Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013-00111
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/14/2013
Parcel: 1 S135BA00102
Jurisdiction: Tigard
Site address: 10218 SW WASHINGTON SQUARE RD
Project: Starbucks Subdivision: OAKBURG Lot: 27
Project Description: (1) branch circuit for future equipment
Contractor: LIN R ROGERS ELECTRICAL CONTRACTORS Owner: PPR SQUARE TOO 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 OAR 5 001 -00 . 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: W / Permittee Signature: /l 4-Pr �--I e- 1 MO
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.
Electr cal Perm _RECE
Re serv ed . � Permit Application FEB 1 4 2013 pm t >u I it i, l `l ().l ; , �
City Tigard 17atr1B . a [.L dv 13 -
PP lica
Ci of PormtN ° .:�
111 Phone: 503,71824 9 , Tigard, 503. 98.1 Or TIGARD »et Resew Other Permit: ReadYIBY: T ri; Internet: www o rgoV75 BUILDING DIUISIO f ed/Metho d : - Su Information
l l Yx - , : ! t _ :. x1 a ; - ,r. --k s„t "c r H r5 z .£ s Y . r?' ; y s }-
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit a set of plans wlmms chocked below):
❑ Service or feedcr 400 amps or more ❑ Building over three stories.
❑ Demolition ❑Other:
where the available fault current ❑ Marinas and boatyards.
+ r '- i : r -; f , : :: . *` exceeds 10,000 amps at 150 votes or ❑ Floating buildings.
? . k[_._,... Iess to ground, or exceeds 14,000 ❑ Cammercial-uw agriwltwal
❑ i- and 2- family dwelling i ommercial /industrial ❑ Accessory building 4 amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
Y€ T ❑ Emergency system_ la separately derived system.
Y ,.. k` _ ' _ ... . �.. __ _ .. _.. ❑ Addition of new motor load of "A" "E', 9-2 ", "I-3".
1o0HP or mare. occalramcy.
Job no.: Job site address: 10218 SW Washington Sq. Rd.
❑ Six or more residential units. ❑ Recreatioml 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 :Starbucks LaBoulange ❑ Service or feeder 600 amps ormore.
S tarbucks 9 f 11 „.. Yoh {/. `
Cross street/directions to job site: Demme qtr Fp& rm i •
— Greenburg Rd. New residential stogie- or multi - tunny dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'l Tax map /parcel no.: 1 S135BA00102
Limited ted sq. ft_ or portion 33.92 1
e enerner gy, residential 75.00 2
t ` s F : r xru ,., �� ^ ' ' (with above 54 . ft.)
Limited energy, multi- family 75.00 2
Install (1) 120V 20A circuit for future equipment residential (with above sq. ft)
Services or feeders Installatloo and/or relocation
200 amps or less 100.70 2
i - 201 amps to 400 amps 133.56 2
r x : - S
401 amps to 600 amps 200.34 2
Name: Starbudcs Corporation
601 amps to 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
relocation
Phone: ( 206 ) 318 -1575 Fax: ( ) 200 amps or less I 59.36 1
201 amps to 400 amps 125.08 2
I `
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 16854 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits — new, alteration, or extension, Rer panel
Owner signature: Date: A. Fee for branch circuits with 1
.: ¢ 7 r' cur 1 ; s above service or feeds fee,
7.42 2
Business name: Lin R. Rogers Electrical Contractors, Inc. B. Fee for branch circuits without
service or feeder fee, f ast 1 56.18 2
Contact name: Alyssa Coursey branch circuit
Each add'I branch c 7.42 _ 2
Address: 2050 Marconi Drive Suite 200 Miscellaneous (service or feeder not induded)
City/State/ZIP: Alpharetta, GA 30005 Each mg, service or modular d: 67.84 2
dwelling, service and/tx feeds
Phone: ( 770 ) 772 -3472 Fax: : ( 86¢ 496 -7839 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
�� ip< Si o routhae lighting 67.84 2
?NYF_ .. �r: s` , ,, , - - A: � .. ._ « ' � t ; ,' ; : ' t _._i Iti: , !l.:_? Signal circuit(s) or limited-ener
panel, alteration, or extension. Page 2 2
Business name: Lin R. R. ers Electrical Contra • r n
Each additional inspection over allowable in any of the above
Address: 2050 Marconi Drive Suite 200 Additional inspection (1 hr min) 6625/ hr
City/State/ZIP: Alpharetta, GA 30005 Investigation (I hr min) 66.25! hr
Industrial ptent (1 hr min) 78.18/ br
Phone: ( 770 ) 772 -3400 Fax: ( 866 496 -7839 Inspections for which no fee is 9000 / hr
-.ecificall listed '/r hr min
CCB Lie.: 118038 Electrical Lic.: 37 -727C Suprv. Lie.: 4292S `2 ig-:: 11...... .._ ... t .
Suprv. Electrician signature, required: Subtotal $56.18
Plan review (25% of permit fee):
•
Print name: Paul Howell Date: 2 -13 -13 State surcharge (12% of pernlit fee): $6.74
TOTAL PERMIT FEE: $62.92
Authorized signature: '�/ / /
+, .r ` Thb 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 pcamu.
1:1auildis Pensits1ELC- PermitAppdoc 07/01/10 440.4615T(11 N5/COM/WEa
0T0 /900121 XVd 9£ :17T £TOZ /17T /Z0