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Permit CITY OF TIGARD • ELECTRICAL RESTRICTED ENERGY PERMIT . - COMMUNITY DEVELOPMENT Permit #: ELR2011 -00146 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/23/2011 Parcel: 151260000300 Jurisdiction: TIGARD Site address: 9591 SW WASHINGTON SQUARE RD B10 Project: Victoria's Secret Subdivision: WASHINGTON SQUARE MALL Lot: 0 Project Description: Security system. Contractor: 3 GUYS ELECTRIC LLC Owner: PPR WASHINGTON SQUARE LLC 2062 NW 15TH CT 2235 FARADAY AVE STE #0 GRESHAM, OR 97030 CARLSBAD, CA 92008 PHONE: 503 - 729 -1522 PHONE: FAX: 503 - 661 -7378 FEES Description Date Amount Specifics: Restricted Energy Permit 06/23/2011 $75.00 12% State Surcharge - Electrical 06/23/2011 $9.00 Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio & Stereo: N Security Alarm: Y Garage Door Opener: N HVAC: N Vacuum System: N Other: N Other Desc: Total $84.00 • 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 -0090 You may obtain a copy of th "_:- t questions to OUNC by calling 503 or 1.800 332.2344. 1 Issued % Perm ittee Signature: i 4 / 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. OG/23/2011 07:58 FAX 5039883377 MULT COUNtY AttORNEY Zj001 /003 E Permit Application � �(Gh0 I."01.2 OFF ICE l Isi,:.oN1.1' City of Tigard " ��11 w Received / � 2 i t* C Date ; a mf Fermi[ No �iL. -)(' - a --- 13125 SW Hall Blvd., Tigard, 0 II' • . � ; ^ 1 Plan Review Phone, 503.718.2439 Fax; 503,'' :,1960 q I D B : Other Fermis / o j �� _U0, I •1 1. t.: A II 11) Inspection Line; 503,639.417 J D 0 rano Rondy/By brit: See Qo tfor Internet: www.tigatd r.gov , \3 5 sf Notifled/Method; y Supplemental Information ' 11 ,, +l1 ° '!' '!'�i !'r;!i,illli� ll'IiI III)liy' '�iy�, �, r Ih 4 ) ,, I•li; 1 +� 1 , ”1 „ ,1 '+ "9 ! ,,1 , r,lirii, ,, , , , rl d4;ii''' ,11 , l'O �,y , i (, , I 1 k i { li, , I I , ,� � ' , „,li B�if,n6,„r7 k!'1, 1'rl ^;`°'p„ ?i,•1 11!r• „ I,, � li) '�; '� I' I {,,�•!!il ,!�i �il , (il ; { �f il lol�,�'t.l �� � i , y I 'd14',Il,v.l±..tlt IV , r1•il�'��,�,lit�i� fl;,,, {'!., „�,idf.,i,ilE� ,.�i.! ,,.1`11 flail/gilt` ® New Construction MI Addition /altera Please cheek all that apply (submit j aura of plans w /items checked below): ❑ Demolition Sorvioe or feeder 400 amps or mom CI Building over three stories. Cl ❑ O ther: where the available I feu I Current ❑ Marinas and boa Ards. „, !; '�^, 1; 'c,,o,' :iIn;�iiIi : 'i1c °I'I'oliiI „ ,u� , ,'I' :'0 ' Iii'.' 1 It , {'',11,ii" %!!i!" exceed 10,000 t o ;� �i� ,j,r;lil;�i 11;:;1� I }�St<!I ±'1'�'!'�l!� �7, �, 111�ihl ^I�I�,l�ii'i exceeds amps ©Plaalin8building. 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 0 Master builder ❑ Other: ID Fire pump. ❑ Installation of 75 KVA er ?I;1 ' {li !;? ,it:'i iiT;'i !ii' +, 4 1 n [ s �r li 'i' " "' rt 111,+ 1 , ,! f? 1 ir+ q ❑Emergency system, larger separately derived system. , dlhlu, Ni;',,i•, ,1l ii,� b i }i 401 it , I ; r h ' r ' ,1� 1(i '#i il't i, -1 i . ❑ Addilion anew motor load of ❑ ., '' „ „ - 3 " Job no.: Job site address: 9585 Washington Square loop or mom, occupancy, ❑ Six or more residential units, ❑ Recreational vehicle parka. City /State/ZIP: Tigard, Old ❑ Health -care facilities. ❑ Supply voltage far mom than ❑Hazurdous locations. 600 volts nominal. Suite/bldg. /apt. no.: I Project name: Victoria Secret 4417 ❑ Service or feeder 600 umpa or more. Cross street/directions to job site: Washington Square - -- 'r1l"I' p t ta u ! { �jyi ��ijl'. .' 'air' i1fi' °l, �a;; !ii'Ii i� 111!11 i if lsl' 1; ' g quire Mail oot°ri[a Qh'• Foe, Total • New residential single- or multi - family dwelling unit. _ Includes attached garage. Subdivision: Lot no -: 1,000 sq. R or less _ 168.54 4 Ea. add' 1 500 sq, n. or portion 33,92 1 Tax map/parcel no.: Limited energy, residential ll'i , 1 11i1,,1 I'I, , , 1 h , • , v „ 1 ., I , . , , ! , I 75.00 2 ,,I• ,' � i• ,, i'Y',,'i '41 ; , 14'I%'i 1'i •l•ia l ;i�)��***�$� , �((y�eJ '1 ,,,;' i'+' !, 'l i' 1 I p1;'' 6 , ifr' h i�',Jt above s Ih , 1'l l ,i � i 1, I , ; i ii iii ' , ;�!4'�!ill�"OCi��I I �, 1;1 „1I!• ,11�,I 1 l'. , ,ill i �'' I'i' , I N' 9 ' ) - - h!: ,, ,1 4� i n: ,a„ t L (with imited energy, multi - family Install Anti -theft System. residential (with above sq, ft,) 75 2 Services or feeders Installation, alteration, and/or relocation 200 amps or less _ 100,70 2 I °i i il�'l III ,, 1 , 1 i ,l ',I' f, 1' J M, I'li' !; , i f'I ' , , , •, x +'I 1111 di { ,' n' liI�iri;i i�>Qs 1 # 1 0,4' , �i1l! dtT' /WIi!i ili!I!i ;;Yii�'i,:;RII, ilia ,i�il�l`Vt;Eil�l�p ;*,�i!t l I ; I ,i 1 p,. y � 201 amps to 400 "Ps 133,56 2 �Iee l� "i�'•l �'�` 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 Temporary services or feeders Inatallation, alteration, and /or City /State /ZIP: relocation Phone: ( ) 1 1= ; ( ) 200 amps or less 59.36 l Owner installation: This installation is being made on property that 1 own which i not 201 amps to 400 amps 125,08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits - new, alteration, or extension, . er panel Owner signature: _ Date: A. Fee for branch circuits with ! ^';1 I' r;,I ;I' +° , f pl inlloi n , ) 4 , I I! rq 1 l I above service or feeder fee , , , +�1�); �il,al 1DII�,i I ';j l i l , ul;I ", I If'ii iI!I'b 1x11, i 742 2 I ���' , � 1 I I 1, , �p,ll I I �, , '.i, I � Wi q '' „i I .��� ;�� Ii,�l,r ;,�� i Oaeh branch circuit Business name: 3 Guys Electric, LLC B. Pee for branch circuits without service orfecdor foe, firs 56.18 2 Contact name: Wade Hadley branch circuit Each add' I branch circuit 7.42 2 Address: PO Box 1988 Miscellaneous (service or feeder not Included) City/ State/ZIP: Sandy, OR 97055 Each manufactured or modular 67,84 2 dwelling, service and/or feeder Phone: (503) 729 -1522 Fax: : (503) 826 -1133 Reconnect only 67.84 2 Pump or irrigation circle 67,84 2 ■ E -mail: wade3guys a®gmail.eom Sign or outline lighting 67,84 2 `tilli!L,I' ,! 6'h1, 1I'� { ; I Y' , : ,it { Iljkil l , �M , I �y11tt ,I,I 1 p; 1 !II ∎Iii lit % Ii' 1 Irg '11 '1 P;':I 'll „•In' i' �i'',a, ,ylii :m, Ilai,,i i i I „ �. i , +di; Iii1t.11 ,, i,11 , ,,f,i, I,hll,; }, i, i'h 1�6l�l I , „I(,j, „1 or limit a signal citcuit(s) I SY Business name: Same as Above panel. alteration, or extension. l Pape 2 75 2 Each additional Inspection over allowable In any of the above Address: Additional inspection (1 hr min) 66.25/ hr I ' Investigation (I hr min) 66,25/ hr City /State /ZIP: Industrial plant (1 br min) 78,18/ hr Phone: ( ) F ax; ( ) Inspections for which no fee is s•ocificall listed ''A hr min 90.00/ hr CCB Lie.: 177242 Electrical Lie,: CLEI20 Suprv. Lie.: 5 L ept iilgi { ;x 1 1 1 14!1 I I;Ilifgi!I' ly'�u'�� ylm tPR "' nl`' ?2 ' : ��,n a - I RI `,,;(I ,;1,,i , � - permit foe): 75.00 Suprv. Electrician signature, required: ( Plan review (25% of Print name: Vinton Wade Hadley Date: 6/23/11 Stale surcharge (12% of pennim fec): 9.00 TOTAL PERMIT FEE: 84,00 Authorized signature: This permit application wires if a permit is not obtained within 180 days ortar it hap been accepted al corn plele. Print name; Vita June Hudley ate: 6/23/11 4 Number of inspections allowed par permit. l,1aulldhl5t'armMlldt,C- Porinl tApp,tioc o7/al /lo 441- 4SIST(I1N3 /COM/WEE 06/23/2011 07:59 FAX 5039883377 MULT COUNtY AttORNEY Ij002 /003 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: 6.' ItlU+ 01 (�i y��(� + '!+,'�IH� +II } ' ii{ +)I'll "ll ni{y"'�'h,il,+ +;i }ll ' In^;I"�?lWF 010 iv i1ll�na,! It�II++ IIf I�; ,'IaII!S•; {•�I'r`,ggi;1;�i;IPri Fee for Ell residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: '.I I l � � � � � 3' � i 1 11,I i4 l r. �n l � �! ', � p " + , f uI p,LCL% � „ i•. ", ��j,1;ii�i�,�11� +�,�U.;i,�i „ +N {,�t� ° �)�hT�; Il;,,l�lil��i�liil�!l� Fee for each commercial $75.00 system (SEE OAR 918 -309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation [] Pize Alarm Installation ❑ i.xvAc n Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting" ❑ Protective Signaling ® Other Aadahtt S s� tem Total number of commercial systems: 1 *No licenses are required. Licenses are required for all other installations 0, 5u11ding'rormiu \131.C- PormhAopAoo 07/01/10