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Permit CITY OF TIGARD ELECTRICAL PERMIT 31 11, COMMUNITY DEVELOPMENT Permit #: ELC2012 -00010 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/10/2012 Parcel: 1 S 1260000300 Jurisdiction: Tigard Site address: 9699 SW WASHINGTON SQUARE RD C10 Project: Portland Seafood Co Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108 Project Description: Lighting remodel. Contractor: BACHOFNER ELECTRIC LLC Owner: PPR WASHINGTON SQUARE LLC 12031 NE MARX ST BY THOMSON PROPERTY TAX SERVICES PORTLAND, OR 97220 ATTN HILARY RAYMOND 2235 FARADY AVE, STE 0 CARLSBAD, CA 92008 PHONE: 503 - 327 -8872 PHONE: FAX: 503 - 327 -8869 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 01/10/2012 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 01/10/2012 $7.63 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $71.23 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 rquestions to OUNC by calling 503.232.1987 or 1.800.332.2344. -.. � j Issued By ��11` ! �--� ��-: Permittee Signature: _...TSP.a 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. Jan 07 12 07:04p Bachofner Electric 503 3278863 p.3 Electrical Permit Application � V FOR OFFICE LSE ONLY City of Tigard �� R eceived UPI tY ��� Date %B : � f Permit No.: .. a 13125 SW Hall Blvd., Tigard, 0 �72a/ �1. Pt Review 9 jjjj 1% Other Permit: Phone: 503.718.2439 Fax: 503. . 60 6 Date/13 : i tG A 12 H Inspection Line: 503.639 � ` A % �,� .,„.1 Date Ready.By: IE See Page 2 for Internet: www.tigard- or.gov ` . (5 AC. :QV,' ' `` Notified/Method: Supplemental Information TYPE OF wO `�, �' � ) ' _ ` - ` .'` :: , T r - : :. - _ 4, 1r ; rEE,w.: ;: :...,_, '-',:. : ; t' ❑ New construction ® Addition /alterad ent r. .. . z-. } ❑ Service or feeder 400 amps s more ❑ Building checked below): p g over three stories. ❑ Demolition ❑ Other: $ where the available fault current ❑ Marinas and boatyards. CATEGORY OF. CONSTRUCTION',,,.. - exceeds or exceed 10,000 amps at 150 volts o 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 D Emergency system. larger separately derived system. JOB SITE ]INFORMATION AND LOCATION . „ ❑ Addition of new motor load of ❑ "A "E "I - ", "1 -3 ", • Job no.: C 5 3 Job site address: it . ( or or more. occupancy. 76 ? 9 S, sJ u/.tJ.I /N4lOn/ S4 ..20 - ❑ Six or more residential units. ❑Recreational vehicle parks. City / State/ZIP: - 7" 2p 3 ❑ Health -care facilities. ❑ Supply voltage for more than �,�.co , a't6G Q DI Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: ,4.,y, -....a jr...... o el . ❑ Service or feeder 600 amps or more. FEE SCHEDULE. _ Cross street/directions to job site: S.•/ //./.os.✓..!e v... S4. /ea. ��s Description 1 Qty. I Fee. I Total I • New residential single- or multi - family dwelling unit. +', '-r Ie.O. Includes attached garage. Subdivision: Lot no.: 1,000 sq. fl. or less 168.54 4 Ea. add'l 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential 75.00 2 ' • • ' DES_CRIPTION:OF WORK . - , s ,::'. ( w it h above sq. ft.) , Limited energy, multi- family 75.00 2 L I rho ri.v 4 lee' ..-t o o.0 t residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation _ 200 amps or less 100.70 2 © PROPERTY OWNER . I : El TENANT . 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: A r ca ✓o 56.0 roo.o Co.-, P w •• 1 601 amps to 1,000 amps 301.04 2 Address: 4G f 9 sw 0414 t N... r: 7..1 .SQ ,C , Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and /or City/ State/ZIP: . 4 0 • a f 7 7T 3 relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 201 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, least, 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 above service or feeder fee, © A P P L I C A N T ' :. , l .: - . :II CO CT • SON-,- : each branch circuit 7.42 2 /� ,,,,c, Z .re c r e . a Le-['. B. Fee for branch circuits without Business name: (] .aC No f service or feeder fee, first 56.I8 54./45 2 /� Contact name: �p branch circuit Each add'l branch circuit / 7.42 7. 42 2 Address: /2 0 3/ .."C ,/'.e,e ,S Miscellaneous (service or feeder not included) Each manufactured or modular 67.84 2 City / State/ZIP: P ye (.�,4,c 9721 dwelling, service and/or feeder Phone: ( 5 3) d z 7 . 3 5 7r Fax: : ( S o3 ) 52•7. 86 e it Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: r tint h o env - bae a 14 c . /rrc. ee.*f Sign or outline lighting 67.84 2 . , CONTRACTOR.. _ Signal circuit(s) or limited- energy ' - panel, alteration, or extension. Page 2 2 Business name: elgc,/oti✓.r,c ,Ei e z a r c LG C. Each additional inspection over allowable in any of the above Address: / e p 3 / .r/,C ,/-(,e ,e y 5y, Additional inspection (I hr min) 66.25/ hr /� Investigation (1 hrmin) 66.25/ hr City / State/ZIP: /"u s , c , •, ,p C.e ,r G .,./- 9 - r. Z 7 o Industrial plant (1 hr min) 78.18 / hr Phone: (So 3 ) 3z 7 . 8 S 7 a Fax: ($'0 3 ) 32'7 • 8 9 C 9 Inspections for which no fee is 90.00/ hr specifically listed (% hr min) CCB Lic.: /8706Z Electrical Lic.: C S 9 Suprv. Lie.: SG 2s.5 ELECTRICAL PERMIT FEES Subtotal: G3. 6 Suprv. Electrician signature, required: �� Plan review (25% of permit fee): ,B' Print name: 7:re I 6.,,,,,,,,..„, 3 _, Date: /. le, /Z State surcharge (12% of permit fee): 7. 63 TOTAL PERMIT FEE: 7/ t 3 t - Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: R et, eNc< Date: /. q. /Z , • Number of inspections allowed per permit. I^ Building \Perinits\ELC- PermiIApp.doc 07/01%10 440 I /05 /COMIWEB