Permit t
n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
• -- C COMMUNITY DEVELOPMENT Permit It: ELR2009 -00147
Date Issued: 06/04/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S1260000300
Jurisdiction:
Site address: 9665 SW WASHINGTON SQUARE RD CO2
Subdivision: Lot: 0
Project: ARITZIA
Project Description: TI
FEES
Owner:
PPR WASHINGTON SQUARE LLC Description Date Amount
BY THOMPSON PROPERTY TAX SERVUCES, Restricted Energy Permit 06/04/2009 $75.00
2235 FARADAY AVE STE #0 12% State Surcharge - Restricted Energy 06/04/2009 $9.00
PHONE:
Contractor:
GEORGE & SONS ELECTRIC CORP
PO BOX 339
CLACKAMAS, OR 97015
PHONE: 503 -654 -8634
FAX: 503 - 653 -6886
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 Total $84.00
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N Required items and Reports (Conditions)
Nurse Calls: N Protective Signal: N
Security Alarm: Y Other: N
Other Desc:
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 throug A 52- 0 0100 You may obtain a copy of the rules or direct questions to OUNC by calling 503.246 6699 C orr 1.800.332.2344.
Issued By: i Permittee Signature: d A -' ' �L /c
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 503.639.4176 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.
'0
Electrical Permit Application ,,,,,,
` . ' , l flit 01.l l(i: r si (1 \i.1 I A `, \„
1I N I • , : . ":.: . City of Tigard RECEIVED Received r, )Ir rf
13125 SW Hall Blvd, Tigard, OR 97223 Date/13 . ' / /f•�� Permit No. E zi z a /II C�_ „,
Phone, 503.639,4171 Fax: 503.598 I960 JUN 0 1 '2009 Plan Review
r I r it I Inspection Line: 503.639.4175 Date/p . Other Perm / S 40ag �D X7
Internet. www,tigard- or.gov Notified/Method ®Sa P 2 for ••7 th F TIGARD ` Supplemental Information
TYPE OF W1LD1NG D '
PLAIN REVIEW
❑ New construction ® Addition /alteration /replacement Please check all that apply (subm j se ts of plans w /Items checked below)
❑service or feeder 400 amps or more Building over throe stones
❑ Demolition ❑ Other;
where the available fault current ❑ Mannas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings
❑ 1 - and 2-family dwelling Ices to ground, or exceeds 14,000 ❑ Commercial - use agricultural
Y g ® Commercial /industrial 0 Accessory building
❑ Multi amps for all other installations, buildings,
0 builder 0 ❑ Fue pump ❑Installation of 75 KVA or
JOB SffE INFORMATION AND LOCATION ❑Emergency system larger separately denved system
❑ Addition of new motor load of ❑ "A' , "C' "1 - 2” "I - 3"
Job no.: Job site address: 9665 SW Washington Sq. Road I00HP or more occupancy,
❑ Six or more residential units ❑ Recreational vehicle parks
City /State/ZIP: Tigard ORegon El Health - care facilities ❑ Supply voltage for more than
El Hazardous locations 600 volts nominal
Suite/bldg. /apt. no : Project name' Aritxia d Service or feeder 600 amps or more
Cross street/directions x
directions to job site: Job is in Washington Sq Mall FEE SCHEDULE
Deriptioti I t2tr. 1 Pee I Total I
• •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less T 145.15 4
Tax map /parcel no.. - Ea. add'I 500 sq. 11, or portion 33 40 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. fi )
Low voltage permit for magnetic strip hookup to security Limited energy, multi- family 75 00 2
residential (with above sq R )
_ Services or feeders installation, alteration. and/or relocatio
200 amps or less 80 30 2
❑ PROPERTY OWNER 0 TENANT 201 amps to 400 amps 106 85 2
Name: 401 amps to 600 amps 160.60 2
Address: 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) 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
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A, Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee. 46.65 2
Contact name:
first branch circuit
Address: Each add] branch circuit I 6 65 2
- « - Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular 90.90 2
Phone ( ) — Fax: : ( ) dwelling, service and /or feeder
Reconnect only 66.85 2
E -mail: Pump or ungation circle 53 40 2
CONTRACTOR m
RA Sign or outline lighting 53 40 2
Business name: George & Son's Electric Corp. �5ignal circuit(s) or limned -
energy panel, alteration, or
Address: PO Box 339 extension. Describe: / Page 2 2
City/State/ZIP: Clackamas, Oregon 97015 Each additional inspection over allowable in any_of the above
Per inspection 62 50
Phone: (503) 654 -8634 Fax: (503) 653 -6886 Investigation per hour (1 hr mm) 62.50
CCB Lic : 35600 I Electrical Li 3 -1 I 7C Suprv. Lic.. 3185 - Industrial plant per hour 73 75 _
ELEC'I'RtCAL PERMIT FETES
Suprv. Electrician signature. required: Subtotal, 7 S - Di)
, fr
Print name: Craig Robison Date: 6/1/2009 Plan review (25% of permit fee)
State surcharge (12% of permit fee)' 9 , p--J
Authorized signature: TOTAL PERMIT FEE:
This permit applicati expires if a permit is not o b tie witbin 1 8
Print name: Date: days after it has been accepted as complete.
' Number of inspections allowed per permit
I \Bmlding\Permns \F1.C- PermitApp doc 05/21/06 440 - 46157(11 /05 /COM/wEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
8 " — , i i . , i� •.
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
[l Vacuum Systems*
❑ Other:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
® Other Security
Total number of commercial systems: 1.
*No licenses are required. Licenses are required
for all other installations
I \Buddirri\Pcrmtte\ELC- PermttApp doc 03/23/06