Permit II CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00704
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/22/2010
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9585 SW WASHINGTON SQUARE RD MGMT OFF
Project: Washington Square Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project Description: (5) branch circuits and (1) HVAC system for new controls on second floor over H- block.
Contractor: FRAHLER ELECTRIC CO Owner: PPR WASHINGTON SQUARE LLC
11860 SW GREENBURG RD 2235 FARADAY AVE STE #0
TIGARD, OR 97223 CARLSBAD, CA 92008
•
PHONE: 503 -639 -4627 PHONE:
FAX: 503 - 639 -4673
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo /Purchase 12/22/2010 $85.86
Specifics: Service or Feeder
1 ea Signal circuit or Limited 12/22/2010 $75.00
Type of Use: COM Energy Panel
Class of Work: ALT 1 ea 12% State Surcharge - 12/22/2010 $19.30
Electrical
Type of Const:
Occupancy Grp:
Total $180.16
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 het forth in OAR
952- 001 -0010 through OAR 9 2- 001 -0090. You may_ob -'• - • • of the rul- or direct questions to OUNC by calling 503. 2.1987 or 1.800.332.2344.
Issued By: y 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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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 A lica ' E D F OR 'OFFICE USE ONL .
City of Tigard Received �d
• Date/By: 1 I f0 Permit No.: i ` _ �
]3125 SW Hall Blvd,, Tigard, OR 97223' 2, 1 20lo y ��
_ ' ,,, , t P lan Review
. . • _ . Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
l' 1 G A R D • Inspection Line: 503.639.4175 Date Ready/By: : orris: BI See Page 2 for
Internet www.tigard-or.gov CITY OP •11G A t?_r' S Notified/Method: � 737 Supplemental Information
.,W n 7YPEti o� DIN
, i 1"f t p r:f : - /4
❑ New construction n 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 ❑ O t h er: where the available fault current
❑ Marinas and boatyards.
f CATEGORY 0F, %CONST'RUCTIO N r exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
- less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
. ❑ ] - and family dwelling 1M Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder E. Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB'STTE 1NPORMATTON :AND LOCATION ❑Emergency system. larger separately derived systei
., ❑ Addition of new motor load of ❑ "A" "E" "1-2", •'1.3°
lob no,: 68107 Job site address: 9585 SW WASHINGTON SQUARE RD Six or 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: WASHINGTON SQUARE MALL ❑ Service or feeder 600 amps or more.
"FEE SC_ HEDULE
. Cross street/directions to job site: Description . Qtr. I Fee. . Total
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: • Lot no.: 1,000 sq. ft. or less 168.54
Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.92
a " 1)ESCRIPTtION OF WOR ` " t (with above Limited sq. ft residential 75.00
Limited energy, multi - family
NEW CONTROLS FOR CENTRAL. PLANT H —BLOCK residential (with above sq. ft.) 75.00
'
• . Services or feeders installation, alteration, and /or relocation
200 amps or less • y 100.70 ',
®1.ROPERTY,OWNER` ., "TENANT , k , * i 201 amps amps ,133.56 • .. -
401 aiti � P s to 600 - amps" s - - — "
200.34 - ` - - - •
601• amps`to 1,0004mps • 301:04: - -- • • • --
Addi: -- - -- = :-
ess 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 : , .59.36 1
201 amps to 400 amp
mps 125. 2
Owner installation: This installation is being made on property that I own which is not
2
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, p,er panel
Owner signature: Date: A. Fee for branch circuits with
,, ®APPLICANT * ..; n' ¢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 4 7.42 29. 2
Address: Miscellaneous (service or feeder not included) -
City /State /ZIP: Each manufactured or modula 67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) • Reconnect only 67.84 2
E -mail:
Pump or irrigation circle 67.84 2
Sign or outline lighting 67.84 2
.; % CON:,,' CTOR Signal circuit(s) or limited- energy
Business name: F'RA}LER .ELECTRIC COMPANY panel, alteration, or extension. -- Page 2 75•00 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:..._ ... . __ ..._ - . . . - - -• -. P ( )
T OR — 97223 — —° Industrial plant 1 hr - - -- 78.1 '8 %hr
, _ Phone: - ( 503' - ) - 639 - 4627 --- ------- - Fax: (503) - 639 -4673. ___.___.___ _ Inspections•for which no fee is - " •
specifically listed ( % min) 90 00/ hr
f..CCB -Lic: - 37410 ---_ ____- Electrical- Lic __ -13C- Suprv, Lic.:._ -_ -1816S
E LECTRICAL vPERMIf FEES: +:
–Suprv- Electrician• signature, red; • - . – =✓� subtotal 160 85' -
"• Plan review (25% of pe rmit fee).
Print name: R R. w F ER – — - Date: 12/20/10 '- State surcliarge (12% of permit fee): 19.30
Authorized signature: TOTAL PERMIT FEE: 180.16
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.
1:18uilding\Permits\ELC- PermitApp.doc 07/01/10 440-4615T( 1 1/05 /COM/WEB
•
Electrical Permit Application - City of Tigard •
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
- : :_ . RE'SID RRKFONLY .. - .
:..._... Fee for' all -residential systems- combined $75.00'-••• • • - - ` ,� .,, •r •
. _ _ . of Work- Iinvolved'c .- __._..._.- -.... ---:" 77- ._--` . , . •
-!' "; E. Audio' and• Stereo Systems* --
El Burglar Alarm .
❑ G arage Door Opener* • '
❑ Heating, Ventilation and Air Conditioning System* •
❑ V acuum Systems*
- ❑ Othef: - ___. -- - - -- - �- - -
' e MMERCiAL •WO ONL '
Fee for each commercial $75.00
system -
(SEE OAR 918- 309 -0000) - ' _
Check Type of Work Involved: .•.
- "` ' ' , Audio and Stereo S' "stems ... _ _ _
4
"` ' ❑ = Bo Controls ' ' •
.
❑_. Clock Systems •
❑ Data Telecommunication Installation
❑ Fire Alarm Installation -
YJ HVAC
. . . ' Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control* •
❑ Medical
• ❑ Nurse Calls
- - - E Outdoor Landsca` e Li htin ... - -
p , g _,.
- - -
- -- - Protective• Signaling
_. :..__._...__........_ ._ ..........._...
, _, , - , -
-
Total•number of commercialsystems:- . "'" - :
•
*No - licenses are required. - Licenses are required
for all other installations •
I:\ Building U'ermits\ELC- PermitApp.doc 07/01/10