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Permit
CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2012 -00087 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02!08(2012 Parcel: 151260000300 Jurisdiction: Tigard Site address: 9636 SW WASHINGTON SQUARE RD G10 Project: Buckle Subdivision: Lot: Project Description: Electrical TI, (2) services, (42) branch circuits & (2) low voltage systems for fire alarm and access control. 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 2 ea Services or Feeders - 200 02/08/2012 $201.40 Specifics: amps or less 42 crt Branch Circuits w /Purchase 02/08/2012 $311.64 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 $79.56 Occupancy Grp: Electrical Total $742.60 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 acco • - • e 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. ATTEN ' ON: Ore. •n la requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0011 through OAR •. 001 -00: • You may obtain a copy of the rules or direct questions to OUNC by calling 50a 232.1987 or 1.800.3 .2344. Issued By / Permittee Signature: �! '_' ,A,!fira 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. IIO 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. Electrical Permit Application REcElvEr FOR OFFICE USEONLY City of Tigard Received P No.: -7 13125 SW Hall Blvd., Tigard, OR 97223 FEB s Z 2012 Date /By: ,? 7 /A FL�a?O /a? - �8/ g Plan Review ' F:.7 Phone: 503.718.2439 Fax: 503.598.1960 DateB . Other Permit �u� '/'/ O4 C .. TfGA D Inspection Line: 503.639.4175 CiTY OF T1GA D Date Ready /By: Jnris ® See Paget for Internet: www.tigard - or.gov BUD DING DIV1SjON Notified /Method: Supplemental Information "_ '- P -t ` TY PE OF W ORK t? :1 + . ' a �; a :'i" TA'3V .r 't _.. r .. . __ v .. �.,.,.,, . I2E'14IEW .,- - , ❑ New construction E Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below): El Service or feeder 400 amps or more ❑ Building over three stories. El Demolition El Other: where the available fault current ❑ Marinas and boatyards. ti a S TEGORY -OF CONSTI UCTION ¢ . ; a : exceeds 10,000 amps at 150 volts or ❑ Floating buildings. ._. _ less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling E Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or r JOB STTE INFORMATIONAND.7 OCATTON " ❑Emergency system larger separately derived system. i , i. r r , u.:..., " O rs _..... - -... , " . j ❑ Addition of new motor load of Job no.: 69150 Job site address:WASHINGTON SQUARE ROAD 100HP or more. occupancy. ," ❑ Six or more residential units. ❑ Recreational vehicle parks. p City /State /ZIP: TIGARD, OR 97223 636 ❑ Health -care facilities ❑ Supply voltage for more than ['Hazardous locations. 600 volts nominal. • Suite /bldg. /apt. no.: 471 Project name: BUCKLE STORE ❑ Service or feeder 600 amps or more. Cross street/directions to job site: `t °i FEE SCHEDiLE r " Description I Qty. I y Fee. I Total I III 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'I 500 sq. ft. or portion 33.92 1 Tax-map/parcel no.: Limited . energy, residential c, I .. r 75.00 2 ..r .,_ V .s , , „" ._ � 'DI SERA'. -TON 4 1 ORK...� ". .;3 y.. 1; : , 4 (with above sq. fr.) _ x _ ".., .. ,_.,._., - . Limited energy, multi - family 75.00 2 TENANT.IMPROVEMENT residential (with above sq. ft.) Services or feeders installation, alteration, and /or relocation 1) 0144. data 3 200 amps or less 2 100.70 201.40 2 4 i ❑ PO R ERTfYi Q) E A ' W .. - k Q.. ILN$lN3' { k - „r : 201 amps to 400 amps 133.56 2 Name: - . - . - 401 amps to 600: amps , ' - 200.34 - - .' . 2 601 amps to 1 ,000 amps ' - - :. 2 1 Address: .. - - -- . _. - - -- - - -- - . - .. .. - - - - - -... - - - - • - -- o 1 ,. ver 1,000,amps or volts 55226. 2 City /State /ZIP: .Temporary services orifeeders installation, alteration, and /or ' . . .._ . - - - -- - . - . -- - relocation . Phone: ( ) .- - ._ -- - . Fax: ( -- . ) "'200 amps or less - -, - . - 59.36 1 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that-I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits- new, alteration, or extension, :er panel Owner signature: Date: A. Fee for branch circuits with • r n APPLCAl1 "CONTACT I,EItS ©N above service or feeder fee, 42 7A2 311.64 2 .�..... _.: each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, first 56.18 2 • Contact name: branch circuit Each add'I branch circuit 7.42 2 Address: _ Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular 67.84 2 dwelling, service and /or feeder Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E- Sign or outline lighting 67.84 2 .,"gig ;'' ,V.4 . atr'x4ite " Q,NMM.1 T01314 r`- t ,. a, ... _.? .-A x: Signal circuit(s) or limited-energy Business name: FRAHER ELECTRIC COMPANY panel, alteration, or extension. 2 Page 2 150.00 2 Each additional inspection over allowable in any of the above Address: 11860 SW GREENBURG ROAD • Additional inspection (1 hr min) 66.25/ hr • City/State/ZIP,: TIGARD, .OW 97223' '. Investigation "(1.hrmin) 66.25/ hi • , Industrial plant.(] Br thin)" - -- - .... '78..18/ hr P ho ne : (5(3) 639 - 4627 -- _ __ .. _ . ..... _ '..Fax: -(503) 6394673 - - - - - - - - - Inspections for which is - - 90.00 / hr ifi speccally listed (% hr min) ..,. CCB Lic.: 37410 34 13C _ _ .. . Electncal.Llc.. - ._ Suprv. L•lc.. S1lOS • -- a. =� ;� >�;.ELECTRTC r >:a =`�:`_� "= ..a - ,;; ,. ,�'..� .., _ ., .. s1L'' PER7. VIITr�ES `ir'�.�;,= „�;: °: I - • _ _ -- _ - Suprv. Electrician. signature, required: -- - - -.- - " -- - - - Subtbtal: 663.04 • �� / ,. .. ,. . • -Plan review(25% of permit fee): -• Print name: ADAM ETHERINGTON Date: 02/01/12 State surcharge (12% of permit fee)' 79.56 Authorized signature: TOTAL PERMIT FEE: 742.60 This permit application expires if a permit is not obtained within 18 days after it has been accepted as complete. Print name: Date: • Number of inspections allowed per permit. i\ Building \Permits\ELC- PermitApp.doc 07/01/10 440- 46 :5T(11/05/COM /WEB Electrical Permit Application - City of Tigard . Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: ORES DENeTWW∎ , ONLY. : _- - . ` aN 'Fee all residential systems combined • $75.00 • ' ' Check Type. of.Work Involved: • . . Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* n Heating, Ventilation and Air Conditioning System* n Vacuum Systems* ❑ Other: #04 ,, o . RCIAL WORK ONL_t .._ .r . _h _ Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: • ❑• Audio and Stereo Systems "" ❑ Boiler Controls _ - . - • - - - : . • n Clock Systems - - - - • - - - . - - ® Data Telecommunication Installation EXI Fire Alarm Installation ❑ HVAC • n Instrumentation n Intercom and Paging Systems • ❑ Landscape Irrigation Control'k n Medical ❑ Nurse Calls • ❑ Outdoor Landscape Lighting* ,• . Protective Signaling . . . . _ . Total. number of comm systems: 2 *No licenses are required. Licenses are required for all other installations 1\ Building \Permits\ELC- PermitApp.doc 07/0]/10 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RE "SI- I?ENTIuAI WORK ONLI' :,.::::" n ; " , ; ":. s ' T �` Fee for all residential systems combined .. $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCI _ k . ,_.. AL;WQRK ONLY: __ ..,, .._ Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling Other Total number of commerciaLsystems: — *No licenses are required. Licenses are required for all other installations I:\ Building \Permits\ELC- PemitApp.doc 07/01/10