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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: ELR2012 -00061 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/05/2012 • Parcel: 1S1260000300 Jurisdiction: Tigard Site address: 9573 SW WASHINGTON SQUARE RD B06 Project: The Limited Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108 Project Description: (1) limited energy for anti -theft system. Contractor: 3 GUYS ELECTRIC LLC Owner: PPR WASHINGTON SQUARE LLC 2062 NW 15TH CT BY THOMSON PROPERTY TAX SERVICES GRESHAM, OR 97030 ATTN HILARY RAYMOND 2235 FARADY AVE, STE 0 CARLSBAD, CA 92008 PHONE: 503 - 729 -1522 PHONE: FAX: 503 - 661 -7378 FEES - Description Date Amount Specifics: Restricted Energy Permit 04/05/2012 $75.00 12% State Surcharge - Electrical 04/05/2012 $9.00 Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio & Stereo: N Boiler Controls: N CCTV: N Clock Systems: N Data & Telecommunications: N Fire Alarm: N HVAC: N Instrumentation: N Intercom /Paging: N Landscape /Irrigation: N Landscape Lighting: N Medical: N Nurse Calls: N Protective Signal: N Security Alarm: N Other: y Total $84.00 Other Desc: 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: tN 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 603.639.4176 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. 04/04/2012 10:43 FAX 5039883377 MULT COUNtY AttORNEY a001/003 Electrical Permit Application ' I: U R (II I: I; 1 I :' 0 \ I 1 City of Tigard p 'gti © i :_ Pbrmit NO.: EL>J' d�a� a 13125 SW Hell Blvd,, Tigard, OR 9 1 . " ' �•' /tvC Q��� Phone: 503.718.2439 Fax: 503.59 tun ��� 1 Plaattewety Q�""eu�� // Defo2�o/ inspection Line: 503.639.4175 ti >�te Ro , I , , : . ,. ! , M Q J Dato Roddy/ay, ic Internet: www,tigard- or.gov Q 4 .4 NotitledtMethed: I B See Peas 2 for Supplemental Information I:l'n �'i,: fig' � ':"l.s^r, ^T•1 ^t __ , n. ^ ^.:rr.• r lu:l :lnn. , ., - _ � 1gi . J f ,. . � :. �'; � { .1, .III I I!'�; I :r� t�! r l' {,I1 l i_1 � I'L I �IIaa�ci �' � a!:�I,:I r• l l r n: .: l� l all t I l 1, ly; , h 'l 1, VIII \ Ill l 1 I -C r o 2 - ;! . ' 1 1' . ' . t I :- ! hl ! :,I -' - .1 . � '.i I 1 L I t ''''1::'''''- i - I — '-• -. -.- ..,.Lll,.l, �� _ 1.. .... ' --• -,. ..�. ��� L U � f.ub,, , i,.;�l.���. s t.- r... .. {: .:� ..�.__ _ � c �:_ ' :_; ❑ New construction ® Addition/alteration/repl •' Please cheek all that apply (submit 1 sett of plane whits checked below): J ❑ Demolition ID Other: ❑ WO"; or feeder 400 ampa or mere ❑ Building Duct three stories wham the available It y; ":r i;I e,.: {' I ::nu; - .�.. „r n•: rnnl,lac ;a 7n :zl'.a' , :«' err. ;c J fault =rent ❑marinas endboatyade. I ` III 7• "I'Ir • . SIT ! U,. ,.. 1:' tip 11: . �, ; l, err - 1 ,,.i.d: , I ! I'. !`1!1 11 :0,'}' ._ n',. ,, 1 41 ': , , r, : al ,1:1 17 I ,�j claa a o.'rr .. , „r ,ii: i { { , ,,,`I Ireeup 0,000 amps st 15 volts m CI Flagin g J �'4`I I I 1 � I„ , I ., , ,.,, , , ; . 1 1 I , ! . 1 al , I � , , I I I`,I { ,: buildings, 1' Ile :..LIL lI t 1 „�a_ e� Lau L cell' 1n:. =: aa:.� u ' i� •'•:.la ilL_ lass to ground, or exceeds 14,000 D Commercial-use agricultural ❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buldlnas, ❑ Multi- family ❑ Master builder ❑ Other: ❑Fire OwnP, O InstsIodon of 75 KVA or "r 7,7', , r T;Ti: - -,.-. ":r 7:'.' 1 77 . 1; �711�S..t nC. -'I: -i.t- ^I: -,1� ,I. .,...I•I __ -_ __ ' t i�;;t l .( "U1 Gl'� "; e I,.y ,I' .I` ,:;: v -,; � � � „��:, ° T ":I '`i�, � i : : .. Emerg ®4'aYstom• larger tiara 1 erg �1Y vied system. ,.0 IL h ( , I •• .n,W11 } _ I I',I I I I{ N 1 9 , 1,V ' f l 4 , , +, l! 4! Yl I V.,:'1,1.1.11;.2 1 i I p l rs f +L l , ',, l ' d l l'�; 0 D Addhim of rroa meter lead of ❑ " " . "1 -3` aIL� Li..S1J.. - I:, ', xi 1 � :_l Il.,x,_,w,.i 1,.. I, l u.1.L .:1.,1 .�.]._ . �._ _� _ � Job no.: Job site address: 9573 SW Washington Square Rd. 100HP or more. occupancy. ❑ Six or more residential units. 0 Emmetpnpl vehicle parka. City /State/2LP: Tigard, OR 97223 ❑ Health-cam facilities D supply voltage for more than ❑ Hazardous locations, 600 volts nominal. Suite/bldg./apt. no.: Project name: The Limited D SeMee ea feeder 600 amps or more. Cross streeddirecuorms to job site: Washington Square Mall D E I 1. 'I 11 I?Ir Fl i h'' ,, ,;; i`1” ' ` - 1 , I . • , • antPam ., Q , g. R ae. 71DtV . � • - New residential single- or multi-family dwelling unit Includes attached garage. Subdivision: Lot no.: 1,000 aq, ii, or leas 168.54 4 Tax map /parcel no.: Ea. add'! 500 sq. ft. or portion 33,92 1 . ih� d :Ii;:!! " " •'I •' ° 1 rr;h::p: -Tq -r.�_ ,�nr pl , ;�, : • 1 . . � ; • L •�. ,., 1 �,, , . r;I _,t Limited anew, residential 75.40 2 1 h �T1 I , i 1, , � i l 'r, i l 1I l •1 j LI 1 1 I T I. I Ir i p )1 , ; I I r 1 ;' 1 L Il 1 it 1 f ,, I : If ` 1 ;' : ' 4{ I , II I i�'` 1 1 1 { . (with above sq. ft.) _il_a .._ .1::::. i _ 11,n l hill:. :,111I I11tlIf tlu.w.,.,LU1,..hiLi:..1' 1 r .,, ,., .,r:.1. �,1 Ina L�..LI,�1 L 1 , ,r...,.,wl I, Limited energy, multi - family 75.00 2 Install anti-theft system. residential (with above sq. R) Services or feeders Installatlon,alteratlon, end/or relocation 200 amps or less 100.70 2 ,. .1.;1 - ':p:l;u:•,a;l:lnlu •l : ai; u_pi lr!f '1;fR_t '". _ rn4 F; 1:1n,.1p . 1 ' ,I: :LLIe�.: L 1 _ f1 ',i'1 nex: �fu'�'2�ig�IiI'jli;!li Ii{ �u� , r ��fif I:; t��, 1Il,;, �jia, . it ? 201 amps 10400 snips 133.56 2 Name: 401 amps to 600 amps 200.34 2 601 maps to 1,000 amps 301.04 2 Address: • Over 1,000 amps or volts 552.26 2 ' _ City /SteuJZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) I Fax: ( ) - 200 amps or lass 59.36 1 , Owner installation: This installation is being made on property that I own which is not zol amps to 125,08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. - 401 m 599 tiros 1 'S4 2 Branch clrcults - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with 'U: Grfily,1 lifr[17 ;=-, r•ii: r3 :7? 1 ' 1 -- - �° — Fff 11 - , rr i . -,r - '-c f,�, L l l', e4rl ,....I; :)` I .]1,I�� I! I 1 '17 I 7, �F n ' , I ll,: ,, n i f 1 1 + ! , > > { *Ova service or feeder fee, , L.e L.,..__ •, ,. n .�11I ' ll:ll ll. ; • ., � .1. ._ ,.,I.L 1 I 1-:,1 11 11 I . ', o,,I ,- lid II , :.1 1 ,, each b cheek 7,42 2 Business name: 3 Guys Electric, LLC B. Fee for branch circuits without service or feeder fee, lint 5618 2 Contact name: Wade Hadley branch circuit Address: 38871 Jerger St. Each add'l branch circuit _ 7,42 2 g Miscellaneous (service or feeder not Included) City/State/ZIP: Sandy, OR 97055 Each manufactured or modular 67,84 2 dwelling, service and/or ibcder Phone: (503) 729 -1522 Fax: : (503) 826-1133 Reconnect only 67.84 2 _ E -mail: wade3guys@gmaiLcom Pump or b outline ti n circle 67,84 2 'a'n; ••i Y�i�'i_ � `Iil , �,� r v,,� li:•if'' �'i� d 'ii1� •`' •u I ' "�.' °', Ip „ ' I :�;F I 1:�,__�i'�T :I l Sign or outline lighting 67.84 2 'I;' 4 1 I!,I,:Ir; a l ,;I:T1 1 , {LL.{ h,. !I a :1.:;�Ir'. . rnI l t i1.�1' .��I� II T`.i�'L: Signal drart(e)orlimited-energy 1 75.00 Business name: 3 Guys Electric, LLC panel, alteration or extension. Page 2 2 Each additional inspeedon over allowable In any of the abov Address: PO BOX 1988 Additional inspection (1 hr min) 66.25/ hr Investigation (I hr min) 66,25/ he City /State/Z>1 Sandy, OR 97055 • Industrial plant (t ar nun) 78 . 18/ hr P ono: (503) 729-1522 Fax: (503) 826 -1133 5ptxtions ibr whkh no tbo Is a • call listed % hr min 90,00/ hr CCB Lie.: 177242 Electrical Lic.: CLE120 Suprv. Lie,: SI6LEA ,i 1 ;; '' :'! { I I9':I1lw.. °'0'iI i i s t__ ''LL L : (Li ',, . ': , i .,.. I ill / Subtotal: 75.00 � � Suprv. Electrician signature. roquircd: / a!_.,I” _ulw./ _ 1f.�- Plan review (2590 of permit too): Print name: Vinton Wade Hadley Date: 4/04/12 State surcharge (12% of permit fee): 9.00 TOTAL PERMIT PM: 84.00 e/ Authorized signature: 1(24. Y Thla Permit epp6mtioo urea if a permit is not obtained within 180 Print name: Vita Jane Hadley per 4/04/12 days agar It her bean accepted as complete. • Number of ieepoedeee allowed par permit. L:1aulldla PennIUt5LC.PormItApp,doa 07/0u/10 440.4615T(Ii,oaiCOw wen 04/04/2012 10:43 FAX 5039883377• MULT COUNtY AttORNEY 002/003 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED, ENERGY PERMIT FEES: • It !J:�.; ::i�: �I iI IJ :�� +n;' @J �11Y:• ., �i,�i�`r; 15 d;iS.'rk5 i'iil�'t2::j";ii iij;; li; : ',l i)`•�1''I �;,I�.iC; :.5�`I Sf!'� '`J�i�iil;i�'i l; Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Hearing, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: Fee for each commercial $75.00 system (SWF. OAR 918 - 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Botler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ O utd o or Landscape TJghtinga' ❑ Protective Signaling ❑ Other And-Theft System Total number of commercial systems: 1 *No licenses are required. Licensee are required • for all other installations 1: 1Bu1WInpwarmIuNsLC.votmltApp.do 07 /01/10