Permit q CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 -00107
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/14/2013
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9359 SW WASHINGTON SQUARE RD T21
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's • 2-001-0 90. You may / obtain a copy of the rules or direct questions to OUNC by calling 503.232.198 1' 7 or 1.800.332.2344.
O A 1 L
Issued By: �. `�I�' �-�t �v �—C K/1 Permittee Signature: I l P r I f r--7
U&i
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 rim R( ) H i ( t I I (I \ 1.1
FEB 1 4 2013 Received �f )
II City of Ti ga r d >3ate/B _ �l i w r 3 � Pernvt 41)/ 3- 00(07
13125 SW Hall Blvd., Tigard, OR 3
Phone: 503.718.2439 Fax: 503 F TIGARD Date/B "eW Other Permit:
i A.p. ri Inspection Line: 503.639.4175
DD BUILDING D'VISIF,Jr ' Dat i°° RI See Page 2for
Internet: www.tigard- or.gov 1 Notified/Method � O Supplemental Information
..• _ s
Please check all that apply (submit a sets of plans w /items checked below):
❑ New construction ®Addition /alterahon/replacement
❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories.
_, , where the available fault current ❑ Marinas and boatyards.
exceeds 10,000 amps as 150 volts or ❑ Floating buildings.
❑ 1- and 2- family dwelling f ommerciau/industrial ❑ Accessory building amps ew ether�avnllations, ❑ buings ia1 ase agriwtnaal
❑ Multi -family ❑ Master builder ❑ Other. ❑ Fire pump. ❑ Installation of 75 KVA or
;. ;, r r - ❑ Emergency system. larger separately derived system.
. -. —, . - -._ .. - -- -.. _ _ _ -. -. ❑Additmnofaewmomrloadof ❑ "A ", )- ,'1- 2'. "l -3 ".
Job no.: Job site address: 9359 SW Washing Square Rd. T -21 lix or or momoccupancy.
. on
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard, OR 97223 O Health-care facilities. ❑ Supply voltage for more than
0 Hazardous locations: 600 volts nominal.
Suite /bidgJaptno.: Project name:StarbucksLaBoulange ❑ Service orfccder600 amps ormore:
Cross street/directions to job site: Starbucks Description p ry PQ Tam •
New residential single- or mufti - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. fl. or less 168.54 4
Ea. add'1500 sq. ft. or portion 33.92 1
Tax map /parcel no 1612600000300 Limited energy, residential 75.00 2
(with above sq. ft.)
Limited energy, multi - family 7500 2
Install (1) 120V 20A circuit for future equipment. residential (with above sq. R)
Services or feeders inatalla • alteration, and/or relocation
200 amps or less 10.70 2
Fi 201 amps to 400 amps l33.56 2
401 amps to 600 amps 200.34 2
Name: Starbucks Corporation 601 amps to 1,000 amps 301.04 2
Address: 2401 Utah Avenue South • Over 1,000 amps or volts 552.26 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 I 1
201 amps to 400 amps 1 1 125.08 I 2
Owner installation: This insiallation is being made on property that I own which is not I I I
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 neaps 168.54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
5 above service or feeder fee.
:rr 7.42 2
. � ...._. _ ._ _ ........ ' _ _, '..:_. _ `._ .._: - -.._ .., . ... ... ...... . ,, .. ._ _ -.. each branch circuit
Business name: Lin R. Rogers Electrical Contactors, Inc. B. Fee for branch circuits without
service or feeder fee, first 1 56.18 1 2
Contact name: Alyssa Coursey branch circuit
Each add'l branch circuit 7.42 2
Address: 2050 Marconi Drive Suite 200 Miscellaneous (service or feeder not Included)
City/State/ZIP: Alpharetta, GA 30005 Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( 770 ) 772 -3472 Fax: : ( 86P 496 -7839 Reconnect only 67.84 2
E-mail: (.�Jl� t�Q,. I -,- ... >�(, f'TLT[ ctom Pump or irrigation circle 67.84 2
£ 7i �;t n. 3 'Yti s " Sign or outline lighting 67.84 2
'5" \ 'a} i� -); . . -:_.. ." .� • :. y _ -- " ", ' Signal circuit(s) -energy
panel, Business name: Lin R. R. • ers Electrical Contractors, Inc. Each additional
inspection over allowable to any of the above 2 -
Address: 2050 Marconi Drive Suite 200 Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: Alpharetta, GA 30005 Investigation (1 hr min) 6625 / hr
industrial plant (I hr min) 78.18/ hr
Phone: ( 770 ) 772 -3400 Fax: ( 866 496 -7839 Inspections for which no fee is 90.00 / hr
s.ecificall listed 14 hr min
CCB Lic.:118038 Electrical Lic.: 37 -727C Suprv. Lie.: 4292S `, wy a 2 _,:E . r:,, ,,.._,._ .... :.. ' ,. 1?;
Subtotal: $56.18
Suprv. Electrician signature, required: Plan review (25% of permit fee):
Print name: Paul Howell = f� Date: 2 -13-13 State surcharge (12% of permit fee): $6.74
Authorized signature: - . j r TOTAL PERMIT FEE: $62.92
J "' Thus permit application expires if a permit is not obtained within 100
Print name: days after it bas been accepted as complete.
Date' • Number of inspections allowed per permit
I:tamldinglPe,mitsELC -Pe.miutpp4oc 07/01/10 440-4615T(1 L/SS/COM/wEa
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Katy Cobb
7. ; ; Rogers Electric
` `'' 2050 Marconi Drive
r ^ Suite 200
Alpharetta, GA 30005
rte; ,
Phone 770 -772 -3435
ROGERS ELECTRIC Fax 866-496-7839
•
fax transmittal
To: Fax:
City of Tigard, OR
503-598 -
1960
From: Katy Cobb Date: 02/14/2013
fi
.01.V 14.-7
k Re: Starbucks Pages:
0
: Please see • • ttached (8) electrical permit • lications and credit card
audio ' • o • form. If you have any que • : • or concerns, please feel free
to col ,: m: at the number listed : • : e. • •
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