Permit q CITY OF TIGARD ELECTRICAL PERMIT
2 . COMMUNITY DEVELOPMENT Permit #: ELC2011 -00519
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 718.2439 Date Issued: 09/21/2011
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9530 SW WASHINGTON SQUARE RD H10
Project: Apple Subdivision: Lot:
Project Description: Electrical for TI
Contractor: FRAHLER ELECTRIC CO Owner: PPR WASHINGTON SQUARE LLC
11860 SW GREENBURG RD BY THOMSON PROPERTY TAX SERVICES
TIGARD, OR 97223 ATTN HILARY RAYMOND
2235 FARADY AVE, STE 0
CARLSBAD, CA 92008
PHONE. 503 - 639 -4627 PHONE
FAX 503 - 639 -4673
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo /Purchase 09/21/2011 $71 02
Specifics: Service or Feeder
1 ea 12% State Surcharge - 09/21/2011 $8.52
Type of Use: Electrical
Class of Work:
Type of Const:
Occupancy Grp:
Total $79.54
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 2- 001 -0090 You may obtain a copy oft - ru =s or direct questions to OUNC by calling 503 232 1987 or 1 800 332 2344.
Issued By: v" 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.
1
Electrical Permit Application 1
, • FOR OFFICE USE ONLY
. -
1 1312 City SW Hall Blvd Tigard OR Tigard • cV ' .) R d
„ 1 op eceive view ,....7,
-
iffiETIM Permit No.: - . •`,/i... - ."*. - t
5 ., , 972c '' .i6'; A Dat
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' : •• Phone: 503.718.2439 Fax 503.598.196U . ' -‘. 1.. ir \3 '
ih e/B • ,A1 /Am
Plan Re
Date/B . if
Other Permit • o .„, /
TIGARD
Inspection Line: 503.639.4175 Date Ready/By: 1) .-°1
0
ENS n See Page 2 for
Internet: www.tigard-or.gov
—c•• 112-401,- I:lotified/Method. Supplemental Information
;::. !Iti li( i:COMMWn:'
El New construction [ZI Addition/alteration/repidwa . Please check all that apply (submit 2 sets of plans w/items checked below)-
V . 0 Service or feeder 400 amps or more El Building over three stories
El Demolition 0 Other: where the available fault current El Marinas and boatyards.
V 5 A 1 0.44'. : -IPPI I P.'! : ',C A :# 0 0,. 1 - *S- co§tkt,#y*PIAat . ::Ir El: exceeds 10,000 amps at 150 volts or 0 Floating buildings
less to ground, or exceeds 14,000 0 Commercial-use agricultural
I=1 1- and 2-family dwelling [E] Commercial/industrial El Accessory building amps for all other installations. buildings
0 Multi-family ID Master builder 111 Other: 0 Fire pump. 0 Installation of 75 KVA or
,,,,, 0 Emergency system larger separately derived system
-00441.5rt icitirgirElINkiiii4ATION, AD LOCATION . , Ii '-:-: . - "' fi-'
. „,. .,.,., „., , , , A p: 0 Addition of new motor load of
Job no.: 68798 Job site address: 9530 SW Washington Square Road 100HP or more.
0 Six or more residenti occupancy
al units. 0 Recreational vehicle parks.
City/State/ZIP: Tigard, Ore, 97223 , 0 Health facilities 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal
Suite/bldg./apt. no.: Project name: Apple Store 0 Service or feeder 600 amps or more.
F.,gNi$0 , " kl :. " g1 , -4:1
Cross street/directions to job site: Description I OtY• I Fee. I Total I *
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 1
Tax map/parcel no.:
Limited energy, residential
7 4;e;1':11Ailt.IF ':1 AS: : DtsckulicoN;,0,frW,Ofilc if :: ' -1”47 (with above sq. ft.) 75.00 2
Limited energy, multi-family
Office space improvements residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
- -I:imtnil'ROYERIVitraiiA ' R 2 *,, *21::;--Vii? ;y01#11/44 :AShr;:: ,,:,, 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: -
• 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: relocation .
Phone: ( ) Fax: ( ) 200 amps or less 59.36 '
1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168 54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
l'InAPPLICANT . ,,-"V''' • 67-wi= =1 0 ,c0WATctiitiolsi','-' - above service or feeder fee,
7.42 2
each branch circuit
Business name: B Fee for branch circuits without
service or feeder fee, first 1 56.18
56 18 2
Contact name: branch circuit
Each add'I branch circuit 2 7.42 14.84 2
Address: Miscellaneous (service or feeder not included) _
Each manufactured or modular
City/State/ZIP: , dwelling, service and/or feeder 67.84" 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E Pump or irrigation circle 67.84 2
- mail :
Sign or outline lighting 67.84 2
'41::$'r..: ' ta:::1 ti. Signal circuit(s) or limited-energy
panel, alteration, or extension. Page 2 2
Business name: FRAH1ER ELECTRIC COMPANY Each additional inspection over allowable in any of the above
Address: . 11860 SW GREENBURG ROAD Additional inspection (1 hr mm) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City/State/ZIP:. TIGARD,- OR - 97223 Industrial plant (1 hr min) 78.18/ hr
Phone: ( 503) 639-4627 . . Fax: ( 503 ) 639-4673 Inspections which no fee-is
- 90 00/ hr
•
specifically listed ( hr mm)
CCB Lie.: 37410 Electrical Lie.: 34-13C Suprv. Lic.: 5110S :11:::.;A::::?": , WPriticAu, , lex 11141T1 FEES - '::
Suprv. Electrician signature, required: /a ( '
i1; Subtotal: 71.02
1 4... ,
Plan review (25% of permit fee).
Print name: ADAM ETHERINGTON Date: 09/20/11 State surcharge (12% of permit fee): 8.52
TOTAL PERMIT FEE: 79.54 .
Authorized signature:
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 \Building \Permits TLC-PermitApp.doc 07/01/10 440-4615T(11/05/COM/WEB
03/20/2012 11:39 FRAHLER ELECTRIC 3 95035981960 N0.242 D01
,9—/i , S } y
FRAHLER ELECTRIC COMPANY e .
11860 S.W. Greenberg Road, Tigard, Oregon 97223
PHONE (503) 639.4627
COB #37410 . . .
Fax Transmittal
Fax # (503)639.4673
S ATE: 030ll• RECEIVING FAX NUMBER: 6543) 598 -1960•
RECEIVING LOCATION :_ T
PERSON SENT TO:
SENDER: .
NUMBER OF PAGES; / • (including. transmittal)
SUBJECT:
MESSAGE: 4 r _ _ rL42011 -4047 2.
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COMMENTS:
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- COMMERCIAL * STREET LIGHTING * INDUSTRIAL
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03/15/2012 15:12 FRAHLER ELECTRIC -, 95035981960 NO.232 D01
. _ I
RE
MAR 152012 •
FRAHLER ELECTRIC COMPAN _
OF TIGARD
11860 S.W. Greenburg Road, Tigard, Oregon i NG DIVISION
PHONE (503)639.4627
CCB 837410 •
Fax Transmittal
Fax # (503)639 -4673
DATE: 4� �S l L RECEIVING FAX NUMBER: 3 ' - •
RECEIVING LOCATION: — 1 7 -31%64..d...--
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PERSON SENT TO: DAi Sqrlige5 at . • Ir
SENDER: b.rtdiAi
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NUMBER OF PAGES: transnm r
SUBJECT: 3 5 7, I WAS/ -p r - • , " 04 c v
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MESSAGE:
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C o / MENTS:
COMMERCIAL * STREET LIGHTING * INDUSTRIAL
03/15/2012 15:12 FRAHLER ELECTRIC 4 95035981960 NO.232 102
RECEIVED
Community Development MAR 15 2012
Request for Permit Action
- 1, ,.; A R 9 CITY OF TIGARD
BUILDING DIVISION
TO: CITY OF TIGARD
Building Division Services Supervisor
13125 SW Hall Blvd, Tigard, OR 97223
• Phone: 503.7182430 Fax: 503.598.1960 www.tigard- or.gov
FROM: ❑ Owner 0 Applicant Contractor ❑ City Staff
. (check one)
REFUND OR Name: FRAHLER ELECTRIC COMPANY
INVOICE TO: 0141,ncs' or Individual)
Mailing Address; 11860 SW GREENBURG ROAD —
City/State /Zip: TIGARD, OR 97223
Phone No.: (503) 639 -4627
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
T TION.
® CANCEL PERMI .APPLYCA
® REFUND PERMIT FEES (attach receipt, if available).
❑ INVOICE FOR FEES DUE (attach case fee schedule and explain below).
❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit).
Permit #: ELC2011 -00519
Site Address or Parcel #: 9530 SW WASHINGTON SQUARE ROAD
Project Name: APPLE .
Subdivision Name: Lot #:
EXPLANATION: CUSTOMER HAS CANCELLED THE PROJECT
Signature: Date: 03/15/12
SANDRA K HARRISON
Print Name:
1 Director or Building Official may authorize the refund of
a) any fee which was erroneously paid or collected.
b) not more than 80% of the land we application fee when an application is withdrawn or canceled before any review efforr has been expended.
c) not more than 80a /o of the land use application fee for issued permits.
d) not more than 80% of the building plan review fee when an application is emceed before any plan review effort has been expended.
e) not more than 80% of the building permit fee for issued permits prior to any inspecdon requests.
2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds.
Rte ro Sys Admin: Date By Rte to B14aAdrnin: Date By
Refund Processed: Date By Invoice Processed: Date By
Permit Canceled: Date By Parcel Tag Added: Date By
Receipt # Date Method Amount $
1:\ 13uildin g \FormARegPetmitACtion•dac Bev 02 /23/2011
03/15/2012 15: FRAHLER ELECTRIC 4 95035981960 NO.232 P03
CITY OF TIGARD . RECEIPT
13126 SW Hall Blvd., Tigaro OR 97223
- 503.639.4171
i li;Ah.l)
Receipt Number: 183982 - 09121(2011
CASE NO., FEE DESCRIPTION EigNUE ACCOUNT NUMBER PAI
ELC2011.00519 Branch Circuits wa /Purchase Service or 220-0000.43103 $7102
Feeder $t3 52
ELC2011 - 00519 12% State Surcharge - Electrical 100 - 0000 -24001
Total: $79.54
PAYMENT !WNW CHECKS, # CC AUTH. CODE, AMR CASHIER ID RECEIPT DATE RECEIPT AMT
Check 044403 BTAGGART 09/21/2011 $79.54
Payor. Frahler Electric Company
Total Payments: $ 79 . 54
Balance Due: $0.00
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