Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2009 -00396
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/04/2009
Parcel: 1 S 1260000300
Jurisdiction: TIGARD
Site address: 9585 SW WASHINGTON SQUARE RD MGMT OFF
Subdivision: Lot: 0
Project: Washington Square
Project Description: Install /alter (9) branch circuits, and (2) restricted energy for voice data in food court.
Owner: FEES
PPR WASHINGTON SQUARE LLC Quantity Description Date Amount
BY THOMPSON PROPERTY TAX SERVUCES,
2235 FARADAY AVE STE #0 1 ea Limited Energy 08/04/2009 $75 00
PHONE: 9 crt Branch Circuits 08/04/2009 $100.05
wo /Purchase Service or
Feeder
Contractor: 1 ea 12% State Surcharge - 08/04/2009 $21.01
Electrical
FRAHLER ELECTRIC CO 1 ea Limited Energy 08/04/2009 $75.00
11860 SW GREENBURG RD 0 ea 12% State Surcharge - 08/04/2009 $9.00
TIGARD, OR 97223 Electrical
PHONE: 503 - 639 -4627
FAX: 503- 639 -4673
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $280.06
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 thro gh AR 952.001 - 0 JVX 100. You may obttain copy of the rules or direct questions to OUNC by calling 503.246 6699 or 1 800 332.2344.
IAX.I l
Issued By: X �lM�� Permittee Signature: 2-e_CL , A fr ( l Cait Or)
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 603.639.4175 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.
i i
• Electrical Permit A t t lic.iu ,: ��� r-olz orr10E USE ONLY
• City of Tigard ° 13125 SW Hall Blvd., Ti 9, 113 2.0 Received �/A g �� %,
.74 Date/By: 414 PemvtNo O�,
C Tigard, OR 972,- Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 e 1069•0 Date/By. Other Permit: TIGARD Inspection Line: 503.639.4175 GO Or `` 1`C10�i Date ReadyBy. hais: 0 See Page 2 for
Internet: www.tigard- or.gov �� ^ 1wA DG V 7 Notified/Method. Cj supplemental Information
TYPE OF ORK ,`� 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
❑ 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
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.: 66815 Job site address: 9585 SW WASHINGTON SQ ROAD 1001-11' 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: AKOO NETWORK FOOD COURT ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Conniption I Qty. I Fee. I Total 1 •
New residential single- or multi -family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. R 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
ADDING DISPLAY MONITORS AND ASSOCIATED WIRING residential (with above sq ft.)
Services or feeders installation, alteration, and/or relocation
AT FOOD COURT 200 amps or less 80.30 2
• ❑ PROPERTY OWNER ❑ . TENANT 201 amps to 400 amps 106.85 2
Name: • - - - - • • - . • 401 amps to 600 amps . 160.60 2
601 anps to 1,000 amps . 240.60 2
Address: 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
Contact name: without service or feeder fee, 1 46.8 46.85 2
first branch circuit
Address: RETURN APPLICATION Each add'1 branch circuit 8 6.65 53.20 2
Miscellaneous (service or feeder not included)
City/ State/ZIP: ( ) 11COPY Each manufactured or modular 90.90 2
PhOIIe: ) dwelling, service and/or feeder 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 COPMANY energy panel, alteration, or
Address: 11860 SW GREENBURG ROAD fit to ER 2 Page 2 150. 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 . . -- - Fax: 603 ) 639 -4673 - - - - • . Investigation per hour (1 hr mm) 62.50 , -
- CCB Lic:: - 37410 -- - Electrical Lic.:- 34 -13C- Suprv. Lic.: 1816S -• Industrial plant per hour - 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, retj6, /�' • . Subtotal: 250.05 •
Print name: R. W. FRAHLER _ Date: 07/27/09 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 30.01
Authorized signature: - TOTAL PERMIT FEE: 280.06
Print name: Date: This per application expires If a permit is not obtained within 180
days after It has been accepted as complete.
I
Electrical Permit Application - City of Tigard _ . , •
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for ll 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:
COMMERCIAL WORK 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: 2
*No licenses are required. Licenses are required
for all other installations