Permit CITY OF TIGARD ELECTRICAL PERMIT
1111 2- • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00413
T [GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/16/2012
Parcel: 1 S126CD00300
Jurisdiction: Tigard
Site address: 9500 SW WASHINGTON SQUARE RD
Project: JC Penney Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: (7) branch circuits for TI
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
7 crt Branch Circuits wo /Purchase 07/16/2012 $100.70
Specifics:, Service or Feeder
1 ea 12% State Surcharge - 07/16/2012 $12.08
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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 i rdance w 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. TENTION: Oregon a , • quires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 1- 0010 th .ugh OAR 90001 -00• • . ou may obtain a copy of the rules or direct questions to OUNC by calli .1987 or 1.800.332.2 4. .�
to / 1P,P iAddr
1 sued By: _ Permittee Signatu • . ..► aliZ/ •
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' , i i 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.
Jul. 13. 2012 11:27AM No. 0857 P. 1
Electrical Permit Applica ' 1 (JR (OFFICE IL SE (1 L1
City of Tigard P - Received �" p `� -�fO2 ✓ 43
Da Permit No.:
a 13125 SW Hall Blvd., Tigard, OR 97223 " �
.� 111" ;!r te/B Phone: 503.718.2439 FM: 503.59 + Daiea : . QtherPermit:
r t t A u t ) Inspection Line: 503.639.4175 U 2012 e Ready/13y: Jails: 115 t l See Page 2 for
Internet: www.tigard•or.gov CI 1 Nmifitdfletbod: supplemwlad Informailan
•
Typ , r ,. r, 1.. - r_ ` , ' I • P LAN REVIEW
❑ New construction ® Add ition/alteratio re Please check ail that apply (submit 3 secs of plans write= checked below):
O Soma or fader 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other:
where the available fault entreat 13 Marinas and boatyards.
•
• • • CATEGORY OP 'CONSTRUCTION: • exceeds 10,000 amps at 150 soils or ❑Floating buildings.
[] 1 - and 2 - family dwelling ® Commercial /industrial less to gmimd, or exceeds 14,000 ❑ Commercial-use agricultural
❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of75 KVA or
JOB SITE INFORMATION AND' LOCATION '. ❑Eme+tt�Ysystem. larger separately duivedsystem.
. Cl Addition of new motor load of ❑ "A ", "E ", "1 -2". "1 -3 ",
Job no.: 74623 I Job site address: 9500 Washington Square Mall Rd 100HP or more. occupancy.
0 Six or more residential units, ❑ Recreational vehicle parks.
City /Stale /ZIP: Tigard OR 97223 ❑Healrhtare facilities. 0 Supply voltage for more than
Cl Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: I Project name: JCPenney ❑ Service or feeder 600 amps or more.
FEE SCHEDULE.,
Cross street/directions to job site: norm/ nom I my- I Fen 1 Tota - New residential single- or muitl•famlly dwelling unit.
Includes attached garage.
Subdivision: I Lot no,: 1.000 sq. R or less 168.54 4
Tax map /parcel no.: Ea. Kin 500sq. R. or portion 33.92 1
Limited energy, residential 75.00 2
»ESC '1'nON.OF WORK, ..... • •`. ' (with abovo sq. It.)
Limited energy, multi - family 75.00 2
JCP Store 0298 - Washington Square Mall - Modify lighting and receptacles for residential (with above sq. ft.)
Services or feeders Installation, alterati and/or relocation
new displays 200 amps or less 100.70 2
❑ , PROPERTY OWNER _
❑ 201ampato400amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps Or Volta 552.26 l 2
City/State/Z1P: Temporary services or feeders installation, alteration, and/o
relocation
Phone: ( ) I Pte; ( ) 200 amps or less 59.36 1
Owner Installation: This installation is being made on property that 1 own which is not 201 amps !0400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 163.54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Dale: • A. Foe for branch circuits with
® APPL1 CANT. ❑,.CONTACT :p13Ii$ON • ' •: . above service or leerier fee,
• each branch circuit 7.42 2
Business name: EC Company B. Fee for branch circuits without
service or feeder fee, first 1 56.18 56,18 2
Contact name: Kathy Kelley branch circuit
Each add'1 branch circuit 1 6 1 7.42 1 44.52 2
Address: PO Box 10286 Mlscelrancous (service or feeder not included)
City /State,/ZIP: Portland OR 97296 Each manufacttatod or modular 67 84 2
dwelling, service and/or feeder
Phone: (503) 224.3511 I Fax: : (503) 248.6353 Reconnect only 67.84 2
E- mail: kathyk@e- e- eo,eom Pump or irrigation circle 67.84 2
Sign or oulline lighting 67.84 2
• . CONTRACTOR s . Signal circuit(s) or limited-energy
Business name: EC Company panel, alteration, or extension. Page 2 2
Each additional Inspection over allowable in any of the above
Address: PO Box 10286 Additional inspection (1 hr min) I 662,5/ hr
City /State/ZIP: Portland OR 97296 Investigation (1 hr min) 66.25/hr _
Industrial plant (1 hr min) 78.18/ Dr
Phone: (503)224,3511 I Fax: (503) 248.6353 Inspections for which no fee is - '
sp ciftcally listed (Yee ht min) hr
CCB Lic.: 49737 I Electrical • • 6.45C Suprv. Lic.: 2345 - S . • ELECTRICAL PERMIT HEWS
Suprv. Electrician signature, required: / Subtotal: 100.70
if Plan review (25% ofpermil &e):
Print name: Ron Coffnnn I Date: 7/13/2012 State surcharge (12%ofpermit fee): 12.08
Authorized signature: ,i �i TOTAL PERMIT FEE: 112.78
r This permit application expires Ira permit Is not obtained within 180 •
Print name: Anna Heft Date: 7/13/2012 days after it has been accepted as complete.
e Number of inspectioas allowed per permit.
LlamldiaalPamitslELC .PermlApp.doe 07101/10 440-06157(111O$FCOMAV®