Permit Q.
II II CITY OF TIGARD ELECTRICAL PERMIT
�. COMMUNITY DEVELOPMENT Permit #: ELC2009 -00212
T I G ARD 13125 SW Hall Blvd., Tigard OR 97223 503 639.4171 Date Issued: 05/12/2009
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9473 SW WASHINGTON SQUARE DR A08
Subdivision: Lot: 0
Project: Cinnabon
Project Description: Reconnect.
Owner: FEES
PPR WASHINGTON SQUARE LLC Quantity Description Date Amount
BY THOMPSON PROPERTY TAX SERVUCES, 1 ea Reconnect Only 05/12/2009 $66.85
2235 FARADAY AVE STE #0 1 ea 12% State Surcharge - 05/12/2009 $8.02
PHONE:
Electrical
Contractor:
RK ELECTRIC INC
24495 NW OAK DR
HILLSBORO, OR 97124 '
PHONE. 503 - 640 -1344
FAX: 503- 356 -0513
Type of Use:
Class of Work: Type of Const:
Occupancy Grp:
Total $74 87
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 AR 952 -001 -0100 You may obtain a copy of the rules or direct questions to OUNC by calling 503 246 6699 or 1 800.332 2344.
Issued By: -a��Q t Q � Permittee Signature:
_ .s.s...___1 4 1:3 0 , L Q2
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'N Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an Inspection that business day.
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.
Mate 07 2009 11:03AM HP LASERJET 3330 P.1
b.
Electrical Permit Ap of-. ??, I� I t)
OR FF1ct: [SF �):`i.,
City of Tigard , .' il __, � Received
13125 SW Hall Blvd ,Tigard, OR 9722 n ,, plan „By S. ? 4k v Permit No.: E �C znoQ . C 0212
-, . Phone: 503 639.4171 Fax tj q98 V Date/Br 90o 2. a Review
1
Ivtf� I "' Other Permit:
i ,-, , tt r i Inspection Line: 503.639.4175' Date Ready/By, Ions la See Page 2 for
Internet. www.tigard r F ' ' RD Notified/Method. [ I C
Supplemental Information
I, W..... toRii+tl ilrlaK.4.5IMr3.lLRENE 5 -0 :
-
❑ New construction El Ar a terationfreplacement Please check all that apply (submit 2 sete of plans wilt ems checked bclow): •
0 Service or fader 400 amps or more 0 Building over three Stories.
❑ Demolition ❑ Other:
where t he available fault current
'� yy!r77 p nn�r. l � t � � ❑Marinas and boatyards.
.1 ®:} , i UA'!I n ..5� . I �i , ai, n,I _ 11 i;l ' n � i?I . r ; exceeds 10,000 amps at 150 volts or 0 Floating build nip
0 Com mercial /industrial !!'r less to ground, or exceeds ons. ❑ Commercial -t�se agnculhual
❑ 1 - and 2- family dwelling
❑ Accessory building amps for all other installations. buildings
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
'U+ • ',!�, - ,4 �•' ' ! 1 :--1 1 '1 1 ''. ' ,:i" " ���� �!F 4 u;•y, ❑ Finer tic s st em
larger separately eriveds stem
7 , '' i ,, • ) .' fl ode �r'ii ." _A io411 t•I i. - c.Ikii' " ' ;i'
: i 4 6 : ' x ii£ = -,, • , e' tt s [5 , H ue ri 't n t r Be Y Y erne motel d system ❑ Adduhoe of new motor load of
Job no.. 1479 Job site address -9058 SW Washington Square Rd. 100HP °r °re occupancy
❑ Six ormor msideaaal onus. ❑ Recreational vehicle parks
City/Stale /ZIP: Portland, OR 97223 9 473 ❑Health-care facilities. ❑ Supply voltage for more than
I ❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.- I Project name: Cinnabon ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: 4 - a '` L` "7. t : ' `. '� ' ",
_�.
Description Qty. F ee. Total - •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision I Lot no.: 1,000 sq. R. or less 145.15 4
Tax mapiparcel no.: Ea. add'; 500 sq ft, or portion 33.40 1
ett inert q is Limited energy, residential
��I } i t o M I l f i + MR !ate Ir`• l (with above sq. ft.) 75.00 2
Reconnect Limited energy, multi- family
residential (with above sq. .) 75.00 2
Services or feeders installation, alteration, and/or relocation
1 � ° : ' � a r n t': A 5: ! `• „ is� yt _ 200 amps or less 80 30 2
li',. ')r!a i rl I .!like t Fj: li : )i it,4 $;,!1•rE'„cH"�i.-- - ;, t, ),;t11;,.‘ >' t `a; I 201 amps to 400 amps 106 85 2
Name: Western Roasters 401 amps to 600 amps 160 60 2
601 amps to 1,000 amps 240 60 2
Address:
7800 SW Durham Rd., Suite 900 Over 1,000 amps or volts 454.65 2
City/Stale/ZIP. Tigard, OR 97224 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (503 ) 639.2747 Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100 30 2
Intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. _ 401 amps to 599 amps 133 75 2
Owner signature: Date: Branch circuits - new, alteration, or extension per panel
t:t ).. ` - '`l l �I °, t' I,1 ®I(I PI” n!�mF .r A Fee for branch circuits with
:
u.,u�;t�wzaral�a � l t y :r , jIEW above service or feeder fee, 6.65 2
Business name: RK Electric, Inc. each branch circuit - B. Fee for branch circuits - .
Contact name: Zach Milton without service or feeder fee, a6 85 2
first branch circuit
Address: Each addl branch circuit 6.65 2
City/State /Z1P: Miscellaneous (service or feeder not included)
Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone' ( 503 ) 640.1 344 I Fax: : (503 ) 356.0513 Reconnect only 1 66.85 $66 85 2
E-mail: Pump or irrigation circle 53.40 _ 2
+ ! iai i •, INI I , , Sign or outline lighting 53.40 2
Business name: RK Electric, Inc. Signal circuit(s) or limited -
energy panel, alteration, or
Address. 24495 NW Oak Dr. extension Describe: Page 2 2
City/State /ZIP: Hillsboro OR 97124 Each additional Inspection over allowable in any_af the above
Phone. ( 503) 640 -1344 I Fax: Per inspection 62.50
( 503) 356 -0513 Investrgation per hour (t hr mm) 62 50
CCB Lie.- 94275 I Electrical Lit.. 34-375C • I Supry Lie.: 4724 -S Industrial plant per hour 73.75
Supry Elect ecian signature, required:
- t • - I b • \ .1c) ,, NNEITE fl b1 ,
Subtotal: l ri 66.85
, ':'4':';',`
-<< $
Print name: Ron L. urtz • te: 5/6/09 Plan review (25% of permit fee) $0.00
Authorized signal ,
State surcharge (12% of permit fee): $8.02
. 'I ,L. TOTAL PERMIT FEE: $74,87
Print name. Ron L. Kurtz Date: 5/6/09 This permit application expires if a permit is not obtained within 180
days after it bas been accepted as complete.
I tBmldrse\Perm,ntELC- PetmnApp • doe 05/23/06 ' Number of inspections allowed per permit - S- 1 440 l /05 /CO r,1/ WEB 7'4