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Permit • CITY OF TIGARD ELECTRICAL PERMIT 1111 COMMUNITY DEVELOPMENT Permit #: ELC2012 -00090 I,CAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/08/2012 T Parcel: 151260000300 Jurisdiction: Tigard Site address: 9612 SW WASHINGTON SQUARE RD GO2 Project: Claires Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108 Project Description: Electrical for TI. Low voltage for data and fire alarm systems. Contractor: JC ELECTRIC INC Owner: PPR WASHINGTON SQUARE LLC 118 NW 184TH STREET BY THOMSON PROPERTY TAX SERVICES RIDGEFIELD, WA 98647 ATTN HILARY RAYMOND 2235 FARADY AVE, STE 0 CARLSBAD, CA 92008 PHONE: 360 887 - 7889 PHONE: FAX: 360- 887 -5584 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 02/08/2012 $100.70 Specifics: amps or less 23 crt Branch Circuits w /Purchase 02/08/2012 $170.66 Type of Use: COM Service or Feeder Class of Work: ALT 2 ea Signal circuit or Limited 02/08/2012 $150.00 Energy Panel Type of Const: 1 ea 12% State Surcharge - 02/08/2012 $50.56 Occupancy Grp: Electrical • Total $471.92 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 rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. / -- _ Issued By • • Permittee Signature: ri '~ r� 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. 02/07/2012 12:34 3608875584 J. C. ELECTRIC, INC. PAGE 02/03 Electrical Per Application r- L f OFFICE USE City of Tigard FEB — 7 2012 Received ■ 13125 sw H all Blvd., Tigard, OR 97223 nate/B p 7 /d— Permit No,:u Idt --OW/0 ' ` Phone: 503.718.2439 Fax; 503.598.1960 OFTIGARD, Dale/By: ow Other Permit: n t1 tIUAlt,1� Inspection Line: 503.639.4175 ® DING �v 1 Date Rrad B r- goo__ �x � I Internet; wwwtigard- or.gov p��I� DIi'�G DIVIe7EO \� y y • lure: S See ant I for Notified Method: :,j1t ti�f .'; • l,i i`i ...F� :� , '� ! Y!i �{!) ' H t„ ' „u, -,1, s,.; 71 Supplemental Information �..11'� -ti I• ,,I it. , ch ,ii. ��i'r 1 "iii =h ;, •u. .,. ..��i .,.11, Lii #Il :� ,.,.. 7 GI tt. "•7'�i :.i, i�a {J. �hf�h, c.kt,'a: �i��,li t� a,�.�,,.,.., �,}f a t, ..,,, J � i 1 t :, . l , d; 1, .; # ,� ,i 11'1 , ,.. KIP w , 1'l'!' }y" t , $i ... l : i{ r r,,'"' , 'f :. : ,..,;.,, , r�i1(�t�a' aril � :,1t 4�s ,yt ; .,:: : � , � : ; �. ; I !; ;� t i 1 r I � ��y�y ,,,, ` : :�'� New h } 'i ii� �r.;1i1.fi}} 4� : :i.ou. ,..!:. ` 1 • ,' ` .', , .ns,! r. =E ;! 1islitl 3.. ii,lj�i;lll�i�' :3,;: 1 .�si;T!{��( , 1., : :.�11 . :,,. N Construction ❑ Addition/alteration/replacement Please check all that apply ep pp Y (submit 2 sate of plans w /iteets checked below): ❑ Demolition Other: 0 Service or feeder 400 amps or more 0 Building over three stories, Floating buildings. ' ,,:' :: a.;; II' ,,;. un t , rst „ :,.. ,,, ;i , where the available fault current i j,)...,,.E,.., �, , ; :., ... 1 , n 1 i . i l , +, ' 1 °u�� r , . { i i it : : ❑Marinas and boa errs ,II V i.4 ?thi'.dt s l it` ill11 , esr n+a 5i, jsgr1 ,' �', i I p I,,t j 1. j ; , ri • i ;� � �' '� ���, �' � , I i .,i d s ] 0,000 amps at 150 volts or 0 OS>1S t ilsl ,,. :,' „ „ r ,li,i' � lexcee to ound_orexceeds14,00t1 ❑ 1- and 2 - family dwelling Commercial /industrial ❑ Accessory building ❑ Ge al - use agriauhurat amps for all other installations. buildingsldings . ❑ Multi ❑ Master builder ❑ Other: ❑ Fire pump. © installation of 7s KVq, or ❑E 1t�y iL'I.i' ) ,Iflnj i(',i' n tl yn us�s,(, i?i t� }� tu, iutKmn lam+ Emergency separately d :,:I i I ,i lt1 I,t i ��a o ” �p,4, 7N ii trd• �t ,J 111,0101114111111'1, ge o system. larger ", "1-2 " " system. i hr ' ai rn�ictli tit t iaca, rni +ti ❑fvldirion of new moron load of !] "A" "E" l -2 derived riv n Job no.: 20 i a 0 )\ Job site address, 0 . :� 100HP or more. 0001r ' it.. �• R L 0 Six or more residential units, ❑ Rec al vehicle parks City /State /ZIP: ' C rj , ,a ❑Health - care facilities. ❑ Supply voltage for more than ❑ }tazatdous locations. 600 volts nominal. Suite/bldg. /apt. no.: Ga I Project name: CA l se a 0 Service or feeder 600 asps or more. Cross street/directions to job site: \ : 'i, i s i! 14�1,, �1Il I;! flit; . 343331, m N sP+ bil' it `,l, i 'I ',Jl�r.iEii;;lr., l!c ;,. j�1�p�{ ms� �h. , m yy a�t�i n>< y nu, dA. t , i ■i l = :. :, :: �r Pc.y �(���.� x+ �. ems[.: • • �'- De6ert Bart Ly'4 -FRO. iy�w e New residential single- or multi - family dwelling unit. r Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Tax map /parcel no.: • Ea. add'1500 sq. lt, or portion 33.92 I ' ry jg P ya } 1,, 4 i tu a t 9i Limited energy, residential ; iE i • al i �lEsl silll�.flli fi` P `a ,1ry- "�g U i11{.,t ai lP {j + sAinr , I it +, i +!'Ili)' w' 75.00 ' .� ,t,iFtFii. tII ursrK[n7n Mtr�tak,gfAII{ ,I�il h � lid 16�� !, r ,L! ,I (with 2 il Limited energy, multi - family --\ ^ - . 1 ! . residential (with above sq. ft.) 75.00 2 Services or feeders installation, alteration, and/or relocation ;i:, iii ....., l:: ''' "' , ,: , : ::; , :e.: ,. aanl r : � ; I i n amps or less 100.70 200 a t ,' i g. #i 7 I 1. ,1 i� 1 i + . l q,! l ° 1f 1 1 �a ;li 1 , �f k e,1 " i ' ii i I CiQ 2 C � a r fiflf�1l�tsM 'i �i l "� ! � •�i't a'I ����i! s � � ll�,l�� ll� 201 amps to 400 amps 133,56 2 Name: 401 attlps'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 City/State /ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) Fax: ( • ) 200 amps or less 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, and 701. 40 1 amps t 599 amp 168.54 2 OWll er signature: Branch circuits — new, altcration extension, per panel Date: A. Fee for branch l +411 i ll�l ' .'j` l!lt>' jf�i(pti � : j °� °. t S� ? " � i iS, 31kIY '11.i!:;. 1 ' I iu + slatsA ran h circuits with i , L.: ll +� .. it i;.,.1„' a ,4y „ i 1 1. ; }, t +, l , i ov r fc, ' ima rl 9 4, ii It„ I ; I e -+ ' r ; i ij �„J�s ±�»���tu�+>l�ndutta'k H0 to `� � 1', =�1, , service or fxda 7.42 eaabe ch b eit utt 2.3 1 , 4 2 Business name: B. Fee for branch circuits wtthout service or feeder fee, first Contact name: branch circuit 56.18 2 Address: Each add'! branch circuit 7.42 2 Miscellaneous (service or feeder not included) CitylStzttel2IP: • Each manufactured or modular dwelling, service and/or feeder 67,84 2 Phone: ( ) Fax:: ( ) Recormect only • 67.84 2 E moil: Pump or irrigatio circle 67.84 2 1; :Es' ?' { , ids? : a :; :, :;,'�it, 1 " , i ?i;i-l1`'ii; : :p :; :; „fig !" �^m _ :, Sign or outline lighting 67.84 i'•0 : :, ., ,' : :: ;, r :,.dil',: Iltl:t,i. i- ! i, JOlyaiNNi i ;; YL'' 1 li�;' + 'ij1 1 .K 1 .Iji,�l� 1 ,!''' !II; ° iS131'i 11;j%',ll! �IIi la' % 2 Signal circuit(s) or limited Business name: -cc tC, lAC . panel, alteratio or extension. 2 Pa" 2 V% +Ga 2 Address: Each additional inspection over allowable in an of the above \ 11S 11 1 _a5 Additional inspection (1 hr min) 66.25/ hr , City/State /ZIP: t t , ` 4 Investi (1 hr min,) 66.25/ hr - •M I p (1 Far th in) 78.18 / hr Phone: • c Fax: (z1,0}r) �, r Inspections for which no fee is CCB Lie.: V 11 cificall listed' (yA hr mm 90 00/ hr IMI 1 \% _ Ele ctrical Lic,; :�. Suprv. Lic.: ; j: .' I Po t a, rv. � . ���,t" 1 f� �,l��,Sfi,t�, a 'r+ '�� ��� +ir § }i����`;4� i � �i :'' P Electrician sig' . , ,0 equired: Ar Subtotal. .1« yl� Su Print name: review (25% of permit fee); ,... /� i. t s State surcharge (12% of permit fee): ., Authorized signature: /S i i. TOTAL P U.,llT FEE: 1 — . This permit application expires if a permit is not obtained wings 180 Print name: �L days after it has bee Date; Y e acc as complete. � . ' 6 5..._ ° Number of inspections allowed per permit. L\ auildie5 1pennit,\ELC- Pcmitapp.doc 07/01/10 • 4 .40- 46157(1 I /05 /COMA'EB 02/07/2012 12:34 3608875584 J.C. ELECTRIC, INC. PAGE 03/03 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: , .y „ ",. !•. 9 t +�r� k nna S' t I ljtla wit ', 1111iiil l- Fee for ate residential systems combined .. $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener` n Heating, Ventilation and Aix Conditioning System* ❑ Vacuum Systems* ❑ Other: .4,m Fee for each commercial $75.00 system (SEE OAR 918 - 3090000) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls E] Clock Systems Data Telecommunication Installation Fire Alarm Installation El HVAC ❑ Instrumentation ❑ Ii>_tercona and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling El Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations x:1 Building\pvinhamc- PermitApp.do0 07/01/30