC by calling 503 246,6699 or 1 800 332 2344
Issued By: .- 3 1,( } A 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' t (L ll 1 �/ k V (� 9 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.
r
le ''•trical Permit A licatio FOR OFFICE USE ONLY
City of Tigard a CEIVED Received
Date/B / .... . Permit No Z a �L
; 0 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone 503.639.4171 Fax: 503.598.196a r- 0 Date/By. Other Permit
tu Pal olt `' .7
6 2009
TIGARD Inspection Line: 503.639.4175 Date Ready/By. tuns See Page 2 for
Internet: www.tigard or.gov
CITY OF TIGARD Notified/Method. 't I(+ Supplemental Information
TYPE OF i riRDING DIVISION PLAN REVIEW
N ew construction Please check all that apply (submit 2 sets of plans whtems checked below):
❑ � Addition/alteration/replacement )
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition 0 Other:
where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings
less to ground, or exceeds 14,000 ❑ Commercial -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
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system.
❑ Addition of new motor load of ❑ "A ", E ", "1 - ", "1 - ",
Job no.: 66996 Job site address: 100HP or more.
9538 SW WASHINGTON SQUARE RE ❑ Sic or more residential units. occupancy. ❑ Recreational vehicle parks.
City/ State/ZIP: TIGARD, OR 97223 ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt no.: Project name: ORANGE TREE YOGURT ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Der 1ptton I Q1. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
75.00 2
. DESCRIPTION OF WORK (with above sq ft.)
Limited energy, multi - family i 75.00 2
TENANT IMPROVEMENT residential (with above sq f .)
Services or feeders installation, alteration, and/or relocation
200 amps or less 1 80.30 30 2 -
El PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 i CO. 70 2 .
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
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 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A for branch or feeder w I 4-8.%
❑ APPLICANT I 0 CONTACT PERSON above service tx ce feeeder feeee, , 20 5 1,33C 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: witho service or feeder fee 46.85 2
first branch circuit
Address: Each add'1 branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 90.90 2
Phone: dwelling, service and/or feeder
( ) Fax: ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
. Signal circuit(s) or limited -
Business name: FRAHLER ELECTRIC COMPANY energy panel, alteration, or
Address: 11860 SW GREENBURG ROAD extension. Describe: Page 2 2
City/State/ZIP: TIGARD, OR 97223 Each additional inspection over allowable in any of the above .
Per inspection' — 62.50 62.50
. 'Phone: ( 503 639 -4627 Fax: ( 503) 639 -4673 Investigation per hour (l.br min) ' 62.50 ,
CCB Lic.: 37410 Electncal Lic.: 34 -13C Suprv. Lic.: 5110S Industrial plant per hour 73.75 ,
ELECTRICAL PERMIT FEES a b
Suprv. Electrician signature, required:, C subtotal: 0 . .
Print name: ADAM ETHERINGTON Date: 10/01/09 Plan review (25% of permit fee): ' ., $ q
State surcharge (12% of permit fee): ;5✓
Authorized signature:
TOTAL PERMIT FEE: ��
Print name: This permit application expires if a permit is not obtained within 180
Date: days after it has been accepted as complete
/ .? 9 l' 9 -� ,00-4,
III n CITY OF IGARD ELECTRICAL PERMIT
„ ;' g ; :',.- COMMUNITY DEVELOPMENT Permit #: ELC2009 -00533
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 10/08/2009
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9538 SW WASHINGTON SQUARE RD H14
Subdivision: Lot: 0
Project: Orange Tree Yogurt
Project Description: TI. Install (1) 200 amp or less service, and add /alter (20) branch circuits. 12/9/09, add low voltage
for data.
Owner: FEES
PPR WASHINGTON SQUARE LLC Quantity Description Date Amount
2235 FARADAY AVE STE #O
CARLSBAD, CA 92008 1 ea Services or Feeders - 200 10/08/2009 $100.70
amps or less
PHONE: 20 crt Branch Circuits w /Purchase 10/08/2009 $148.40
Service or Feeder
1 ea 12% State Surcharge - 10/08/2009 $29.89
Contractor: Electrical
FRAHLER ELECTRIC CO 1 ea Signal circuit or Limited 12/09/2009 $67.84
11860 SW GREENBURG RD Energy Panel
TIGARD, OR 97223 0 ea 12% State Surcharge - 12/09/2009 $8.14
PHONE: 503 - 639 -4627 Electrical
FAX: 503 - 639 -4673
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $354.97
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 - - • - - ' h 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. A NTION: Oregon -w re. ' es you to follow the rules adopted by the Oregon Utility No' '• ent- . Those rules are set forth in OAR
952 -00 -0010 th •ugh OAR 952 -1.1 -0 00. You obtain a copy of the rules or direct questions to OUNC b '• ..iu..: or 1.800.332.2344.
Iss ed By: ` // '4! � Per mittee Si s wcP " � " � /
OWNER INSTALLATION ONLY I
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.
Electrical Permit Application FOR OFFICE USE ONLY
Received '' AA
City of Tigard Permit No: K� � e0,533
11 1111 Date/By:
13125 SW Hall Blvd., Tigard. OR 97223 Plan Review
' 0 .. • Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
Date /B :
TIGARD Inspection Line: 503.639.4175 Date Ready /By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction gg 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 ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -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
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
El Addition of new motor load of ❑ "A - - , "E ", "I -2 ", "I -3 ",
Job no.: 66996 Job site address: 9538 SW WASHINGTON SQUARE RD. 1001-1Pormore. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: TIGARD, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: ORANGE TREE YOGURT ' ' ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. 1 Fee. [ Total 1 •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.92 1
Limited energy, residential 67.84 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 67.84 2
(1) LIMITED ENERGY FOR DATA residential (with above sq. ft.)
PLEASE ADD TO PERMIT ELC2009 -00533 Services or feeders installation, alteration, and /or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 I
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 125.08 2
intended for sale. lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
7A2 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 56.18 2
first branch circuit
Address: Each add'I branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 67.84 2
dwelling, service and /or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E -mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Signal circuit(s) or limited -
Business name: FRAHLER ELECTRIC COMPANY ever gy panel, alteration. or
Address: 11860 SW GREENBURG ROAD extension. DATA Describe: 1 Page 2 67.84 I 2
City /State /ZIP: TIGARD, OR 97223 Each additional inspection over allowable in any of the above _
Per inspection 66.25
Phone: ( 503 639 -4627 Fax:( 503 639 -4673 Investigation per hour (I hr min) 66.25
CCB Lic.: 37410 Electrical Lic.: 34 -13C Suprv. Lic.: 1816S Industrial plant per hour 78.18
ELECTRICAL PERMIT FEES
Suprv. Electrician signature. red: / f"k�/ i Subtotal: 67.84
°" Plan review (25% of permit fee):
Print name: Date:
R. W. FRAM FR 12/09/09 State surcharge (12% of permit fee): 8.14
Authorized signature: TOTAL PERMIT FEE: 75- 98
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.
1 \Building \Permits \ELC - Perm it App doc 10/01/09 440- 4615T(I I /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK, ONLY; „ , , , .,, z
Fee for all residential systems combined ... $67.84
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COM ,g.C' IAL WORg1ONa q . f ... x . ff ,,
Fee for each commercial $67.84
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
g Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
n Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ building \Perm its \ELC- Permit App .doc 10/01/09