Permit CITY OF TIGARD ELECTRICAL PERMIT
'�! . COMMUNITY DEVELOPMENT Permit #: ELC2011 -00486
Tii{GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/30/2011
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9530 SW WASHINGTON SQUARE RD H10
Project: Apple Store Subdivision: Lot:
Project Description: (1) branch circuit.
Contractor: BADGER ELECTRIC INC. Owner: PPR WASHINGTON SQUARE LLC
4415 NE SANDY BLVD STE 205 BY THOMSON PROPERTY TAX SERVICES
PORTLAND, OR 97123 ATTN HILARY RAYMOND
2235 FARADY AVE, STE 0
CARLSBAD, CA 92008
PHONE: 503 - 288 -4756 PHONE:
FAX: 503 - 493 -7173
FEES
Quantity Description Date Amount
• 1 crt Branch Circuits wo /Purchase 08/30/2011 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/30/2011 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 the ru irect questions to OUNC by calling 503 232.1987 or 1.800.332.234
glab
Issued By: Perrriittee Signature: .v
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.
AUG -29 -2011 12:34P FROM: BADGER ELECTRIC, INC 503- 493 -7173 TO:5035981960 P.2
- 1 P r C Ff. ).-''''..?.. ., .. • , '
a
Ai
4. ., >! turn
1 / �� /
At r/ L
€;" 1r 5‘; 5‘;
al P ell ..._. '.. � _.� l
'1125 SW (•final Mod .. Ttsarrl, OR 97223
AUG PiU G 2 9 20 1 t 93n Rcrs tV —
I'hin`aL 503 639 4171 ion. 503.5` 3, 1960 ' '' whorl t
Inspection Line: 503.639.4175 T1C` . r,R,,,,_.......___
. - > " ,.. i 1` C'. tiwe i4 See Pa e 2 for
T�/ _ ) na3�i dy,� - .. Intend.: www.tigard -or nov � 1 5 ` tfr, 1 /Mcittusi :176 F I Supplemental lararmation
nt (Ili rlihtn rotri� it o :,
u."1".."4'"'" - •
Zitioniallerationirepiacetnent PCC Orr 1VOR[£ P1,AN LRW -
c f irma (reel: all that apply (submit 3 N H• p lans w •'it a nx cber.k:d beim,. �l hit + ran4iructit�n t
F ❑ $
6 sw r rimier 400 ampp or ■ 1 17 over Nailing g ov three Mu i %
0 IJemolition ❑ Other Otero the:wadable fatal current C] Hennas and toz,aria
CATEG a RY OF CONSTRUCTION exceeds 10.000 amps at 150 volts 0 FIuJ"„iiy L,.a:uu.y.,.
Iris to ground, or exceeds 14,000 13 Commercial-ow ayriculturat +
i i .- svtn)_Iomily C' ('ommereinUinduStrial ❑ Accessory build ing ,,..u..cthr sit ctbrrirm,ttrtir *r01 t
d f Muhl Mildly [1 Master builder ❑ Other: ❑ Fire pump. 0 lnatauattonof75KVAor
t �3 „ :rt ;erg Yiiiiv AND LOCATION ❑ Emergency system. larger sept ly derived systems
❑ Addition of new motor load of ❑ "A”, "E", °I "1 i
Job no.: (024 3 Job site address: '' — 104HPormore,
� - / C t ❑Sur or mtae residential arcs occupancy.
CI Recreational vehicle parks.
City/State/ZIP: • • i a 6 i, q 7 r • 2— 0 O Htuldecato ticttittbs. ❑ Supply village for mono than
(] Iitvxduwt5 Merlons. 600 volts nominal.
Suite/bldg..fapt. no.: Q0 �� rvjeci nano: 6 n r C e 0 Service or (ce 600 amps or mot 1
t..° r+ ossstrcct /dircctionstojjjobbssite: I E DULf
New residential singes or aril •
ea attached garage. I . IIy dwelling unit.
Iociud
Subdivision: , t o � or 1 B
Tax ma /parcel no.: mr -, energy. rcs • . dal 67.84 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy multi-family CiULt�i, � tiA i �iL../ 4-4/ residential wilt above . , . ft. 1 Services or feeders iastaNatioa, don, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER ) 0 TENANT 201 amps to 400 amps 133.56 2
Name 401 snipe 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
Ci lSiate/ZiP: Temporary services or feeders u Mlatfon, alteration, and/or
ty relocation F
Phone: ( ) i Fax: ( ) 200 amps or less 1'' 59.36 1
Owner Installation: This installation is being made on property that I own which is not 201 amps to 400 amps ( 125.0$ 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps j' tra.sa 2
Branch circuits- new, alteratio or ex tension, r panel
Owner signature: Date: A. Fee for branch circuits with
above service or feeder fee. l'
❑ APPI.LCAKf ❑CONTACT PERSON above branch circuit 7.42 2
Business name: B. Fee for branch circuits withont I.
service or feeder foe, first
Contact name: branch circuit I 36.18 s Ly 2
Each add'( brunch circuit I is 7.42 2
Address: Miscellaneous (service or (cede ` • t included)
C Each manufactured or modular
City/State/ZIP: dwelling, service and/or feeder :1' 67.64 2
lStllit
Phone: ( ) I 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 timited- energy i +';
Business name: f Ia ( ..(/'t 1 r —r • cl alteration or extension. 3 - 2 2
1 ` ` 1-'1' Each addidonal inspecdoa over r amble
Address:144 C` v n ii^ 5 (1.1/1r,y il IVO tt., Additional i :,. , - 'on (I hr min)
L `
Invcsdgntion(i hr min) till 66.251 hr _III
City/State/ZIP: Q4 SIA ( (XI cif 2 ? q
Industrial plant (1 hr thin) III 78.18/ hr _■
Phone: ( `j (f ) ) ) 5-VC ' _115 1 Fax: (may )) f. , (" 13 Inspections for which no fee is till 90.0W hr — .
L ��s� s, - i6cal listed SS hr min
CCI3 Lic.: 15(n5 ') I Electrical Lic.: .3 S7 Id Suprv. Lic.:5(47 , ELECTRICAL „t I r
Suprv. Electrician signature, required: i Subtotal: Mil
Plan review (25% , t • ii feel:
4 Print name' 0 I ` w `_ to . Date: g' t ` State surcharge (12% a ��'�
Authorized Si 1.11 :. I TOTAL I
{� f � A / /i ' • This permit applkatlua expires if nett Is not obtained withta ISO
Print nttme.�) \ t 1 ✓ l s l�� Dale: 6 I d it lea p a complete.
t Numbs of i allowed rG
'n