Permit a CITY OF TIGARD ELECTRICAL PERMIT
1 1 I COMMUNITY DEVELOPMENT Permit #: ELC2013 -00115
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/14/2013
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9467 SW WASHINGTON SQUARE RD All
Project: Starbucks Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: (1) branch circuit for future equipment
Contractor: LIN R ROGERS ELECTRICAL CONTRACTORS Owner: PPR WASHINGTON SQUARE LLC
2050 MARCONI DRIVE SUITE 200 PO BOX 847
ALPHARETTA, GA 30005 CARLSBAD, CA 92018
PHONE: 770 - 772 -3472 PHONE:
FAX: 866 -496 -7839
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 02/14/2013 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 02/14/2013 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 -00 0. You may / obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
I '
Issued By: or' Permittee Signature: IM i' PPLI
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.
RECEIVED
Electrical Permit Application lcllt clrrl( I I ,I: 1)■I.1
City of Tigard FEB 1 4 2013 9-11'4 ! '3 PetmitNoV1— Ol 3 -av! I
13125 SW Hall Blvd„ Tigard, OR ' F T IGARD
'
Other Phone: 503.718.2439 Fax: 503. Q s • , „, _ : Permit
Inspection ww.d��gav WUIL DIVISION N°° k j. -( la See for
;S 4,,;',4.4i..,':-'1,-,:;:':..; ...µ y '.7;"`z---;;;7:;:::'1%,1/4'
..t 7 :r s .F:. r ti'” . Per f2 '';el t3 hLy.; i>:.ir t:IT
• ❑ New constru ® A Please check all that apply (submit see orplain whams checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other. where the evadable fault current ❑ Marinas and boatyards.
M .: -, . - - - - :� , i exceeds 10,000 amps al 150 volts or ❑ Floating buildings.
, ; k rr k, _ .., A _ F . , . . _: ..._ .... ,, - ...�.. _ _ . less to ground. mexceeds 14,000 ❑ Commercial -use egriadtoral
❑ 1- and 2 -family dwelling i • mmercial/industrial ❑ Accessory building amps for an oiher installations. buildings.
❑ Multi -family ❑ Master builder ❑ Other: ❑ Fee PWmP• ❑ InstaIation of 75 KVA or
y ; r s 1 r ❑ Emergency system large separately derived system.
s _- .a _ . .. _-..- _ ., .-_ . - —. - . . _ -_. ❑Addition of sew motor load of ❑ "A "E", "I.2", "I -3 ".
Job no.: Job site address: 9467 SW Washington Sq. Rd. 100HP co occupancy.
❑ Six or more residential units. ❑ Recreatierral vehicle parks.
City/State/ZIP: Tigard, OR 97223 ❑ Healthcare facilities. ❑ Supply voltage for man than
A- ❑ Hazardous locations. 600 volts nominal
/T
Suite/bldg. /apt no.: • Project name:StarbUckS LaBoulange ❑Service or feeds 600 amps or mom
Cross street/directions to job site: StarbuLks .+U'?' . .. _. ,. Y_ �. xa
] Derertptioo � Q'y Fm Total •
W Greenburg Rd 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 , 1
Tax map/parcel no 1512600000300 Li mited ener resi
} f l �` , gy, eatial 7500 2
_ .... Li ener
gy, multi - family 75.00 2
Install (1) 120V 20A circuit for future equipment. residential (with above sq. ft)
Services or feeders Instala11on and/or relocation
I.
. 200 amps or less 100.70 2
., , y 201 amps to 400 amps 133.56 2
401 amps to 600 amps 20034 2
s to Starbudcs Corporation 601 amp 1,000 amps _ 301.04 2
Address: 2401 Utah Avenue South Over 1,000 amps or volts 55226 2
City/State/ZIP: Seattle, WA 98134 Temporary services or feeders installation, alteration, and /or
retoeation
Phone: ( 208 ) 318 -1575 Fax: ( ) 200 amps or less I 593 It 6 1 Owner Installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 1 -
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, p panel
Owner signature: Date: A. Fee for brands circuits with
y - °; above service or feeder fee 7 42
..: .. c 5 .' ti . :_ ._. . :.: ; .._ each branch circuit 2
Business name: Lin R. Rogers Electrical Contractors, Inc. B. Fee for branch circuits without
service or fader fee, fast 1 56.18 2
• Contact name: Alyssa Coursey brands circuit
Each add'I branch circuit 7.42 2
Address: 2050 Marconi Drive Suite 200 Miscellaneous (service or feeder not included)
I Alpharetta,
Each manufaclmedormodular 67.84 2
City/Slate/ZIP: P dwelling, service and/or fader
Phone: ( 770 ) 772 - 3472 Fax: : ( 86p 498 - 7839 Reconnect only 67.84 _ 2
Pump or irrigation circle 67.84 2
Q " t f WM d L1 Sign or outline lighting 67.84 2
F �
;. .. , ;.cT` - .� .,. _ : , :.. _ ? _. • _ -_.= r . ..__i i,i.= si cireuit(s) .limited-ener .
panel, alteration, or extension. Page 2 2
Business name. Lin R R ers Electrical Contractors, Inc.
Each additional inspection over allowable In any of the ahoy
Address: 2050 Marconi Drive Suite 200 Additional inspection (1 hr min) 6625/hr
City/State/ZIP: Alpharetta, GA 30005 Investigation (1 hr min) 6625/ hr
Industrial plant (1 hr min) 78.18/ hr
' - ` - 'Phone: ( 770 ) 772 Fax: ( 864 498 - 7839 Inspections for which no fee is 90.00 / hr
-" fi •- listed 'h hr mm
CCB Lie. :118038 Electrical Lic.: 37 -727c Suprv- Lic.: 4292S r ^ 14.1T �1..x.. _' :. :.. ,'.2.. -.:1...;'?„.. 1.. , . r_.: , ( r '±. ? ,. _7, .
•
' Suprv. Electrician signature, required: Subt $56.18
' Plan review (25% of permit fee) ): .
Print name: Paul Howell O _ !/_ /' I I i n' , Date: 2 - 13 - 13 State surcharge (12% of permit fee): $6.74
TOTAL PERMIT FEE: $62.92
Authorized signature: This permit application erpiree if a permit is not obtained within 180
days alter it his been accepted is complete.
Print name: Date: • Number of inspections allowed per permit
1: 1BuildraglPc eei4t0.C-Pami1App.dac 07/01/10 440-46151(1 tlns/COM/WEB
OTO /600 0 . . - % Vd 9£:6T £TOZ /6T /Z0
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9467 SW WASHINGTON SQUARE RD A11,
TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
05/14/2013 00:00
ELC2013-00115
PASS - No C of O
Violation Summary:
Inspector Contractor