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Permit CITY OF TIGARD ELECTRICAL PERMIT ` ` COMMUNITY DEVELOPMENT Permit #: ELC2011 -00302 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/10/2011 Parcel: 1S1260000300 Jurisdiction: TIGARD Site address: 9502 SW WASHINGTON SQUARE RD J03 Project: Wetzels Pretzels Subdivision: WASHINGTON SQUARE MALL Lot: 0 Project Description: (1) 200 amp service, (20) branch circuits, (1) data /telecommunications and (1) fire alarm. Contractor: FRAHLER ELECTRIC CO Owner: PPR WASHINGTON SQUARE LLC 11860 SW GREENBURG RD 2235 FARADAY AVE STE #O TIGARD, OR 97223 CARLSBAD, CA 92008 PHONE: 503 - 639 -4627 PHONE: FAX: 503 - 639 -4673 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 06/10/2011 $100.70 Specifics: amps or less 20 crt Branch Circuits w /Purchase 06/10/2011 $148.40 Type of Use: COM Service or Feeder Class of Work: ALT 2 ea Signal circuit or Limited 06/10/2011 $150.00 Energy Panel Type of Const: 1 ea 12% State Surcharge - 06/10/2011 $47.89 Occupancy Grp: Electrical Total $446.99 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 - e 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. • ENTION: Or -:•n law requires you to follow the rules adopted by the Oregon Utility NotificalipA7 Center. Those rules are set forth in OAR 952 -00 -0010 through OAR • • .01-409. ou may obtain a copy of the rules or direct questions to OUNC by calling 50.232.1987 or 1.800. 2.2344. — ,1 Issued By: , // ,l Permittee Signature: -/ ri ,AlrOlgr _ 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' / _ /i/ - 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 Application FOR OFFICE USE ONLY .r City Of Tigard Received DateB y j 40/,3// "(07i— Permit No. � j 2 n!/ • 13125 SW Hall Blvd., Tigard, OR 97223 :11111 I g Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other PermitauP, Zone_ I v a 3 3 T 1 G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris. H See Page 2 for Internet: www.tigard- or.gov Notified/Method: llCr- Supplemental Information TYPE OF WORD PLAN REVIEW ❑ New construction la Addition /alteration /replacement Please check all that apply (submit 2 sets of plans whtems 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 ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: vm Job site address: GJ50,? — .xJ a424/1 � le, or more. occupancy. ❑ Six or more residential units. El Recreational vehicle parks. City/State /ZIP: i la �� © 4 9 y3 ❑Health-care facilities. El Supply voltage for more than pill-te,6 El Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: 10 1, 4 . 5 ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: J _ Description Qty ee. . F Total - — —' — New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Tax map/parcel no.: Ea. add'I 500 sq. ft, or portion 33.92 1 Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi - family 75.00 2 I ,✓ 'o+t+ 5 _ residential (with above sq. ft.) < Services or feeders installation, alteration, and /or relocation 200 amps or less 1 100.70 100,79 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 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 /State /ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 amps or less 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 1 ❑ APPLICANT I ❑ CONTACT PERSON , service or feeder fee ZD 7.42 144g. 1 -- each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: branch circuit Each add'1 branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) Each manufactured or modular City/State /ZIP: dwelling, service and/or feeder 67.84 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: �, w ��u�� panel, alteration, or extension. 2 �i�Q Page 2 I 5 2 - Each additional inspection over allowable in any of the above Address: ( 0,06) Z ell h�7�� Additional inspection (] hr min) 66.25/ hr City/State /ZIP: blew" � [ 7 73 Investigation t 1 min) 66.25/ hr � t Industrial plant (1 hr min) 78.18/ hr Phone: ( ( Fax: (57)3) 6 35_4.67 3 Inspections for which no fee is 90.00 / hr specifically listed ( hr min) CCB Lic.: 5-7y 0 Electrical Lic.: 3 ... Suprv. Lic.: 5 IIDS ELECTRICAL PERMIT FEES ot Suprv. Electrician signature, required: lii+"�"` L / � . Plan review (25% of permit Subt feeal: ): 399 1p Print name: 4,1, C E��t�, I Date. S /ii State surcharge (12% of permit fee): 41. g/ Authorized signature: TOTAL PERMIT FEE: 44 b, 99 w." This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. * Number of inspections allowed per permit. I:\ Building \Permits \ELC- PermitApp.doc 07/01 /10 440- 4615TO 1 /05 /COM/WEB Electrical Permit Application - City of Tigard ; Page 2 - Supplemental Information LIMI'T'ED ENERGY PERMIT FEES: _ .. RESIDEI�TT,T.WitWOWONLY , a .. Fee' for all`resid'enrial Systeriis co iibi'ned $75:00 - - ck Type ' , . yh - of Work:Involved:: . ,; .: • _._ ..' • . .. Che - ❑ Audio and Stereo Sy stems* _ . . ❑ Burglar Alarm n Garage Door Opener* . ❑ Heating, Ventilation and Air Conditioning System* ❑ , Vacuum Systems* ❑ Other: C1VlMERC O NLY Fee for each commercial $75.00 system (SEE OAR 918_ 309 -00 " = = - •- , Check Type of Work Involved: - •:- - n ..Audio and Stereo Systems - - : - -•1 • [� B oiler Controls ❑ Clock Systems Data Telecommunication Installation F Fire Alarm Installation ❑ H VAC n Instrumentation • n Intercom and Paging Systems . ❑ Landscape Irrigation Coritrol * - • • ❑ - - - Medical _ -:._.. _ ...-.' - -- - - - -- -- - - _ -- - _..._.._._ _ . . ❑ Nurse Calls - .. ❑ Outdoor Landscape Lighting* - Protective Signaling n O ther • Total number of commercial systems:_ _ , *No licenses are required. Licenses are 'required for all other installations 1 :\Building \Permds ELC- Permit App doc 07/01/10