Permit •
n CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 -00041
T F GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/17/2013
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9459 SW WASHINGTON SQUARE RD A14
Project: Foot Locker Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: (2) branch circuits to install plug mold
Contractor: OREGON ELECTRIC CONSTRUCTION INC. Owner: PPR WASHINGTON SQUARE LLC
1709 SE 3RD AVE PO BOX 847
PORTLAND, OR 97124 CARLSBAD, CA 92018
•
PHONE: 503 - 234 -9900 PHONE:
FAX: 503 - 234 -1001
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 01/17/2013 $63.60
Specifics:, Service or Feeder
1 ea 12% State Surcharge - 01/17/2013 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 952 -001 -0 90. 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: Perm ittee Signature: Olt 4P/ 1/c1 T7O tit
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 Application RECEIVE') FOR OFFICE USE ONLY
City of Tigard ' V / - 2 , 3 s,...f 1 Permit No0/ 3 - oc.)0 1 -f /
II 2 • 1312 SW Hall Blvd., "Figaid, OR 9 1 7 2013 Plan ReVICIA I
i Phone 503.718.2439 Fax: 503.598.1960 Daicaly. Odle: Penult.
Inspection Line: 503.639.4 I 75 : Dam 1 63 Sec Page 2 for
TIGARD CITY OF TIGARD 1 R 71
Internet www ill 1 Non ficdAlcthnd: G Supplemental Inform at ion
FYPE OF WORK PLAN RVIFW
BUILDING DIVISION
fl - . -- w construction z Additionla Iteration/replacement Please check all 'ha aptly (submit 2 wit, of plans whterns thit:Led below):
0 Servic e Or feeder 400 amps ni more 0 Building user throe Si its
I=1 l)elllitilti011 0 Other; where the available faul:curient 0 Mai Inas anti boatyards.
. . ... .... .. . . ______H
. . ..... .., ,- — .. . .„ .. ...... - „_.. _ - . ......_ .„-... .. ..
-- - -- -tCATEGORY : i0E-CONSTRUCTION:. - .:::...- . ... - -- -- -: - . -:..:..__- -.-. exceeds to,000 air,ps at 15o volts' or 0 Floairig b '
less to ground, or exceeds 11,i/tit: 0 Cianmerciel-ase agniVlillral
D I- and 2-family dwelling [Ei Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi-family El Master builder 0 Other: 0 Fire pump 0 Insiallation of 75 KVA ia
0 Emergency s
sin larger separately datvcd
: . :::: ' 0 Additina or new 111010, load of
Job no • 84274 Job site address: 9459 SW WASHINGTON SQUARE RI) 100HP ni lame. compare)
0 Six or more residential units. 0 Recreaziona■ ,clucic parks.
City/State/ZIP: TIGARD, OR 97223 El licaith-care facilities 0 Supply , Car more than '
0 Hazardous locations 606 ,oln, nomical.
Suiteibldgjapt. no A 1.i.., I Project name: FOOT LOCKER, WA SQ 0 Service or feeder Wu 41111)S or crane
- FEE SCHEDULE
Cross st i ecu'direct ions to job site: Oescri ition ! Iv. Fee. Total _ .1 a I
New residential single- or multi-luridly dwelling unit.
. Includes attached garage.
Subdivision: Lot. no.: ' t ;300 sq. l
ft. 01 ess
..„ I I • - • -
• i 108.) , 1 4
La. 3thl'l 500 is. ft. or portion : 33.')2 j 1
Tax map/parcel no.: —
Limned chergy, residential 75.00 7
;, '
DESCRIPTION :OF5WORx. cyith above se. it)
. • _
Limited et:erg), rmiti-family
INSTALL PLUG MOLD WITH (2) CIRCUITS residential (with above so. ).) I 75.110 I ? ;
I Services or feeders installation, alteration, and/or relocation
I . . 200 amps or less I 1(.10.70 ' -
1 a 4' .40kikt*:A)W190 : ; -l i:: : : '.:- ---.:' - .::::' .::.:::: - ::-: , ' a TENANT ,..-: r:- . .:•: . -:--; ',. 201 amps tn 4111) amps 133.56 ' 1
, 401 :imps to 600 amps , 200.14
- Name: WASHINGTON SQUARE
' 601 amps to 1,000 ainps i 31)1.04 I
_
Address: 9459 SW WASHINGTON SQUARE RI) ' Over 1.000 amp, or ...ohs .
, 552.26 =
CityiState./ZIP: TIGARD, OR 97223 Temporary services or feeders installation, alteration, audio
: relocation
-- 1 •
Phone: i ) I Fax: ( ) • 20 amps or less I 5.3t5 ,
20 l amps (..A 400 amps 125.0; 7
; ()Avner installation: 'I installation is being made on property that I own which is not
401 amps lo 599 amps 1 1
intended for sale, lease, rent. or exchange. according to ORS 447, 449, 670, and 701. , . 66.54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: - Date: A. Fee fee branch enceiis wolf i ' - - —
.. . .. ,,bove service oi feeder tee, '
. .. : `, :: .:.0: / ';:''::. ' r.:,: tOP4TAL • : , .. : 7 12 1
_
eachbranch circuit
13usiness name: OREGON ELECTRIC CONSTRUCTION, INC 13 Fee Ibr branch circuits wilfriew •
se! vice or tcoder tee, i'irst 1 56.15 , 1
56.1S.
COnlad. name: RICH LADD branch circuit
,
Each ar1.1 branch circuit I I 741 1.42 2 I
Address: 1709 SE 3151) AVE _.......
Miscellaneous (service or [ceder nut included) _I
EnchiiiatmfactUred Or modular
Ciry/StateiZIP: PORTLAND, OR 97214 d I 67 10 2
wello in service ami/or f.oder
...._ .... • , . ,
i Phone: (503) 535 Fax: : (503) 535 Reconnect only I 67.84 1
-
Pump or irrigation circle 67.84
1
I/-mail: laurel@oregon-clectri
'Sign or ° mune lighting 67.84
' -
.-- ' - ---; Signal cirewt(i) or Innitiaa _
Business name: OREGON ELECTRIC CONSTRUCTION. INC _panel. enc Or extension. Page 2 --,
_
Each additional inspection over allowable in attv of the above
Address: 171)9 SE 3RD AVE Additional inspection ( : lir on 66.2)/ Iii
Investigation 0 hr nun , 06.2: hr
City/St ite/ZIP: POR I), OR 97214
.. _____, Milu,:inal plant l I hi min) 78 !Al its
Phone: 1503) 234-9400 I Fax: Inspections for which no fee is
specifically tsted hr min
n0.
4 Lie 00/ hi
i
CCB Lie.: 203 Till( : Electrical 26-95c l
.- . Supry Lic • 4818S
_ i C./.1
.
Subtotal 63.60
Suprv. Electrician signature. required: ti L 4 vi:::\_____
Plan review (25% of permit fee)
Print name: MARK WEINBENDER,....... i Date: 1117/13 State surcharge I 12% 0f permit lee) 7.63
TOTAL PERMIT FEE 71 23
Autlirnized aturc7Tilit : ;hi j/ 4e .
0-I This priritiit application expire. if a permit is nut ulataioeLl wiihio 18(1
1 , -
da)s after il has been accepted s
j Print name: M ARK Vv' Date. 1/17/13
a Nuipticr of ;nspealiCaS al a complete.
lOwed par pannii.
1: \itt,Ild...10%-r.r.,,,:;\ Fif renhoApp Lic.c 07/a1 -1 I cm Imi:COMAVE0