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Permit /z�P2 iAi & ♦ /3d /ic � - I w h CITY OF TIGARD ELECTRICAL PERMIT I` • COMMUNITY DEVELOPMENT Permit #: ELC2010 -00158 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/07/2010 TIGARD Parcel: 1S1260000300 Jurisdiction: TIGARD Site address: 9565 SW WASHINGTON SQUARE DR BO3A Subdivision: Lot: 0 Project: Icing Project Description: (21) branch circuits for TI. 4/30/10: ADD (1) 200 amp or less service panel relocation. Owner: FEES PPR WASHINGTON SQUARE LLC Quantity Description Date Amount 2235 FARADAY AVE STE #O CARLSBAD, CA 92008 21 crt Branch Circuits 04/07/2010 $204.58 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 04/07/2010 $24.55 Electrical Contractor: 52 da Electrical Permit 04/30/2010 $51.95 FRAHLER ELECTRIC CO 6 da 12% State Surcharge - 04/30/2010 $6.23 11860 SW GREENBURG RD Electrical 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 $287.31 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: - PermitteeSignature: 0 -4 L9' V / (7,9-77 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. 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. q CITY OF TIGARD ELECTRICAL PERMIT t. COMMUNITY DEVELOPMENT Permit #: ELC201000158 Date Issued: 04/07/2010 T (G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S1260000300 Jurisdiction: TIGARD Site address: 9565 SW WASHINGTON SQUARE DR BO3A Subdivision: Lot: 0 Project: Icing Project Description: (21) branch circuits for TI. Owner: FEES PPR WASHINGTON SQUARE LLC Quantity Description Date Amount 2235 FARADAY AVE STE #O CARLSBAD, CA 92008 21 crt Branch Circuits 04/07/2010 $204.58 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 04/07/2010 $24.55 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 $229.13 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. AT OF1TI N: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -0 -0010 through OAR 93 - 00 You may obtain a of the rules or direct questions to OUNC by calli•; I , • 6.6699 or 1.800.332.2344.. Iss d By: , - �J`�`� A./li Permittee Signat 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' 4 4 / ` ( 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. S Electrical Permit Application FOR 01 flCL USSL r Rec eived � ■. irk �h7b ' City of Tigard D ° 131 SW Hall Blvd., Tigard, OR 97 .' - as1 Date/By: / 3// 1� re t ELC2010 -00158 Plan Revie C Ph one: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: TIGARD Inspection Line: 503.639 Qf R 2 7 20 o DateReady /By: 1uri la See Page 2 for Internet: www.tigard- or.gov Notified/Method: I`" Supplemental Information • x .;r , r 1 - { e t x6 r '.. VP' M� r ..r r {i. J "t., , .r -Al: , l seA s ❑ New construction [I Addition /al t, ti t WilNacaliVritSION Please check all that apply (submit 2 sets of plans w /items checked below) ❑ Service or feeder 400 amps or more ❑ Building over three stones. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. a � ..CGpIi OJ C Q t 1 E 1'JO r exceeds 10,000 amps at 150 volts or ❑ Floating buildings. : 't N. F , ,, "' " "` ' i'z ` " 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 SUB �S1 E `$1>ILtA ... ...iI'I1oN ..,CfC47°lON Y . ❑ Emer system lar separately derived systr ..�., : F . . .. ,, ,.._ , _ ,.� . .,..: ,: _. .�. . .. ,..., ., „,,i, , .._, ,. Addition of new motor load of ' ❑A ❑ Job 110.: l site address: IOOHPormore. occupancy. h745� 9565B SW WASHINGTON SQUARE RD ❑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: ICING ❑ Service or feeder 600 amps or more Cross street/directions to . job site: ; Description :' y '” IE ; S4�HE DULE " ; ` ' ., w 1 Qty. 1 Fee. I Totnl 1 New residential single- or multi - family dwelling unit. includes attached garage. Subdivision: Lot no.: 1,000 sq. tt. or less 168.54 Ea. add'I 500 sq. ft. or portion 33.92 Tax map /parcel no.: mited ener residential • ,y k fiy.t'' , ` n ` 'DI C.I<L r 61 ,�T.� '}t d '`'` , ` ._ ; ., t j t (with above sq. ft.) 67.84 Limited energy, multi-family 67.84 • REVISED PERMIT — PT .EASE MAKE CHANGES TO REFLECT THTS residential (with above sq. ft.) Services or feeders installation, alteration, and /or relocation APPLICATION ADD FOR RELOCATING SERVICE PANEL 200 amps or less 1 100.70 100.70 r { k' . . . l *O .iliii�' OV NTB. ' s fi r r ' I `r Ti' `.. . 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 /or relocation Phone: ( ) • Fax: ( ) 200 amps or less 59.36 Owner installation: This installation is being made on property that I own which is not 201 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 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with '�"',>`0' 'J '� `� -' '� 74 �' '` S f j ,- 7 C'" 3�c,y t i- ° �' ; , above service or feeder fee, �_ :,� ._.. � ,� ,� ..,, � � �_.�... � _.�... 21 7 42 155.82 Business name: each branch circuit B. Fee for branch circuits without service or feeder fee, Contact name: first branch circuit 56.18 Address: Each add'l branch circuit 7.42 Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular • _ dwelling, service and /or feeder 67.84 Phone: ( ) Fax: : ( ) Reconnect only 67.84 E -mail: Pump or irrigation circle 67.84 Si gn or outline lighting 67.84 `' ��{ 4 - w � fi .:: �� , ... ': CU*'.Rr�:i�31C9R`; . � � : ,, .. ;. � �..:,, . , ' ' b g Business name: Signal circuit(s) or limited - FRAHT ,FR ET .FCTR TC COMPANY energy panel, alteration, or Address: extension. Describe: Page 2 11860 SW GREENBURG ROAD City/State /ZIP: TIGARD , OR 97223 Each additional inspection over allowable iii any of the above Per inspection 66.25 one: ( 503 639 -4637 Fax ( 503 ) 37410 �'T9 -47 j Investigation per hour (1 hr min) 66.25 CCB Lic.: , Electr Lic.: 34 -130 p S u rv. Lic.: 5110S 1 / industrial plant per hour 78.18 %te.TI: ttcA:IL.. PER J11T ITEE s Suprv. Electrician signature, required: t ' ,, .. Subtotal: 256.52 Print name: / Date: Plan review (25% of permit fee): ADAM MUER T NGTON O4/21/10 State surcharge (12 %ofpermit fee): 10 7c Authorized signature: TOTAL PERMIT FEE: 287.31 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 pennit. I:\ Building \Permits1ELC -Perm itApp.doc 10/01/09 440- 461 ST( 11105 /COM/WEB PD. 04/06/07 229.13. - TOTAL DUE 58.18 ,rV pi 1 I a ils 4^ t -t6 I r 1 r �� + 1 rl Electrical Permit Application " , , �' , z , - 3 s 1 � l OR of H ( 1 uSi 1 0rl;1 - ;:).;21': , ': II r Received • j' I w :11 C ity of Tigard DateB : Perm No. c --- 4 C solo • �0� � a 13125 SW Hall Blvd., Tigard, OR 97223 plan Review . 0 Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit �lQ_ o d i7 ,, Ins ection Line: 503.639.4175 Date Ready/By: luris: BI See Page 2 for T I [CARD i P Not ified/Method - Supplemental Information 1 .: ni. . -, i:d. Internet: www.tigara-or.gov PP TYPE OF .WORK PLAN REVIEW ❑ 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. 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 Z Commercial/indusl ial ❑ Accessory building amps for all other installations. buildings. /SO ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of,.. kVA or ❑ Emergency system. larger separately derived system. JOB SITE. INFORMATION' AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "i - ", "1 - ", Job no.: 67452 Job site address: 9565B SW WASHINGTON SQUARE RD. 100HP or more. 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: ICING ❑ Service or feeder 600 amps or more. . FEE. SCHEDULE Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 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'l 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential 67.84 2 DESCRIPTION OF WORK" ft.) (with above sq. ft Limited energy, multi - family 67.84 2 TENANT IMPROVEMENT residential (with above sq. ft.) 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 2 401 amps to 600 amps 200.34 2 Name: 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and/or City/State/ZIP: relocation Phone: ( ) Fax: ( ) 200 amps or Tess 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease; rent, or exchange, according to ORS 447, 449, 670, and 701. 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, 7.42 2 each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, first 1 56.18 56.18 2 Contact name: branch circuit Each add'l branch circuit 20 7.42 148.40 2 Address: Miscellaneous (service or feeder not included) Each manufactured or modular 67 84 2 City/ State/ZIP: dwelling, service and/or feeder Phone: (. ) Fax: ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E -mail: Sign or outline lighting 67.84 2 , CONTRACTOR , . - Signal circuit(s) or limited- energy Business name: FRAHLER ELECTRIC COMPANY panel, alteration, or extension. Page 2 2 Each additional inspection over allowable in any of the above Address: 11860 SW GREENBURG ROAD Additional inspection (1 hr min) 66.25/ hr Investigation (1 hr min) 66.25/ hr City/ State/ZIP: TIGARD, OR 97223 Industrial plant (1 hr min) 78.18 / hr Phone: (503) 639 -4627 Fax: (503) 639 -4673 Inspections for which no fee is 90.00/ hr . specifically listed (''4 hr min) • CCB Lic.: 37410 Electrical Lic.: 34 -13C Suprv. Lic.: 1816S ELECTRICAL PERMIT FEES � Subtotal: 204.58 Suprv. Electrician signature, rky fired: �j et/h Plan review (25% of permit fee): Print name: R. W. FRAHLER �� ,� Date: 04 /06/10 State surcharge (12% of permit fee): 24.55 TOTAL PERMIT FEE: 229.13 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Date: . Number of inspections allowed per permit. Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: 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: 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 ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems Landscape Irrigation Control* Medical ❑ Nurse Calls Outdoor Landscape Lighting* n Protective Signaling Other Total number of commercial systems: _ *No licenses are required. Licenses are required for all other installations \ Building \PermitslELC- PennitApp.Aoc 10/01/09