Permit CITY OF TIGARD ELECTRICAL PERMIT
i
a.., COMMUNITY DEVELOPMENT Permit #: ELC2009-00121
Date Issued: 03/13/2009
T I G A RD 13125 SW Hall Blvd , Tigard OR 97223 503.639 4171 parcel: 1S1260000300
Jurisdiction:
Site address: 9665 SW WASHINGTON_SQUAREAD.0O2
Subdivision: Lot: 0
Project: ARITZIA
Project Description: TI
Owner: FEES
WASHINGTON SQUARE LLC Quantity Description Date Amount
BY THE MACERICH COMPANY, 9585 SW
WASHINGTON SQUARE RD 1 ea Services or Feeders - 200 03/13/2009 $80 30
amps or less
PHONE 2 art Branch Circuits w /Purchase 03/13/2009 $13.30
Service or Feeder
1 ea 12% State Surcharge - 03/13/2009 $11.23
Contractor: Electrical
FRAHLER ELECTRIC CO 0 da Additional Plan Review 03/13/2009 $0 01
11860 SW GREENBURG RD
TIGARD, OR 97223
PHONE: 503 - 639 -4627 •
FAX: 503 - 639 -4673
•
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: M
Total $104 84
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 A NTION la regon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952 -00 -0010 through O 9 , 01 -0100 You may obtain a copy of the rules or direct questions to OUNC by calling 503.246 6699 or 1 800 332 2344
Issu y: _ , .■ / / /IL _4_A . Permittee Signatu- _—_:-.. ✓
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 G
r
SIGNATURE OF SUPR �� //
. ELEC' `�� d.rOL/ �G �(� Date: d / J
„ r
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.
Electrical Permit Application RECEIVED FOR OFFICE USE ONLY
City of Tigard MAR 11 2009 D�sy. 3 (l o9 ' �'' PeinitNo.: E,ceao69-��/
• 13125 SW Hall Blvd., Tigard, OR 97223 Pi
, 11111 C • Phone: 503.639.4171 Far 503.598.1 OF TIGARD Da Y Other Permit 1 GA l: E, Inspection Line: gov75 BUILDING DIVISION Daie "YIBY mu � Supplemental See Page for
Notified/Method. % 1(O Supplemental l Information
:TYPE'OF :WORK - : - - - "TIAN • -
❑ New construction ER Addition/alteration/replacement Please check all that apply (submit 2 sets of plans whtems checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stones.
❑ Demolition ❑ Other where the available fault current ❑ Marinas and boatyards
'CATEGORY OF •CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
❑ 1- and 2- family dwelling [$ Commercial/industrial ❑ Accessory building si to ground, all other a exceeds 1 ns ❑ Commercial-use agricultural
for all other installations buildings
❑ Multi- family ❑ Master builder ❑ Other- ❑ Fire pump ❑ Installation of 75 KV A or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2", "1 -3 ",
Job no.: 66516 Job site address: 9665 SW WASH. SQ. RD. 100P or more. occupancy
El SIX or more residential units. ❑ Recreational vehicle parks.
City /state/ZIP: TIGARD, OR 97223 A 2.T ❑ Health -care facihhes ❑Supply voltage for more than
❑ H Hazardous locations 6 volts nominal
Suite/bldg. /apt no.: CO2 Project name: S ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: De¢atpaon I oa• I Fee. I Total 1 •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft or less 145.15 4
Ea add'l 500 sq. ft or portion 33.40 1
Tax map/parcel no.: Limited energy, residential
. , `DESCRIPTION .OF ;WORK : ',- " , , .. (with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
RELOCATE SERVICE PANELS residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 1 80.30 80.30 2
0.PROPERTY'OWNER . . -. - '❑'TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: 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
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
' ,❑ APPLICANT - ' : ❑ -CONTACT ,PERSON. - above service or feeder fee, 2 6.65 13.30 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee 46.85 2
first branch circuit
Address: Each add'1 branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/ State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E - mail: Pump or irrigation circle 53.40 2
' CONTRACTOR • , - Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: FRAHLER ELECTRIC COMPANY energy panel, alteration, or
Address: 11860 SW GREENBURG ROAD extension. Describe: Page 2 2
City/State/ZIP: TIGARD, OR 97223 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( 503 > 639 -4627 7.1. Fax: ( 503 ) 639 -4673 Investi
Investigation per hour (1 hr min) 62.50
CCB Lic.: 37410 Electrical Lic.. 1 34 - 13C Suprv. Lic.: � 1 1ps° Industrial plant per hour • 73.75
;ELECTRICAL PERMTTEES
Suprv. Electrician signature, required:
Print name: ADAM ETHERINGTON Date: 03/09/09 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 11 . 24
Authorized signature: TOTAL PERMIT FEE: 1O�i. 84
Print nine: Date: This permit application expires if a permit is not obtained within 150
days after it has been accepted as complete.
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LINIITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY: ' -
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*
❑ Vacuum Systems*
❑ Other:
:CONfl1�IBG�A:O.ONLY ;
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
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations