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Permit
it. 4 /40/0 9 Cam. - f — * �1;o � - CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ° • COMMUNITY DEVELOPMENT Permit #: ELR2009 00113 I C A P. D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/16/2009 T Parcel: 1 S 1260000300 Jurisdiction: TIGARD Site address: 9665 SW WASHINGTON SQUARE DR CO2 Subdivision: Lot: 0 Project: Aritzia Project Description: Install restrictd energy for voice /data. 4/20/09, adding audio /stereo wiring Owner: FEES PPR WASHINGTON SQUARE LLC Description Date Amount BY THOMPSON PROPERTY TAX SERVUCES, Restricted Energy Permit 04 /16/2009 $75.00 2235 FARADAY AVE STE #0 12% State Surcharge - Restricted Energy 04/16/2009 $9.00 PHONE: Limited Energy 04/20/2009 $75 00 12% State Surcharge - Electrical 04/20/2009 $9 00 Contractor: WILSONVILLE LOCK & SECURITY 8269 I SW WILSONVILLE RD. WILSONVILLE, OR 97070 PHONE. 503- 682 -2323 FAX: 503- 682 -5868 Type of Use: COM Class of Work: ALT Total Number of Systems: 2 Audio & Stereo: Y Boiler Controls: CCTV: Clock Systems: Data & Telecommunications: Y Fire Alarm: HVAC: Instrumentation' Total $168.00 Intercom/Paging: Landscape /Irngation: Landscape Lighting: Medical: Required Items and Reports (Conditions) Nurse Calls: Protective Signal: Security Alarm: Other. 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 i - • dance 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 • - s ATTENTIO Or- • • n law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set fort in OAR 952 -00 -0010 through OARS -00 -01 ! • You may obtain a copy of the rules or direct questions to OUNC by cal • •=: e ' • 6699 or 1.800 332 23'44 „ Issu • By: ' Permittee Signatu !' '7' 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. Electrical Permit Application � �' , i i1; i,l l II I , °,,I 1 i\ 1 ,` , City of Tigard Received �f g y , ei Ibinm Nu +•r/r ! ^� / " 00i/3 _ IN-. 13125 SW h Uate/b all Blvd . Tigard, OR 97223 APR 2 0 2009 me. a iew ' Phone. 50 1630,4171 I'm. 503.598 1960 pateinv. Other Permit I I t i t R I Inspection Line. 503.039.4175 CITY OF TIGARD Dale scatt /H Jm in �i ~o p�mag e 2 Information Internet. www tigard -or goo I^^ Na�tifial/Mdhtd, .. _- ,_ ..� —_ -- BUILDING D V I l O __ TYPE OF WORK PLAN REVIEW ED New construction ❑ Addition/alteration /replacement Please check all that apply (submit ;sets of plans w /items checked below). ❑ Service or feeder 400 amps or more ❑ Building nvei ilh EC ripneV [] Demolition ❑ Other: where the available rash current (] Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,100 amps at 150 volts or ❑ Floating buddimei. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ I - and 2- family dwelling ® Cotnmercial/industrial ❑ Accessory building otitis for 911099r 1nai911ano19 budding. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Mire pump. 0 installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency aysiem larger separatel derived system 0 Addition of new motor load of ❑ °n" i•' I - 2" "I a" Job no.: Job site address: 9665 SW Washington Sq. Rd. t00HP or noire. occupancy ❑ Six nr more residential units ❑ Recreational vehicle parka City/State/ZIP. Tigard, OR 97223 ❑ Health -care facilities ❑ Supply voltage for more than -- - - - -• -- ❑Hazardous location, 6[w mils nominal Suite/bldg. /apt no.: Project name: Aritzia ❑ service rn feeder son snips or more FEE SCHEDULE Cross street/directions to job site: Washington Square Mall Deacfgitnn LQq., I Fee. I iar I • New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: I.ut nU„ 1,000 sq. It or less 145 15 4 Fa. add] 500 sq tt. or portion 33.40 1 Tax map/parcel no.: Limited energy, residential — DESCRIPTION OF WORK / -� (wish above sq R.) 7500 2 E OO / Li mited energy, b ilti•fa Audio / Stern a • O 2 2 3 residential (wnh;rMrve,(I It ) I 75.00 75 00 2 ^ Scrvires or feeders installation, alteration, and/or relocation I -- 200 amps or less 80.30 2 ❑ PROPERTY OWNER ❑ TENANT - 201 amps to 400 amps 1(1(,115 2 Name: 401 amps to 6011 amps 160 60 2 601 amps to 1,000 amps 240 60 2 Address: Over 1,000 amps or volts 454.65 2 City/State/II V: 'temporary services or feeders installation, alteration, and/or - relocation Phone: ( ) Fax: ( ) 200 amps or Icss _ 66 85 1 Owner installation: This installation is being made on property that I own which is not 201 snips 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: A. circuits - new, alteration, or extension, f;1er panel I - A. Fee for branch circuits with © APPLICANT ❑ CONTACT PERSON above service or feeder fee, each branch circuit 6 65 2 HUSIness name: B Fee for branch circuits Contact name: without service or feeder fee, 46,85 2 first branch circuit Address: Each add'i branch circuit I 6.65 12 - Miscellaneous (service or feeder not included) City / State/ZIP: Each manufactured or modular 90 90 2 -- - dwellinj, service and /or keder Phone: ( ) - Fax, ; ( ) Reconnect only 66 $5 2 E-mail: Pump or irrigation circle 53 40 2 CONTRACTOR Sign or outline lighting 53.40 2 Business name: Wilsonville Lock & Signal c,rcuit(s) or limited- L -' -' energy panel, alteration, or Address: 8369 I SW Wilsonville Rd. extension Describe: Page 2 2 City /State /YIP: Wilsonville, OR 97070 Each additional Inspection over allowable in any of the above - Per inspection 62.50 Phone: (503) 682 -22323 Fax: (503) 682 -5868 - Investigation per hour (l to min) 62,50 CCB Lie.: 49329 Electrical Lie.: 3- 198cIe Suprv. Lie.; 4367LEA Industnal plant per hour 73.75 "" -- -- ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal 75,00 -- s t fee): Print name: Scott Vosburg Plan review (25%/ of permit $ Date : -20-09 _ State surcharge (12% of permit fee): 9.0(1 Authorized signature: .......i.t. - TOTAL PERMIT FEE: 84,00 Ma permit application expires if a permit Is not obtained within 1110 Print name: Scott V osburg _ Date: 04 -20 -09 days after ie tae heap accepted as complete. • Number of inspeciwe, allowed per permit i inidinaWermrttlf'i.l.- YnnatAsp 'ue o5/1 3ro6 an-46i 51(1 I Mg :QM/WED Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* n Burglar Alarm I I Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* 0 Vacuum Systems* ❑ Other. COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (S1:1', OAR 918- 309 -0000) Check Type of Work Involved: ® Audio and Stereo Systems ❑ Boiler Controls n Clock Systems El Data Telecommunication Installation n Fire Alarm installation [] F IVAC n Instrumentation ❑ Intercom and Paging Systems ❑ landscape Irrigation Control* ❑ Medical n Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling O Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I UluddinglPernut tI4 -P , .ii duo 1.11(23 /1.16 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: ELR2009 -00113 Date Issued: 04/16/2009 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S1260000300 Jurisdiction: TIGARD Site address: 9665 SW WASHINGTON SQUARE DR CO2 Subdivision: Lot: 0 Project: Aritzia Project Description: Install restnctd energy for voice /data. Owner: FEES PPR WASHINGTON SQUARE LLC Description Date Amount BY THOMPSON PROPERTY TAX SERVUCES, Restricted Energy Permit 04/16/2009 $75 00 2235 FARADAY AVE STE #0 12% State Surcharge - Restricted Energy 04/16/2009 $9 00 PHONE Contractor: WILSONVILLE LOCK & SECURITY 8269 I SW WILSONVILLE RD WILSONVILLE, OR 97070 PHONE 503 - 682 -2323 FAX 503 - 682 -5868 Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio & Stereo* Boiler Controls* CCTV. Clock Systems: Data & Telecommunications. Y Fire Alarm: HVAC Instrumentation Total $84 00 Intercom /Paging Landscape /Irrigation. Landscape Lighting• Medical. Required Items and Reports (Conditions) Nurse Calls: Protective Signal: Security Alarm• Other. 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 rf 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 throw. h OAR 952- 001 -0100 You ma obtain a • py of the rules or direct questions to OUNC by callin 246 6699 or 1 800 332 2344 Issued By 111A 1 �' - • i � I _ ■ \ • Permittee Signature: QQ— lit\ \ d1 / 1 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 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. 'i act 'cal e W gi Iica o ' � l,;is I fl I . { City of Tigard TI ' 4 , i. > 'Waived 13123 SW Hall Blvd., Tigard, t • } 0' Q O. perm(( No.: • . 001 I3 III I • Phone: 503.639.4171 Fran: it .598.19 2009 s Other Permit: r rL., (: , Inspection Llae: 503.639,4175 pp t Chem:(: wwur,tigardor.100 atiIIedl4itthod; Sec Pegs l Inn r r--- r r �� N 6 manes/ Information rlia� o> ; �I SI PLAN UMW ■ Now construction III Addition/RIO . . ant ' eato speck + ' +PP Otubrad lets of plies Wittman C be . ; CD Demolition 31 ()that C]Sarvlecar 400 amps ormom 1113s1dtnpttwrebteovane. whore t atmlablo faatt overeat D totarinee sod bmaymds. CATEGORY C CONSTRUCTION moods 10,000 amps as 150 VOID or Q Floa4in b,tudhtsc. [] 1- and 2- fatherly dwelling Cotnmcrcialrndlutrial ❑ Accessory building /se to �ena4 er mwocde 1a 000 p cammafe:U.uso iypicattursl ampsfor a// enter iaamlt none. bu 0 Multi- Atmily ❑ Master builder ■ Other: G rl v pump, ❑ lslulletioc ern 1CVA or O Bmot om _ !nor nown eiy &And Fromm. JO1B arm INFORMATION AND LOCATION a Addition arum motor toad of ❑'A ", •2 ",'1,2', "1.3" lob no.: — Fob sit: addressl 7 . -�5 11) (7.hn1! {D � t�. 1003Porlrwte, o p - J 1 ' El Ma or mem resident// units. Q Remmtlamt w ark, hlato p. 1 l Ctty /Statc/ZIP: (Ted U R n.'7, 3 Q Haagh - oe:e 4tcnitina ❑ SapPty voltage for mote than 0 Hmandoua bwtiom. 600 mater nominal. Suite/bldg. /apt. no. .. C49 : � Project name. ( '1 tz i a a& mho or feeder d00 . or more. Cross atreet/dittetiona to job alto: FEE SCHEDULE L.= 1..;.-17===mmammoK;173111MIZIMIMITZMISPICNI New rtsldontisl mingle. or mutt!- fserl1y dweiung unit, Includes attached . r e. Subdivision; Lot no.: 1 000 sq. f. or lme 145.1$ . iii 'foot map/parcel no.: Ea. eddl 500 $ or ion 33 -40 shove DUCBWfON OF WORK , it mum, . . i nei• 111 7S.00 mu with r - dt ve t. 'u --•ft-- Jan ... en ,rnU ; 73.00 MU roslderttial (with show so. f Services or .t :: or Innt eliallo , ,,,torah 6 6 tod/or . MIN ❑ PROPERTY OWNER GI am . or less MI 80.30 _ _ d reri wT 201 • , to400. , . , IIII (06.85 131 N1unc: 401 amp' to 600 , , .a IME 160 MIMEO Address 601 am. to (,000 stops 240.60 �Q �� _ Ovor (,000 mope or voile 1• �Q C1ty/Statt1J2;1P: Temporary services nr feeders installation, altered" and/or relocation Phonne: ( ) Fax: ( ) 200 amps or lays 1111•11110 Owner inetallation: This installation is being mado oti property that I own which is twt 201 amps to 400 amps MI 10030 El intended for sales lease, tont, or exchange, according to OR.$ 447, 449, 670. and 701. 401 to 599 ■, . 133.75 _ OLVrfeT stgt>kltUre: drools -. new s • or tomato 6 !, r P anc or ® APPLrCA T —� A. a o ve ewibranch ctcircuits with e, ❑ 00'CPi'ACf 1'FRkON abolle Roder foe, Busincsa nano: — oaaI trench circuit 6.65 II _ & Fee for branch altnuita Contact name; Wthow service or feeder foe, 46.55 II — — first trench circuit Address: Each add'l btaach circuit 6.65 d City /Statc%ZIP: — es �'v 1 nam er feeder u included Each lnm, a . or modular 9x1 • Phone: ( ) Fox; . ( dwellia �ralan td/nr f; eder 90 11111 _ Reconnect only MO 66.83 � Email: r Pu ,• or itH anon circle CONTRACTOR Enn=r1MITMEIIMI 53.40 MIQ Business mono: 53 -40 � � l 1 1 1 �/ 1 11�2 1 GL � `1t �. +rQ; C( 1 i rx . signal coot ar ltt ir ti a- Q 1 eta panel, alteration. or Address: 6 �,1 T v.1 r 16onv i 11e. tcwntatott, Dosoribe: p ogo 2 rJ Ole Glty/Statv2IP: ' i i6(.Snv i { (Q OP 4 ash additional Ine . action war al err ■ble hi a , of the above Phoaae: LSD;3) D•P303 J Fax: (503) (0e.Q-_5* z - 0 6z.so MI _ Invostlgatlon per hour (//tr MEM = CCB LIC.: Electrical Lic.:3./ Suptw- Lic. : 4304 0 Induettit plant pm hour _ T3.75 Suprv. c ct iffi si vL , required: >a 0 • l • t l 1 CTRICAL 't' MS S I Prim. nxunc: ` 5 c L *) 1)(.l . • ter Date: 4{' ) `'r (ft . Plan review (25%of parmi ): Authorized sipteturo; sew ltrtohargc (12% of permit fear z7, a r TOTAL PERMIT FEE: S4;UG` Print name; Date: b p applkmton mpitnr Ifs permit m none . .. withla 180 days altar It bas boon accepted al tomptet I:tHvlIdMp1[Wmttr�Hi.Frwmtyl p,dne 03/21/136 Number ofinapootions Clawed ear pewit aee.461 TT(11/05/035 JAVHD