Permit ,, CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00672
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/01/2011
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9585 SW WASHINGTON SQUARE RD OFFICE
Project: Nissan Leaf Car Event at Washington Square Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: Electrical service for Nissan Leaf car event
Contractor: RED'S ELECTRIC CO INC Owner: PPR WASHINGTON SQUARE LLC
6336 SE 107TH AVE BY THOMSON PROPERTY TAX SERVICES
PORTLAND, OR 97266 ATTN HILARY RAYMOND
2235 FARADY AVE, STE 0
CARLSBAD, CA 92008
PHONE: 503 - 233 -6467 PHONE:
FAX: 503 - 233 -1281
FEES
Quantity Description Date Amount
3 ea Services or Feeders - 200 12/01/2011 $302.10
Specifics: amps or less
1 ea 12% State Surcharge - 12/01/2011 $36.25
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $338.35
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. ATTENTIO.: a - =•n law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules az set forth in OAR
952- 001 -0010 t• ough OAR 9 2 -' 1091. You may obtain a copy of the rules or direct questions to OUNC by calling 50.. 3..1987 or 1.800.332.2 44.
Issued By: �',
1
Permittee Signature: � f �G�a71
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' C / Date:
/Gy— L
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.
Nov. 30. 2011 9:17AM No. 0078 P. 1/2
Electrical Permit Applicatio> FOR OFFICE USE ONLY
City Tigard l �1'O V 3 0 2011 Received
DatelE3 : i Pcrrnit NO,: F - 6 7
13125 SW W Hall Blvd., Tigard, OR 97223 . Plan Retuw
. �.�,.,
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li p i
Phone: 503.718.2439 Fax: 503,59 Date/B : Other Permit:
inspection Line: 503.639,4175 trt OF TIGARD Dale Ready /By: H Se Page 2 for
T LGA R f) BUILDING Notified/M Supplemental e
Internet: ,v,vn•,ugard- or.gov B UILD G DIVISION t t lemental Ldormation
TYPE' OF WORK'.::':.:. " ;,r ...,.... . . • .. PLAN REVIEW .
❑ New construction ❑ 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 0 Other: there the available fault current ❑ Marinas and boatyards.
' '..4. • A exceeds 10,000 amps at 150 volts or 0 Floating buildings.
) C g o Co
TEiGORY O F��QNS'1'RiJC'T10N' , : .
1- and 2-family dwelllCommercial/industrial Aec less to ground, Or exceeds W,000 ❑ Commercial -use agricultural
Accessory building amps for all other installations. buildings,
❑ Mulli family Master builder ® Other: ❑ Fire pump. IiiTa1laito of 75 KVA or
JOB.: Sl"l'E: 1NFORMAT AN .. .. stem. larger separately derived System,
Lt�J1h D:'..LOCA'I'K.ON • :. merlsencY 3
Job no.; 67257 I Job site address �Vashin 1011 S Rd ❑A dd. I P or of new
m motor load of ❑ " en*. o
C c u "E","1-2","1-1", a
1001 Y.
1P or men*. at 1panC
❑ Six or more residential units ❑ Recreational vehicle parks.
City /Stale /ZIP: Tigard, Oregon 97223 ❑ Health -care facilities. ❑ Supply voltage for More than
d Hazardous locations. 600 Fells nominal.
Suite /bldg. /apt. 11o.; Project name: ", r i Q/L • d DSn'vtce or fredcz 600 mopo Or more.
SCHEDULE
Cross street /directions to job cite; Demrionon FEE. O.,J F I Torsi
New residential single- or multi-family dwelling unit.
includes a ltaetted garage.
Subdivision: Lot no.; 1,000 sq. It. or less 1 168.54 4
Ea. add') 500 sq. ft. or portion 33,02 I
el no.: T
p p Limited energy, residential
:.. 75.00 2
DESCRIPTION �Ol? ; WOR K,' ..
zxn
• ;....::, .. . :..:..: ... (with above sq, ft)
Limited energy, multi- family 75,00 2
Nissan Leaf Car Show residential (with above sq. II.)
Services or feeders installation, alteration, and /m• relocallon
200 amps or'leSS 3 100.70 302.10 l 2
❑ ...
O E
ROpIN it Cl' ,WNR , 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 voles 552.26 2
City/State/ZIP: ' /Stoic /l..IP: Temporary services or feeders installation, alteration, and /or
relocatiolr
!'loft;: ( ) Fax: ( ) 200 amps or Icss 59.36
~ 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, had 701. 401 amps to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, per panel
T
Owner signature; Date; A. Fee for branch Circuits with
:. , ' ,. above service or feeder fee,
.. . ... ..., APPLICANT:'`' .: ;..:.:;.,':, . ❑ PERSON:: ;,:, .:. . ; : 7.42 2
Q each branch circuit
Business name; B. Fee for branch circuits without
service or feeder fcc, first 56.18 2
Contact name:
branch circuit
Each addl branch circuit 7.42 _2
Address; Miscellaneous (service or feeder not included)
City/State/21P: Each manufactured or modular 67.84
L
dwelling, service and/or feeder 11 2
Phone ( ) Fax: : ( ) Reconnect only 67.84 2
E pump or irrigation circle 67.84 2
Sign or outline lighting 67,84 2
... r.... C N
,....... ; .'.....: Signal circuit(s) or limited-energy •
Business name; Red's Electric panel, alteration, or extension. Page 2 2
Each additional Inspection over allowable in any of the above
Address: 6336 se 107TH Additional inspection (1 hr min) 66,25/ hr
Investigation (1 hr min) 66.25/ hr
City /Stale /ZIP; Portland, Oregon 97266
Industrial plant (I hr min) 78,18/ hr
Phone: (503) 233.6467 -1; . 5 § 503) 233 -12B1 Inspections for which no fee is — 90.00 / hr
•
• specifically listed (h hr min)
CC13 l,ie.: 4443 Electrical Lie.: 26 -152c 4 Suprv. Lie,: 50105 •••.)ELECTRICAL PERMIT FEES
� Subtotal: 302.10
Suprv, Electrician signature, required: Plan review (25% of permit fee):
Print name: Jim Ferris , Date: jj / y /1/ ' State surcharge (12% fee): 36.2
` TOTAL PERMIT FEE; 338,3
Authorized signature: This permit application expires if a permh Is not obtained within 180
Print name: Date: days after it has been accepted as complete.
Number of inspections allowed per'ternnu.
1:W ildiaa A2l_C-PermilApp.due 07/01/10 4.10.1615T(11 /05 /COMIWES