Permit a CITY OF TIGARD ELECTRICAL PERMIT
`a COMMUNITY DEVELOPMENT Permit #: ELC2009 -00645
t GARB 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/04/2009
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9581 SW WASHINGTON SQUARE DR B08
Subdivision: Lot: 0
Project: Sony Style
Project Description: Install 2" conduit for fiber cable, install (2) branch circuits.
Owner: FEES
PPR WASHINGTON SQUARE LLC Quantity Description Date Amount
2235 FARADAY AVE STE #O
CARLSBAD, CA 92008 2 crt Branch Circuits 12/04/2009 $63.60
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 12/04/2009 $7.63
Electrical
Contractor:
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 $71.23
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. At work will
be done in a •ante wi = ••roved 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. AT ' TION: Oregon law requires ou to follow the rules adopted by the Oregon Utility Notificatio Center. Those rules are set forth in OAR
952 -001 '010 through OAR 952 -04 ,� 10' •u'may obtain a cop of the rules or direct questions to OUNC by calling .24 .6699 or 1.800.332.23• •
Iss ed By: Permittee Sign
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 INSTAJ ONLY
/
SIGNATURE OF SUPR. ELEC' Date: 4
LICENSE NO. /,74
CaII 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
I I 3 I25 of Tigard Received
at e ' s : ; ffmri r� Edc, - 5
`J g / Permit No.: /♦
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
_ Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
Date/By:
T I G A R D Inspection Line: 503.639.4175 Date Ready /By: Juris: ® See Page 2 for
Internet: www.tigard- or.govv �y T�' Notified/Method: Supplemental Information
m �;uj Mi YxY; M1, �", u.7:- Y k• � 1 ; d.. ,, TYPE .4.i :' oR1c ° d b 4 t `'' tg r'' 3 i S .'' !* *40 r ' r n !
❑ 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 ❑ Marinas and boatyards.
T t, .
�,? 4; s rr;cs;� .k ¢ G'c► .ES' -r Q)�' C Q.T r f,'S '1 „ k(FTC7 .! .;'-...7,,,,-,..,::,,, , as -$ � u ` v w "i ., exceeds 10,000 amps at 150 volts or ❑Floating buildings.
s' " `
less to ground, or exceeds 14,000 0 Commercial-use agricultural 1 - and 2 - family dwelling [N Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
x z' �� ' JoB $ t a M ❑ Emergency system. larger separately derived system.
,.. ,.. ... ., , _�_,'. �, ❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I -3 ",
Job no.: 67168 Job site address: 9581 SW WASHINGTON SQUARE ROAL I or more. ec
❑ Six x o or r more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: TIGARD 7 OR 97223 El Health-care facilities. ❑ Supply voltage for more than
• ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: SONY STYLE ❑ Service or feeder 600 amps or more.
M ',, ` ,gY Y,T'EE `SCHEAI'JIE "ti-t a.' " ., ,_; u <'
Cross street/directions to job site: Description I Qty. I Fee. - I 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
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
67.84 2
�a > ,s'i ,' � ., "'DI$SG: itli®J O K '{)I i i E ,, -.` (with above sq. ft.)
2" Limited energy, multi - family
INSTALL 2 CONDUIT FOR SONY STYLE FIBER CABLE residential (with above sq. ft.) 67.84 2
INSTALL (2) DEDICATED 20 AMP OUTLETS Services or feeders installation, alteration, and /or relocation
200 amps or less I I 100.70 2
t~s s' �� � � . lE,`It O A V �N�3R,,, y r� <, i ��_ .. x `. 7 , , 201 amps to 40D amps 133.56
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: ( ) I Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I 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
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel h
-:04, ' ' - AI")Cr AP3' ti ' ....,.; -. a .', 6o T4t', 'I'.` i)ito i ' ; A. above service rtfeeder 7.42 2
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee, 1 56 56.18
.
Contact name: first branch circuit
Address: Each add'l branch circuit 1 7.42 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:
( ) I Fax: : ( ) Reconnect only 67.84 2
E -mail: Pump or irrigation circle 67.84 2
4 F .'; Z:;',. ,r"� ., s, CONT,RAcTOR,'Y;.• . err ..''a<= ° :a.''.,', ,',r Sign or outline lighting 67.84 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 66.25
Phone: ( 503 > 639 -4627 I Fax: ( 503) 639 -4673 Investigation per hour (t hr min) 66.25
CCB Lic.: 37410 I Electrical Lic: I 34 -13C Suprv. Lic.: 1816S Industrial plant per hour 78.18
/dX,� (i� x EiEC IUr�Al _rERl�ub .;.
Suprv. Electrician signature, r r /6A
ed: Subtotal: 63 60
Plan review (25% of permit fee):
Print name: R. W. FRAHLER Date: 12/03/09 State surcharge (12% of permit fee): 7.63
Authorized signature: TOTAL PERMIT FEE: 71.23
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 10/01/09 440- 4615T(11/05 /COM/WEB