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Permit .J CITY OF TIGARD ELECTRICAL PERMIT IN 11 COMMUNITY DEVELOPMENT Permit q: ELC2012 -00078 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/07/2012 Parcel: 1 S 1260000300 Jurisdiction: Tigard Site address: 9485 SW WASHINGTON SQUARE RD A06A Project: Build -A -Bear Workshop S division:VASHINGTON SQUARE ESTATES NO. Lot: 108 Project Description: TI Contractor: TREK ELECTRIC LLC Owner: PPR WASHINGTON SQUARE LLC 2980 SE TUMBLESTONE DR BY THOMSON PROPERTY TAX SERVICES HILLSBORO, OR 97123 / ATTN HILARY RAYMOND 2235 FARADY AVE, STE 0 CARLSBAD, CA 92008 PHONE: 503-430-8984 PHONE: FAX: 866 - 730 -5960 FEES Quantity Description Date Amount 5 crt Branch Circuits wo /Purchase 02/07/2012 $85.86 Specifics: Service or Feeder 1 ea 12% State Surcharge - 02/07/2012 $10.30 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: • Total $96.16 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 •52- 001 -0090. You may obtain a copy of t or direct questions to OUNC by calling 503.232.1987 or 1 800.332.2344. Issued By: �` L _— y: 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. CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2012 -00078 T t G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/07/2012 Parcel: 1S 1260000300 Jurisdiction: Tigard Site address: 9485 SW WASHINGTON SQUARE RD AO6A Project: Build -A -Bear Workshop Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108 Project Description: TI 2/28/2012: REPRINTED permit to include data telecommunications work. Contractor: TREK ELECTRIC LLC Owner: PPR WASHINGTON SQUARE LLC 2980 SE TUMBLESTONE DR BY THOMSON PROPERTY TAX SERVICES HILLSBORO, OR 97123 ATTN HILARY RAYMOND 2235 FARADY AVE, STE 0 CARLSBAD, CA 92008 PHONE: 503 -430 -8984 PHONE: FAX: 866 - 730 -5960 FEES Quantity Description Date Amount 5 crt Branch Circuits wo /Purchase 02/07/2012 $85.86 Specifics: Service or Feeder 1 ea 12% State Surcharge - 02/07/2012 $10.30 Type of Use: COM Electrical Class of Work: ALT 1 ea Signal circuit or Limited 02/28/2012 $75.00 Energy Panel Type of Const: 0 ea 12% State Surcharge - 02/28/2012 $9.00 Occupancy Grp: Electrical Total $180.16 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through • 952- 001 -0090. You ma • • . • - • • of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344, Issued By: �� . - s Permittee Signature: c$ - . '/ - 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. mall 503.638.41.75_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. CITY OF TIGARD ELECTRICAL PERMIT 114.. COMMUNITY DEVELOPMENT Permit #: ELC2012 -00078 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/07/2012 Parcel: 1 S 1260000300 Jurisdiction: Tigard Site address: 9485 SW WASHINGTON SQUARE RD AO6A Project: Build -A -Bear Workshop Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108 Project Description: TI Contractor: TREK ELECTRIC LLC Owner: PPR WASHINGTON SQUARE LLC 2980 SE TUMBLESTONE DR BY THOMSON PROPERTY TAX SERVICES HILLSBORO, OR 97123 ATTN HILARY RAYMOND 2235 FARADY AVE, STE 0 CARLSBAD, CA 92008 PHONE: 503 - 430 -8984 PHONE: FAX: 866 - 730 -5960 FEES Quantity Description Date Amount • 5 crt Branch Circuits wo /Purchase 02/07/2012 $85.86 Specifics: Service or Feeder 1 ea 12% State Surcharge - 02/07/2012 $10.30 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $96.16 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OA' •52- 001 -0090. You may obtain a copy of t or direct questions to OUNC by calling 503.232.1987 or 1 800.332.2344. Issued By: • Permittee Signature: .r A&A OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Feb 02 12 08:44a p.1 Electrical Permit I it Application FOR OFFICE USE ONLY City CL of TiT and R ecenvad Date/By. � i _ ; Q 13125 SW Ball Blvd., Tigard, OF.1 , 2 3,,61, �t , 16 , - �. Plan Review Phone: 503.718.2439 : Fax: 503.59$ % % L Q1� DateB\: Other Permit: 1, L C i ` h l) Inspection Line: 503.639.4175 > Date Ready /By: Lurie: 21 See Page 2 for Internet: ww\vtigard- o,.gov ` l � t Notilledl�terltod: r y Supplemental Information a \I A\ TYPE OF WORK Cik. PLAN REVIEW ❑ New construction ® Addition/alteratiohlitiat Please check all that apply (submit 2 sets of plans w /items checked below): ID Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories, where the available fault current ❑ Marinas and boatyards CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 0 Commercial -use agriculttra: ❑ 1- and 2- family dwelling ® commercial/industrial ❑ Accessory building amps foratl other installations. buildings. ❑ Multi- family ❑ Stec builder ❑ Other: ❑Fircpump. 0 Installation of 75 KVAor f ❑ Emergency system larger separately derived system. JOB SITE INFORMATION AND LOCATION ' ❑ Addition of new motor load of Job no.: Job site ( :.dress :� Washington Square Rd 1001 or more. occupancy c� ❑ Six or more residential units. ❑ Recreational vehicle parks City /State/ZIP: Portland OR 9 3 ' 5 J ❑ Health -care facilities. ❑ Supply voltage for more than ❑Hazardous locations. 600 volts nominaL Suite/bldg. /apt. no.: AD6 . / - ',,,Vroject name: Build A Bear Workshop ❑ Service or feeder 600 amps or more. FEE SCI1EDIJLE Cross street/directions to job site: , Description I Qty. 1 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'/ 500 sq. R or portion 33.92 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DECRIPTION OF WORK (with above sq. ft.) Limited energy, multi- family 75 .00 2 Add 5 branch circuits to existing service: residential (with above sq. ft.) Seniees or feeders installation, alteration, and/or relocation _ _ 200 snips or less 100.70 2 0 PROPERTY OWNE114 i ❑ TENANT 201 amps to 400 amps 133.56 2 Name: Washington Square Mall 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: 9585 SW Washington Square Rd. Over 1,000 amps or volts 552.26 2 City/State/ZIP: lState/2ll': Portland OR 97223 Temporary services or feeders installation, alteration, and/or ty relocation Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1 400 201 amps to 4 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 16854 2 401 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new, alteration, or ex tension, per panel Owner signature: Date: k Fee for branch circuits with ❑ APPLICANT ! I ❑ CONTACT PERSON above service or feeder fee, 7.42 2 I each branch circuit Business name: Trek Electric LLC. B. Fee for branch circuits without service or feeder fee, fist 1 56.18 56.18 2 Contact name: Dana Arnzen branch circuit Each add'/ branch circuit 4 7.42 29.68 2 Address: 2980 SE Tttmblestone Dr. Miscellaneous (service or feeder not included) City /State/?. IP: Hillsboro OR 97123 d Each maufactured or modular " � �� d 67 -84 2 Phone: (503) 430 -8984 , Fax:: (866) 730 -5960 Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E -mail: trekelectricgicomcastnet Signor outline lighting 67 - 84 2 1 CONTRACTOR Signal circuit(s) or limited-energy Business name: Trek Electric LLC. panel, alteration, or extension. Page 2 2 Each additional inspection over allowable in any of the above Address: 2980 SE Tumblestone Dr. Additional inspection (1 hr min) 66.25/ hr City /State/ZIP: Hillsboro OR 97123 Investigation (1 hr min) 66.25/ hr Industrial plant ft hr min) 78.18/ hr Phone: (503) 430 - 8984 I Fax: (866) 730 - 5960 Inspections for which no fee is specifically listed (t,4 Lot min) , CCB Lic.: 160427 Electrical Lic.: / K� c Suprv. Lic.: 2468 -S ]ELECTRICAL PERMIT FEES uired; , C / �' Subtotal: .36� i� �(/ Suprv. Electrician signature, re 9 t//"`- Plan review (25% of permit fee): ,s Print name: Melvin Jackson Date: 2/2/12 State surcharge (l 2% of permit fee): ,i41 id, 3J �� TOTAL PERMIT FEE: 18 ei (e r hi Authorized signature: %� "— — — This permit application expires ifa permit is not obtained within 180 days after it has been accepted as complete. Print name: Melvin Jackson Date: 2/2/12 r. _. r: _,* _ ,, :. I co - 'Feb 02 12 08:44a p.1 Electrical Permit Anplication FOR OFFICE USE ONLY City of Tigard, , Ra°"ved g f . .14 ..-- 131 Hall Blvd., Tigard, OR -3 a9 Plan Review Other Phone: 503.718.2439 ! Far 50360, a •LQ� Date/B . ./- 1 c, ,` K , Inspection Lane: 503.639.4175 aa i 14 Date ReadyMy: ® See Page 2 for Interne]: wtvw.tigsrd cl.gov Cy) 4 Q NaiGedMttlnd: Supplemental Information TYPE OF WORK , Q I,�`v \S� PLAN REVIEW ❑ New construction ® Addition/alteratiot Please cluck all drat apply (subeait 2 nets of plain whims checked below): ❑ Demolition ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Other: �� where the available faun anent ❑ Mannar; and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 vela or ❑ Floating buildings. ❑ 1- and 2- family dwelling ® GommerciaVindustrial ❑ Accesso y building less to for other a exceeds 14.000 b 0 Commercial -use agtieulttxs amps for ail other imaallotiaw. buildings. ❑ Multi - family ❑ Master builder ❑ Other: O Fue pump. O installation of 75 KVA or [(Emergency system larger separately derived system. J O B SITE I I a R M A T T O N AND LOCATION ❑ Adduion of new motor bad of ❑ "A ", 'E", "1.2 ", "l -3 ". Job no.: l Job site : ss:505'6 Washington Square Rd. 10011? or more oewpancy ❑ Six emote reaideraial units. ❑ Recreational vehicle parka City/State2IP: Portland OR 9 . 3 PI5 ❑ Health-care facilities ❑ Supply voltage for more than ❑Hazardous locations. 600 volts nominal Suitelbldg. /apt no.: ADM ' ' '. ''roject name: Build A Bear Workshop 0 Savi� or feeder 600 amiss or more FEE SCHEDULE Cross streeidirectauns to job site: aaa i Dtpiau I or,. 1 Bab I Total I • New residential single- or maid- family dwelling anlz. Includes attached garage. • • Subdivision: Lot no: 1,000 sq. ft. or less 168.54 4 Ea. addl 500 sq. ft. or portion 33.92 1 Tax map/parcel no.: Limited energy, residential 73.00 2 DEICRIPTION OF WORK (with above sq. ft.) -_ Limited energy, multifamily 75.00 2 Add S branch circuits to existing service. residential (with above sq. it) Services or feeders installation, alferatlon, and/or relocation 200 amps or Icsa 100.70 2 ❑ PROPERTY OWNERi 1 ❑ TENANT 201 amps to 400 amps 13336 2 401 amps to 600 amps 200.34 2 Name: Washington Square Mall 601 amps to 1,000 amps 301.04 Address: 9585 SW Washington Square Rd. Over 1,000 amps or volts 55226 2 GitylStatelLIP: Portland OR 97223 Temporary services or feeders installation, akeraB °n, and/or relocation Phone: ( ) I Fax: ( ) 200 amps or Icsa 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 aoI amps to 399 amps 16834 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new, alterahion. or extension, tier panel Owner signature: Date: A. Fee for breach circuits with ❑ APPLICANT i I ❑ CONTACT PERSON above service or feeder fee, 7.42 2 each branch circuit Business name: Trek Electric LLC. B. Fee for branch circuits without service or feeder fee, first 1 36.18 56.1 R 2 Contact name: Dana Arnzen branch circuit Each addl branch circuit 4 7.42 29.68 2 Address: 2980 SE Tumblestone Dr. Miscellaneous (service or feeder not included) City/State ZIP: Hillsboro OR 97123 Each manufactured or modular 67.84 2 dwelling, service author feeder Phone: (503) 430 - 8984 I Fax: : (866) 730 - 5960 Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: trekelectric ®comcastnet Sigma outline li sting 67.84 2 !CONTRACTOR Signal circuit bee s) or limitedrgy Business mute: Trek Electric LLC. panel, alteration, or extension. / age 2 2 Each additional inspection ov a ble in any of the abov Address: 2980 SE Tumblestone Dr. At:Waimul inspection (1 66.25/ hr City/State2IP: Hillsboro OR 97123 Investigation (1 ht min) 66.25 / hr Industrial plant (11v 1 78.18/ hr Phone: (503) 430 l Fax: (866) 730 - 5960 Inspections for ch no fee is 90.0W hr specifically • 04 hr tin) GCB Lic.: 160427 Electrical Lic.:J 400 Suprv. Lie.: 2468 -S ELECTRICAL PERMIT FEES — Suprv. Electrician signature, rexluire • i i Subtotal: r, , . - Ad. Plan review (25% of permit fee): Ir— Print name: Melvin Jackson Date: 2/2/12 State surcharge (12%ofpermit fee): L kb 3 Authorized signature: / s /- ' _ _ - - • TOTAL PERMIT FEE: // ,(� f/�1 v , • ! 1 /..7. -- Thla penult apipacatioa expires if a penait to not *bird , -, within 1: r Print name: Melvin Jackson t Date: 2/2/12 we_ r ...r days after Is nM bas - e been accepted as cam . tete. „_ t 1 Y e t , " _ 0./4 �PL / C -N7+ ,--- / Td //✓C L- -.-c P 4' s o ",/ /i1 -ear A -6'v /tar T /T ;a- 010 e to -S / " / e pnJ A9-6-6-- , i4) PVT' )e /Or/ yam / T 9 - f.t.T ff , ,hty Law vo L. T 'c ( / °g,....7 / .9/7-. Feb 02 12 08:44a p.2 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for al residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm I ❑ Garage Door Opener ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY Fee for each commercial $75.00 system (SEE OAR 918-309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls rs .... k Systems ❑ Da Telecommunication Installation It Fire Alarm Installation • ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial syste r. _ - *No liceosec are.required. Licenses -are required - - � - - • • - - - - - -- for all other installations