Permit CITY OF TIGARD ELECTRICAL PERMIT
1 • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00382
T C G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/2512012
Parcel: 1S 126C D00300
Jurisdiction: Tigard
Site address: 9500 SW WASHINGTON SQUARE RD
Project: JC Penney Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: (1) temporary service for 200 amps or less
Contractor: E C COMPANY Owner: PPR WASHINGTON SQUARE, LLC
PO BOX 10286 BY J C PENNEY 0288 -1
PORTLAND, OR 97296 TAX SERVICES
PO BOX 10001
DALLAS, TX 75301
PHONE: 503 - 224 -3511 PHONE:
FAX: 503 - 295 -3012
FEES
Quantity Description Date Amount
Specifics: 1 ea Temp Services or Feeders - 06/25/2012 $59.36
200 amps or less
1 ea 12% State Surcharge - 06/25/2012 $7.12
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $66.48
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 A 952 -0 1 -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: i4 PPl CAT( T(Dia
OWNER INSTALLATION ONLY I�1.
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.
Jun. 25. 2012 2 :11 PM No. 0744 P. 1
Electrical Permit Application I.Y)u 01.1 I( F. USE ONLY
City of Tigard CEIVED Received Permit
Il : 0 13125 SW Roll Blvd.. Tigard, OR 2 Plan Review
view (�' x � 101.1 - D6 383_
Phone: 503.718.2439 Pox: 503.598.1960 Date/8 : Other Permit pfiti "ANA.- 000
T I ( : A It I ) Inspection Line: 503.639.4175 JUN 25 2012 Data ReadyBy: •
Si See Page 2 for
Internet: www.tigard- or.gov Notified/Meth d: • - Supplementallnformarton
T1tPE OF l'i a . 1 . SOP 1 PLAN REVIEW
❑ New construction ® Additi0fll'O (aMn/6tlt, Please check all that apply (submit 2 sets of plans wlnems chucked below): •
•
❑ Demolition Other: Service or feeder 400 amps or more ❑ au @ding over three stories.
where the available fault current ['Marinas and boatyards.
. CATEGORY 'OF CONSTRUCTION exceeds 10,000 amps at 150 volts or a Floating buildings.
•
1 and 2-family dwelling less to ground, or creeeds 14,000 ❑ Commercial -use agriculrmal
❑ y g Commercial /industrial ❑ Accessory building
amps for Oil other installations buildings.
❑ Multi- lhmily ❑ Master builder ❑ Other: 0 Fire pump. ❑ installation of75
• . JO SATE INFORMATION AND LOCATION:. CI Emergency system larger separately derived system.
. 0 Addition craw mown load of ❑ "A ", "E ". "1 -r, "1 -3 ",
Job no.: 74623 I Job site address: 9500 Washington Square Mall Rd 100rtPor occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks
City/State/ZIP: Tigard OR 97223 CI Health-care facdifies. 0 Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: l Project name:.JCPenney ❑ Service or feeder 600 amps ormore.
PEE SCHEDULE
Cross street/directions to job site: Daterrptinn j (NY. I Fee 1 Tool .
- New residential single- or multi - family dwelling unit.
Includes attached garage,
Subdivision: 1 Lot no.: 1,00054. R. or less = 168.54 4
Ea. add'l 500 sq. (L or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
• DESCRIPTION OF WORK... . ,:... _Iwith above sq. R) 75.00 2
Limited energy, multi - family 75.00 2 -
JCP Store 0288 - Temporary Power for Carpet removal equipment residential (with above sq. 11.)
_Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ . PROPERTY. OWNER. . .56 2
:. ❑ T' ' ... . 201 amps to 400 amps 13356
Name: 401 amps to 600 amp _t____200-34
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: ( ) pax ( ) 200 amps or less 1 59.36 59.36 1
Owner installation: This installation is being made an 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. 401 amps to 599 amps 168.54 _ 2
Drench circuits- new, alteradoa, or extension, er aacl
Owner signature: Date:
A. Fee for branch circuits with
• • ® APPLICANT I' `' .. SON, d CONTACT PERSON. above servicaorfeeder fee, 7.42 2
. _ each branch entail •
Business name: EC Company B. Pee for branch circuits withmu
service or feeder tee, first 56.18 2
Contact name: Kathy Kelley branch circuit
Each add'l branch circuit 7.42 2
Address: PO Box 10286 Miscellaneous (service or feeder not included)
City/State/ZIP: Portland OR 97296 Each manufactured or modular 67 84 2
dwelling, service and/or feeder
Phone: (503) 224.3511 [ Tax:: (503) 248.6353 Reconnect only 67.84 2
Pump or irrigadon circle 67.84 2
E -mail: kathyk @e- c- co.com
Sign or outline lighting 67.84 2
CONTRACTOR - . ' - Signal circuit(s) or limited - mergy
Business name: EC Company Panel, alteration, orelxleasion. Page 2 _ 2
Each additional inspection over allowable in any of the abov
Address: PO Box 10286 Additional inspection (I hr min) 66.25/ hr ._,.-
City/State/ZIP: Portland OR 97296 investigation (1 hr min) 66.25/
Industrial plant (I hr min) 78.18/ hr
Phone: (503) 224.3511 Fax: (503) 248,6353 Inspections for which no fee is
hr
scifically listed (u hr min) 90A0/
pe
CCB Lic.: 49737 Electrical Lic.: 26-45C Suprv. Lie.: 2345-S • ....ELECTRICAL:PERMIT TEES' -, •
Suprv. Electrici: signs , . requi Subtotal: 59.36
//' _ Plan review (25% of pcmiit fee):
Print name: Ron ( // Date: 6/25/2012 J State surcharge (12% of permit fee): 7.12
r r TOTAL PERM F EE: 66.48
Authorized signs e: I Vi a �� ,, �/
This permit eppncalien expires Ha permit is not obtained within 180
Print name: Anna Nett _ J Date: 6/25/2012 • days after It has been accepted as complete.
Number of inspections allowed per permit.
Lew;Idugwermtha LC- Pa<mrtApp.doc 07/01/10 440.4615 (I l/05/COM V, 8