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Permit ,a CITY OF TIGARD ELECTRICAL PERMIT ` t a COMMUNITY DEVELOPMENT Permit #: ELC2010 -00202 T t GAKL7 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/27/2010 Parcel: 1S1260000300 Jurisdiction: TIGARD Site address: 9597 SW WASHINGTON SQUARE RD Subdivision: WASHINGTON SQUARE MALL Lot: 0 Project: Spec Space Project Description: Provide temporary panel and power for projector in vacant tenant space. Job No. 67491 Owner: FEES PPR WASHINGTON SQUARE LLC Quantity Description Date Amount 2235 FARADAY AVE STE #O CARLSBAD, CA 92008 1 ea Services or Feeders - 200 04/27/2010 $100.70 amps or less PHONE: 3 crt Branch Circuits w /Purchase 04/27/2010 $22.26 Service or Feeder 1 ea 12% State Surcharge - 04/27/2010 $14.76 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 $137.72 Required Items and Reports (Conditions) This permi ' issued subje o the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be don in accordance with ap oved 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 la , eq ires you to follow the rules adopted by the Ore• • • •y�ion Center. Those rules are set forth in OAR 95 01 -0010 th •ugh OAR 95 101 - ou may obtain a copy of the rules or direct question o OUNC by ca ing • •699 or 1.800.332. 344. lil Issued By: • Permitte mature: 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. EL ( Date: LICENSE NO. 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 Applicatio r e C ' 1l. FOR Or1 USE ONLY City of Tigard LI 1 1� ' l'. II Received lit 2 1 DateBy: 9 P. /Q C.--1.4 Permit No.: 64 A49(.4° ���- 1315 S Hall Blvd., Tigard, 97223 Plan Review C 503.639.4171 Phone: 503.639.4171 Fax 503.598.196A PR 2 Q Q Date/By: Other Permit: TIGARD Date Ready/By: ! aria: I Line: 503.639.4175 y y: ® See Poe 2 for Internet www.tigard-or.gov CI. , Notified/Method: en 9 ; Supplemental Infotma6c n w ,, i ,,F T^ t„ '.F`t�k p,,r d i.1*, ? 'i i l 5 � ,. i 4 1 - iJ t ,, , r �v ^` � r b , i ,. n �xr,.*, ,., ,,.. , v,?.,...4, , , , melgUt ,, %ts' rl , * ,, ' ?.y- i .r /{_ .,. A! " 'vS' ''''-'j'''''4'' +. ' ' '' ' ',. t1 � ,'''' ' hi ' '' '' 2 .� r' , ❑ New construction Ec Addition /alteration /replacement Please checl, all that apply (submit 2 sets of plans w /items checked belo ❑ Demolition ❑ Other: ❑ Service or feeder400 amps or more ID Building over three stories. T y where the available fault current ❑ Marinas and boatyards � ;J'; k gkl : .y. t 7 r ° , '(O„ A4 *;($ +) ifeg " l , , ? x , ? exceeds 10,000 amps al 150 volts or ❑ Floating buildings. ` 5 .:, ` ." ''i' T "" less to ground, or exceeds 14,000 ❑ 1 and 2-family dwelling ®Commercial /industrial D Accessory building amps for all other installations. ❑ buildings. tat -use agriculrw ❑ Multi- family ❑ Master builder ❑ Other: . DFire pump. 0 Installation of 75 KVA or .s di rt : ; 1 ' Oifc§ , l g q �" ° � 6 „rs. "' aa „ r ❑ Emergency ystem. larger separately derived s) t `" ; ❑ Addition of new motor load of a ^, •• _3• Job no.: 67491 .lob site address: 9= SW WASHINGTON SQUARE RE !Oxlip OT more occupancy. Q ❑ Six or more residential units. ❑Recreational vehicle parks City /State /ZIP: TIGARD OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more th ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: ❑ Service o r feeder 600 amps or more WASH SQ SPACE B13 t 4 'al w�iP & K .1,i la .,1 i , WUs ., Cross street/directions to lob site: Description I Qtv. r Fee 1 - Total New residential single- or multi - family dwelling unit, includes artacned garage. Subdivision: Lot no.: 1,000 sq. fl: or less 168.54 Tax map /parcel no Ea. add'l 500 sq. ft. or portion 33.92 la >) Limited energy, residential S'zt:i aa v s i Y' .}. i# `1 `" 67.84 r,� ;. S,.s „ < ... < az ,_ ...a, <'Ti+w+ �k_ • at _ 3 t (with above sq. ft.) Limited energy, multi- family 67.84 PROVTDR TF,NiPORARY PANEL AND POWER FOR PROJECTOR TN residential (with above sq. ft.) Services or feeders installation, alteration, and /or relocation VQ,C4NT TFN. NT SPA('F 200 amps or less 1 100.70 100.7C `rc' n 't* , r `'' &si "; _ :,, _ i a ". ;`'`,F ' 201 amps to 400 amps 133.56 Name: 401 amps to 600 amps 200.34 601 amps to 1,000 amps 301.04 Address: Over 1,000 amps or volts 552.26 City /State /ZIP: Temporary services or feeders installation, alteration, and /c relocation Phone: ( ) Fax. ( ) 200 amps or less 59.36 Owner installation: This installation is being made on property that .I own which is not 20] amps to 400 amps 125.08 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. • 401 amps to 599 amps 168.54 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel A. Fee for branch circuits with F 0 "*T ' 4 " X1 '4 t T & ' t"`' r" t T k.5 r' a- above service or feeder fee, .. _ ., 3 7.42 22.2E each branch circuit Business name: B. Fee for branch circuits Contact name: without service or feeder fe 56.18 first branch circuit Address: Each add'! branch circuit 7.42 i i Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular 67.84 dwelling, service and /or feeder Phone: ( ) Fax: : ( ) Reconnect only 67.84 E -mail: Pump or irrigation circle 67.84 z.: g z P , : & r a .. ._ . ,. . 1 8 . _ . 1 ' O T o a .' ,;' p w M a' u.,,r ;g Sign or outline lighting 67.84 Business name: Signal circuit(s) or limited - FRAHLER ELEurRIC COMPANY energy panel, alteration, or Address: 11860 SW GREENBURG ROAD extension. Describe: Page 2 City /State /ZIP: TIGARD OR 9723 Each additional inspeetion over allowable it-any of the :lbw b , Per inspection 66.25 3. 9-10 ne: ( 503 ) 639 -47 Fax: ( 5O3 )�39 -4673 / Investigation per hour (1 hr min) 6635 CCB Lic.: / Electrical Lic.: S u rv. Lic.: ✓ lndustnal loot per hour 78.18 37410 34 -13C p 1816S p ELECTRICAI,...R,ERAIrr "EES - - Suprv. Electrician signature, rered: � i/�=� Subtotal: 122.96 _ Print name: R W Date: Plan review (25% of permit fee) - F'RAHT .FR OL/2n/10 State surcharge (12% of permit fee): 14.76 _ Authorized signature: TOTAL PERMIT FEE: 1 37 . 72 Print name: permit application expires if a permit is not obtained within 11 Date. days after it been accepted as complete. " Number of inspections allowed per pennn. 1:1Bu ildmg \Permils1ELC- PermitApp.doc 10/01/09 44 0- 46157111/05/COM/IEB