Permit •
•
q CITY OF TIGARD I ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit: ELC2012 -00642
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/08/2012
Parcel: 1S1260000300 •
Jurisdiction: Tigard
Site address: 9585 SW WASHINGTON SQUARE RD OFFICE
Project: AT&T Kiosk in courtyard in front of Sears Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: (5) branch circuits for set -up kiosk in courtyard in front of Sears. 11/14/12 adding (1) low voltage for
DatalTelecommunications REPRINT with new additional low voltage
• Contractor: JRA INC Owner: PPR WASHINGTON SQUARE LLC
11860 SW GREENBURG RD PO BOX 847
TIGARD, OR 97223 CARLSBAD, CA 92018
•
PHONE: 503 - 639 -4627 PHONE:
FAX: 503 - 639 -4673
• - FEES
• Quantity Description Date Amount
1 ea. 12% State Surcharge - 11/08/2012 $10.30
Specifics: Electrical
5 crt Branch Circuits wo /Purchase 11/08/2012 $85.86
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea Limited Energy 11/14/2012 $75.00
Type of Const: 0 ea 12% State Surcharge - 11/14/2012 $9.00
Electrical
Occupancy Grp:
Total $180.16
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 2 -001- 090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ,
Issued By: i� lf'L 1 1§4L1 11 I�
Permittee Signature: N A PR./ ` 4 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' 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.
•
q CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 00642
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/08/2012
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9585 SW WASHINGTON SQUARE RD OFFICE
Project: AT &T Kiosk in courtyard in front of Sears Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: (5) branch circuits for set -up kiosk in courtyard in front of Sears.
Contractor: JRA INC Owner: PPR WASHINGTON SQUARE LLC
11860 SW GREENBURG RD PO BOX 847
TIGARD, OR 97223 CARLSBAD, CA 92018
PHONE: 503 - 639 -4627 PHONE:
FAX: 503 - 639 -4673
FEES
Quantity Description Date Amount
1 ea 12% State Surcharge - 11/08/2012 $10.30
Specifics: Electrical
5 crt Branch Circuits wo /Purchase 11/08/2012 $85.86
Type of Use: COM Service or Feeder
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $96.16
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 OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503 .2 23 ) 87,
2.1987 or 1..800.332.2344.
Issued By: � ,e/� X & �r KX�� ac Permittee Signature: — "' ' 7 ' r
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.
•
Electrical Permit Applicati hoR orrlcr ush ¶ NLY t
OR
�
�
I V IJ Received ' •
City of Tigard DateB : Permit o.: 02012 -O6o 42
v 13125 SW Hall Blvd., Tigard, OR 9722 V 1 3 2012 Plan Review
' - Phone: 503.718.2439 Fax: 503.598.1960 DateB : Other Permit:
•
TI GARD Inspection Line: 503.639 (��/ /� T�/ Date Ready/By: Juris: 0 See Page 2 for
- - Internet: www.tigard- or.gov
CITY i OF 11� Notified/Method: Supplemental Information
o
, , rr.:y,• ,, ;'.:°r k?r a:vF, ,, " -w. }; y;t -.,� ;qt: ;--,• - i e G: r �+�,//���. r _ s 1:: `. �; •
;3<' 1 '+l •. . •`, -•r, ''''7:+��: " - „ .ti- ; °3}n ap l
,t ,T, ; ��7' - 9: =4i. '�i'rp. .. °:.` 4.7 1 ,. -[; . ..._" s, - .,.v 1 - -'' ice K^ �'
r '' , §i f '^ r ? T <YP } .. '.t- z� . F � .�, k- Q '+ . e
,] � u.: . - �`�',� �� U c `t. 'IF', REVIEW n '.,:�.. � e „� �*�
�f�,: EY.`. �c�?ti.: :�J�i:,.,..'C.•zx.a.u'' tams- .ex. r,..+:.��r- rsr�.o . . - ... :`r,'i�a. := .�' =: ., : ?�'i' w :, o�,k. _•w. i � _ , d� rs r�- � v4% § .iy� c' P - :'�^"�'. ��T,.�`:�t.
❑ New construction E Addition/alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
; '' Kk''sJ3 +c" %-'''� 7 4, 4,70 r ` r l "�'Q . f i ""'' , 0 ' :` ' s : `�_y,',.• -'1Z J R•... exceeds 10,000 amps 150 volts or Floating - �::. i •...CATEGORY OF:. CONSTRIICTION :z ..- �;H <: 6 x .' �',_ p ❑ g buildin
;�..:;�'. �- e�. �•:-+ �es't'�.?s5:z,•-- .>_.r�i+L: -_. �„ �--_- e- �; �; r ._��'e ? :.. :�rsnr..•s- ,_._..v�. via:-.', s�i?. �` �is:�zro�." >.%d +Lt-4i.'�:�.'iY 1
less to ground, or exceeds 14,00 0 ❑ Commercial-use agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
;x, �. t ; R , 7 _,� s ifs aY:s z rr > _yam �„ - -`,--,,,--f,, . v ❑ Emergency system. larger separately derived system.
� zIE . P1?r t.'% f 1 JOB SITE�INFO MA153 AND LOGA ? C1 - ' -°: ❑ Addition of new motor load of El "A", "E ", "1 -2 ", "1 -3 ",
S.t'_' - En .:Sx.;:,.'��',..':cK .v�X� - twsv,, r�s :�.zYac•_:itcrm na:a. -., va�.r. »Cw.nas+_"rc any- ass:. >>' - ° 34,a.:_ �5��..dL...
Job no.: 69937 Job site address: 9585 SW WASHINGTON SQUARE RD 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: TIGARD, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: SEARS COURT ❑ Service or feeder 600 amps or more.
C' ` 4£ 2 S FE SCHEDULEc r r =rs ""` ," 0'���r,1'
Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no.:
Limited energy, residential
c ;r . , r : ,.u� izix.,.-�„^ ,,;� . y r' -° h r 75.00 2
tir "; C . i:"'* � DESCRIP ; "; d. V. ; ,; d . "•:. (with above sq. ft.)
'E.- 3= _ ^..���: . f 2:" �s2::§ �. i.- 4��..:. 5r.. w-..,.- .- .�- ,x„_;.- " <�v,:.�ro:.�..,e�� _o-- ., -r..:n •.•.ate: � M :,:;.: n _:.er.*. =m.3 1�.:���i:: z-ii=11.L.
Limited energy, multi - family 75.00 2
ADD DATA LIMITED ENERGY residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
irP Y``� y?' -- .- "1 +'n: on1^a-nf•t+iaT..vS:.,n
_ -3,- ?s Vb ', ®'isPROPERT;Y OWNER ;, i X ., , >• i ®:taTENA'NTA, t 201 amps to 400 amps 133,56 2
'Su..i�.,4e4 .rrae;n; s. :..- ,r- .a.,ora.-. �Cs ! F�": 41 +.�F+;;•i..kr.•.7,s�,.,... -,�" �v:- �.. c: a. �.,�.ti%SF7i,�-N` "`.i... '
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
. r= ,' ' ®t R : i� >' y ' 7. a r" . ;; _;;Ni; 3-- - �,.:.. �.it af... .,. .,. - „ ,�, . above service or feeder fee
, r y s , „ �'a • ,.. M ® CO NT t1CT�"PERSUN '• s, S 7.42 2
.ate ; ... ___. - - .__ :::°_ .� , , _. r:�s:4.,� : -t.. -moo. ..a,, --: ",_., ..: . �.,; r,:� 1 each branch circuit
Business name: B. Fee for branch circuits without .
service or feeder fee, first 56.18 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular - 67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail:
;: - � �?;•T •n .F;:" - r cyr- ^ 4 th^ •°q. - ,� ?.� , ;rr -, - .- - Sign or outline lighting 67.84 2
_': :yy:` .at ; _.>i '?'• ?t5°. (' r _ t r72 GON RAC-TOR3`;ti' c:s "h..t°_<• ::c;- s'^•S£ y: M.
:\_, �y.,:._ v,,,.,,;.,`, y121!.: �c}- YS�Li21 '.S:rii�,!'):.�T,w•,.- •„«•�,^.s, i..�:<i -0:'sfi;.Ads.1: X173",. i` iitiii +ir�'�:1?G•1S`t_'"�a%4.'' >S Signal circuit(s) or limited- energy
Business name: JRA dba FRAHLER ELECTRIC COMPANY panel, alteration, or extension. 1 Page 2 _ 75.00 2
Each additional inspection over allowable in any of the above
Address: 11860 SW GREENBURG ROAD Additional inspection (1 hr min) 66.25/ hr
City/State /ZIP: TIGARD, OR 97223 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 639 - 4627 Fax: (503) 639 - 4673 Inspections for which no fee is 90.00 / hr
specifically listed (%: hr min)
CCB Lic.: 197172 Electrical Lic,: C861 Suprv. Lic,: 5110 S21" - - : MLECTR'ICA'IY PE;R1vII_T 'FEESf? i '•-
Subtotal: 'O
Suprv. Electrician signature, required: Plan review (25% of permit fee):
Print name: ADAM ETHERINGTON Date: State surcharge (12% of permit fee): 9
TOTAL PERMIT FEE: g 17 Q el
Authorized signature: This permit application expires if a permit is not obtained within 180
Print name: • Date: • days after it has been accepted as complete.
Number of inspections allowed per permit.
1:\Building\Permits\ELC- PermitApp.doc 07/01/10 440-4615T(11/05/COM/WEB
Electrical Permit Applicatio FOR OFFICE USE ONLY
. City of Tigard Received
Date/I3 : a Cr ( Y S( Permit No.: gze_do 1 a _ a •
13125 SW Hall Blvd., Tigard, OR 97223 I `/ U 7 2012 Plan Review a.. ' �
Phone: 503.718.2439 Fax: 503.598.1960' Date/B : Other Permit: ' I A4 1.7„.• Mal
TIGARD Inspection Line: 503.639.4175 CITY CIF (;�jj� DateReadyBy: MI IZI See Page 2 for
Internet: www.tigard - or.gov [ C + V� TIC+ ""+� Notified/Method: Supplemental Information
TYPE OF GDW SI PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
Job no.: 69937 Job site address: 9585 SW WASHINGTON SQUARE RD 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: TIGARD, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: SEARS COURT K , ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: /10- ( Description I Qtv. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
PROVIDE (5) CIRCUITS TO SEARS COURT residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation, alteration, and /or
y relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ COMPACT PERSON above service or feeder fee 7.42 2
each branch circuit
Business name: JRA dba FRAHLER ELECTRIC COMPANY B. Fee for branch circuits without
service or feeder fee, first 1 56.18 56.18 2
Contact name: ADAM ETHERINGTON branch circuit
Each add'I branch circuit 4 7.42 29.68 2
Address: 11860 SW GREENBURG ROAD Miscellaneous (service or feeder not included)
City /State /ZIP: TIGARD, OR 97223 Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: (503) 639 - 4627 Fax: : (503) 639 - 4673 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: adam @frahlerelectric.com Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited - energy
Business name: JRA dba FRAHLER ELECTRIC COMPANY panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 11860 SW GREENBURG ROAD Additional inspection(1 hr min) 66.25/hr
City /State /ZIP: TIGARD, OR 97223 Investigation (I hr min) 66.25/hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 639 - 4627 Fax: (503) 639 - 4673 Inspections for which no fee is 90.00/ hr
specifically listed (%] hr min)
CCB Lic.: 197172 Electrical Lic.: C861 Suprv. Lic.: 5110S ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: , Subtotal: 85.86
Plan review (25% of permit fee):
Print name: ADAM ETHERINGTON Date: 11/05/12 State surcharge (12% of permit fee): 10.30
TOTAL PERMIT FEE: 96.16
Authorized signature:
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: • Number of inspections allowed per permit.
I:\ BuildingWermits \ELC- PermitApp.doc 07/01/10 440- 46t5T(t t /05 /COM/WEB
• ,
Electrical Permit Application - of Tigard ,•• o ,4
\.)
Page 2- Supplemental Information
LIMITED ENERGY PERMIT FEES:
ri
•
_ P
itOV grNTVIAL-1 410:ItittiN.ittYVIStrait'k*Nlgal 1.1"TC!
' Fee for all residential systems combined ... $75.00
. ,
Check Type of Work,Involved:
0 Audio and Stereo Systems*
LI Burglar Alarm
Lil Garage Door Opener*
Heating, Ventilation and Air Conditioning System*
Lil Vacuum Systems*
Other:
WOOMMOMME.MaKANOVIZAM-2
Fee for each commercial $75.00
system •
(SEE OAR 918-309-0000)
Check Type of WorlanVolved:
LI •
Audio and Stereo Systems
LI Boiler Controls
Clock Systems
El Data Telecommunication Installation
LI Fire Alarm Installation
EII HVAC
El Instrumentation
Intercom and Paging Systems
El Landscape Irrigation Control*
n Medical . • •
111 Nurse Calls
LI Outdoor Landscape Lighting*
111 Protective Signaling
Lil Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:NBuildingTermits\ELC-PermitApp.doc 07/01/10
•