Permit CITY OF TIGARD ELECTRICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: ELC2012 -00456
T t O A R O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/02/2012
Parcel: 1 S126CD00300
Jurisdiction: Tigard
Site address: 9500 SW WASHINGTON SQUARE RD
Project: JC Penney Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: (8) branch circuits for Phase 2 - add track lighting and power to new displays
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
8 at Branch Circuits wo /Purchase 08/02/2012 $108.12
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/02/2012 $12.97
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $121.09
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 9 - 001 -00 0. You may obtain a A copy } off the rules or direct questions to OUNC by calling 503..232.1987 ('q1 LI C 4 or 1..
Issued By: d L1 _. Permittee Signature: Oa p dKL
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.
Aug. 1. 2012 9:45AM No. 1037 P. 1
RECEIVE
Electrical Permit Application rrllt t)rblc'i.: 1 sl: ()NIA
City of Tigard 9C : . 01 i�� Peanit Nr �r (, _ QD
I N
n 1 3125 SW Hall l Blvd.. Tigard, OR 97223 _ n
i Phone: 503.639.4171 Fax: 503.598.1960i! i l F'HGJ s • • • . Omer Pem> j(� Pfd - 001( T I u A r, t?
Inspection 503.639.4175 Line: r
Internet Line:igard.or.gov BUILDING DIVIS 1� � , S p men o� non
TYPE OF • W ORIC pI,AN IIEVIEw
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 sets of plans whtems checked below):
❑ Demolition Other: ° Service or feeder 400 amps or more ❑ Building over throe aortas.
where the available fault current ❑ Marinas and boatyards
•.- • .' CAT13GORY'OP CONS'TRU6110N : •:.. ;:' . exceeds 10,000 amps at 150 volts or C] Floating buildings.
lea to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps fee au other installations. buildings.
Q Multi- family ❑ Masler builder 0 Other: ❑ Etre Pump. ❑ installation of 75 KVA or
Cl�elt�• larger separately derived system
JOB S1T INFORMATION' AND l.OtkfiQN ':.'. `.,:':.; •• ::, :. ❑AddiGonofnew r load of 0 "A ", "1~, 1 - 2", "I -
Rib n0.:74623 -01 I Job site address: 9500 Washington Square Mall Rd I or more °LC'pB°`I'
❑ Six or more realdewial units ❑ Recreational vehicle parts.
City /Slate/ZIP: Tigard OR 97223 ❑ wall-core facilities. ❑ Supply voltage for more than
- ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt.no.: Project name:. A /,' n ' El Service or feeder 600 amps ormore-
CrossslreeUdlrectionsto 3 'obsitc: ` t J . : :FEB :SC1[00LE... ' :. ; '`':,,.
Description - I Qty. 1 Pea I rod 1
New realdenlial single- or multi - family dwelling unit.
Includes attached garage. _
Subdivision: — I Lot no.: 1,000 sq. a or less 168.54 , 4
Tax map /parcel no.:
--- Ha. MI 500 set. tl or portion 33.92 1
Limited energy, residential
. . DESCRIPTION..op QR..k - . . , ... (with above sq. II) 75.00 2
Limited energy. multi - family
wave 2- Add track lighting and power to new residential (wills above sq. ft) 75.00 2
displays Services or feeders lnslallatian alteration, and/or relocation
200 soaps or less 100.70 2
' :.. i 0 PROPERTY . oviN.ER... ❑ TE04i.i ' ... • •' ,'....::•. 201 amps 1°4°D amps 13156 2
401 amps to 600 amps 200.34 2
Name: 601 am to 1,000
amps amps 301.04 2
Address: Over 1,000 amps ar volts 552.26 2
City /State/ZIP:
Temporary services or feeders Installation, alteration, and/or
relocation _
Phone: ( ) I Pax: ( ) 200 amps or less 59.36 t 1
Owner Installa tion: This installation is being made on properly 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
Branch circuits new, alteration, or extension, per panel
Owner signature: Date: A. Poe for branch circuits w1M
;::. ', I above service o r feeder fee,
• . APPLICANT �, :CON1ACl` pl y), . , ... Y . "• 7.42 2 • each branch circuit
Business name: EC Compare B. pee for Drench circuirs rtdrhare
service or feeder fey fug 1 56 I8 $56.18 2
Contact name: Kathy Kelley branch circuit
Each add'i branch circuit 7 7.42 $51.94 2
Address: PO Box 10286 miscellaneous (service or feeder not lneluded) _
Ciry /State/ZIP: Portland, OR 97296 -
Each mantured or rv, � modular 67.84 2
P11one :( 503) 224 -3511 I Fax: :(503) 295 -3012 Reconnect only 67,84 2
Pump or inigaIion circle 67.84 2
E - mail: kathyk @e- c- co.com
Sign or outline lighting 67.24 a
. CONTRACP,OR.• • .: , ... . . .. • . • Signal circuits) or limited-energy —
Business name: EC Company panel, alteration, or extens Page 2 2
Each additional inspection over allowable in any of the above
Address: PO Box 10286 Addilionalitlspectlon(1 hr min) _ 66.25/hr
ves
City /Slate/ZIP: Portland, OR 97296 IndBarion(tbrmin) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (5 0 3) 224-3511 I Fax: (5 0 3) 295-3012 Inspections for which no fee is
Lie.: 4 9 7 3 7 I rica
>3 ecti _� /� specifically listed (IS hr min) 90.00! hr
6- 5C I M'. Lie. : 2 - j S giieC�'RICAI :PERMIT. ::FEES: •
S uprv. Electrician signature, required:
� Subtotal: $108.12
P lan review (25% of permit 18e):
Print name: Ron • f f man Date: 8/1/2012 State surcharge (12% of permit fee); $12 .9 7
Authorized signatum. r I I 1441
TOTAL PERMIT FEE; $121.09
`JOURO This permit appllcalion expires Ire permit is not obtained within 180
days after r has been accepted as complete.
Print name: Anna Ike t t Date: 8/1/2012 • Ntmtbu of Inspections allowed per permit -
I; laoirdinglpam >;ulELC- PermiIAppdoo 07/01/10 4404615rt11rnSICOMAV®
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