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Permit CITY OF TIGARD ELECTRICAL PERMIT l: COMMUNITY DEVELOPMENT Permit #: ELC2010 00572 T f G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/15/2010 Parcel: 1S1260000300 Jurisdiction: TIGARD Site address: 9619 SW WASHINGTON SQUARE RD Subdivision: WASHINGTON SQUARE MALL Lot: 0 Project: POTTERY BARN Project Description: (2) branch circuits for office addition. Owner: FEES PPR WASHINGTON SQUARE LLC Quantity Description Date Amount 2235 FARADAY AVE STE #O CARLSBAD, CA 92008 2 crt Branch Circuits 10/15/2010 $63.60 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 10/15/2010 $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. 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 OA; • . :.1 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.24 99 or 1.800.332.2344. z • 1111111111b Issued By: Permittee Signature: �� x italY 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. 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 riIR Orrice use ONLY City of Tigard �,1. I in' 1 ,�� .� .� .: 13125 SW Hall Blvd., Tigard, OR 97223 Fax `� Plan Rev Other Permit Phone: 503.639.4171 : 503.598.19 G � % Date/BY L1 g9. 00 243 i - i (, : \ , ; F) Inspection Line: 503.639.4175 c�� Date Ready/By: T ® See Page 2 for Internet www.tigard- or.gov c �j,t- . otiSed/Method: 2 Supplemental Information 'S:- N7.a'''u v }�'k t `l. rt e.. 7 .,t o I?("V�f�R r _ � u �t ' ��. " �- .y 2r- r..r.f' r : .....;.:: . x �+ t >��r'. i , ) � EY 3s s .i+ +:�V 0" ' #. . >.�:::I. �G�? -. ❑New construction ® Addition/slteration/repl }, rA Please check all that apply (submit a sets of plans wlitems checked below): j``_ VIN NG ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑Other: �� were the available fault current ❑ Marinas and boatyards. y iia ij :�! s N i s i - - .. exceeds 10,000 . ❑ Floatin e} �" ..�'..� . � s>: �:. s '�'i�i AX'� ©�[.rca�U : �� i�� �� � .. � at 150 volts or g buildings. less to ground, or exceeds 14,00 ❑ Commercial-use agicnihuat ❑ 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 , y .: .. � 1 r. +.�.,' g ❑ Emergency system. larger separately derived system: '' r gt , c . ni 11.0 0 • r 0 ::* Off, * ' �a ii k k A, ..,�• t . _ , . . t .-. .. .... .. .._�./ :. c � i�.�, . y _ ��`,,.... . > °: ❑Addition of new motor load of ❑ `A °, "E", °1 -2 ", "1 -3 ", Job no.: 67921 Job site address: 100HP or more. 9619 SW WASHINGTON . SQUARE RL, ❑ Sbc or more residential units. ❑ Recreational cnal vehicle parka City /State/Z1P' • TIGARD OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal Suite/bldg. /apt no.: CO1A Project name: POTTERY BARN ❑ Service or feeder 600 maps or more. _ . street/directions to job site: r s!'' � �` .4° . or •p6,•r' Cross str . Description l Qtr. 1 Ben 1 Tota 1 New residential single- or multi- family dwelling unit. - Iadades attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 no.: Ea. add'1500 sq. ft. or portion 33.92 1 Tax map/parcel Limited energy, residential Z 'S;i:. ; •�;cd,6 ?;i= 0/`e ::r i ( t ?'t:j.i r ._ `: ' �_: 75.00 2 1 y .. *\. . d; , . r - ` � `.. a ' •, i ...IE w ... .q . s A . ry'; ,:t5 fix'` p (with above 3q. R) . ,:., Limited energy, multi residential (with above sq. ft.) 75.00 2 TENANT IMPROVEI�NT' IN DIVISION MANAGERS OFFICE Services or feeders installation and/or relocation 200 amps or less 100.70 2 ;` -��'`�`" r! 201 3 � H . '�^ �.i.�Y..N ±'�wV:��"2.11JiF S FO r T��':1, �'$'�. .. .: �.�, L'.IF Y1.7'Lf 11 f J. -..Y.. t° 4°0 atnp.9 13 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 /StffieJZIP Temporary services or feeders installation, alteration, and/or • Phone: ( ) 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 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 snipe to 599 amps 168.54 ^ 2 Branch circuits- new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with Y z ° i"`: r`r,�`�'r{�-r;,! ;tilt;: : its nui;;_a :i :` . i.; . ^., y�' :,< a service 7.42 2 „�' a';;�.,� �,..,,.�,J�.L' 17,'- .I�A�`5' :. �gl.�'•'3@'� - ,6r�i 1� �::�= 1c..�'�� � � �lE_ 'b.:. � . - each branch c Business name: B. Fee for branch circuits without service or feeder fee, first 1 56.18 56 2 Contact name: branch circuit Each add'' branch circuit 1 7.42 7_4.9 2 Address: 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 . Pump or irrigation circle 67.84 2 E - '.r y •.��'r, : l : +:F;: {'r. -'f' g <..4 >�`srfM�� ..a °�....,- .�c•��r;.: Sign orontlinelighting 67.84 2 z "Yi.nr.6 .'t�'.z�,?'w. . + +'.. fry.•f r? ^`°{t'J,5,: [ :ir;'i.CO 'XFOR'�.:.iC¢.°.t'> 4. , n4.1LL ,�'S fi3� '_ �! , r,.'..`.;�Y;; .i?' .. si mrcul*() limited -ener or limited 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 city/state/2w: TIGARD OR 97223 Investigation (1 hr min) 66.25/ hr Industrial plant (1 hr mil) 78.18/ hr Phone: ( 503 639 -4627 Fax: ( 503) 639 -4673 xti008 for which no fee 1s 90.00/ hr specifically listed (li hr min) CCB Lic.: 37410 Electrical Lic.: 34 -13C I suprv. Lic.: 3046S y:, n is ,-r` r ., rrr , >' >Y j{ii>� a�?. =: y . . ��. rf �Ia+fsw2'pIF�'� r�'.w.e'�r:; Subtotal: 63.60 Suprv. Electrician signature, required: 1 I 1) Plan review (25% of permit fee): Print name: RIC BB _ MATHER' Date: 10/15/10 State surcharge (12% of p fee): 7. 63 • Authorized si " -sets v �� TOTAL PERMIT FEE: ]1 _ ' 'ibis pe rmit application expires it a permit to not obtained within 180 Pont name: days after it has been accepted as complete. • Number of inspections allowed per permit I.• BuildiogTermitAELC-PennitApp.doo 07/01/10 440.4615T(11/05/COM/WEB