Permit ,�
1 a y CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
" • COMMUNITY DEVELOPMENT Permit #: ELR2013 -00041
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/20/2013
Parcel: 1 S135BA00102
Jurisdiction: Tigard
Site address: 10108 SW WASHINGTON SQUARE RD
Project: Cost Plus World Market Subdivision: OAKBURG Lot: 27
Project Description: Low voltage for data
Contractor: EFFICIENT COMMUNICATION SOLUTIONS INC Owner: PPR SQUARE TOO LLC
3702 WEST VALLEY HWY N #302 PO BOX 847
AUBURN, WA 98001 CARLSBAD, CA 92018
PHONE: 253 - 886 -5400 PHONE:
FAX: 253 - 886 -5450
FEES
Description Date Amount
Specifics: Restricted Energy Permit 02/20/2013 $75.00
12% State Surcharge - Electrical 02/20/2013 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: Y Fire Alarm: N
HVAC: N Instrumentation: N
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N Total $84.00
Other Desc: Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of O. 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 18b days of issuance, or if work is suspended for more the 180
days. ATTEN = • . • law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -00 ' through OAR 9 •-• • •90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issue =y: • / . � /IL ��d Permittee Signatu
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.
253- 886 -5450 To:503- 598 -1960 5035981960 (2 of 4) 02 -15 -2013 11:24 AM -0800
RECEIVED
Electrical Permit Application FOR OFFICE IISE ONLY
City Tigard Ti and FEB 19 2013 Received M _��
Datde��: � . .
e 13125 SW Hall Blvd., Tigard, OR 'A OF Plan Review
Phone: 503.718.2439 Pox: 503.59L DatdH : Other Permit:
T ic, , R D Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready /By: Jura: 53 Ste Page 2 for
Internet: www.tigard-or.gov Notified/Method. Supplemental information
PLM REVELW .,
❑ New construction ® Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps nr note ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
" ''' s
exceeds 10,000 amps at 150 volts or ❑ Floating building.
CAT1: C:;ORI.'OIi'C'bNSTRUiCT10 I
less to ground or exceeds 14,000 ❑ Commens agricultural
❑ i - 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
❑ Emergency system. largper separately derived system
1. _ .OB _ 10.N Si,,F01tM`A'tiON AND i.O4APt( - - i ❑ Addition ofoew motor load of ❑ "A'''F" "I.2" "I -3"
Job no.: Job site address: 10108 SE Washington Sq Road IO0 ormore. aP�er-
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /StateiZiP: Tigard, OR 97223 ❑ Health -cam facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt no.: I Project flame: Cost Plus World Market ❑ Service or feeder 600 amps or more.
. ,, FEE $CHIEDUI,E
Cross street/directions to job site: Description I City. I I'm. I T ain t 1.•
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'1500 sq. ft. or portion 33.92 I
Tax snap /parcel no.: Limited energy, residential
is `7;: a; 7� 00 2
, r , ' 'DF21CRi' flt)� Ol Walik
. -t ' ' (with above s q. ft.)
Limited energy, multi -fatuity
75.00 2
Voice/Data Cable installation residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation _
200 amps or less 100.70 2
❑,'PROf?ERTY OFVr1ER' , .!A , ,,l', ,p. ?' ,, - 't TENANT -it 201 amps to 400 amps 13356 2
Name: Cost Plus World Market 401 amps to 600 amps 200.34 2
601 amps to 1,000 reaps 301.04 2
Address: 10108 SW Washington Sq Road Over 1.000 amps or volts 552.26 2
City/Strife /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and /or
g relocation
Phone: (503)968 -2060 Fax: ( ) 200 amps or less 59.36 I t
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that 1 own which is not 401 amps to599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670. and 701.
Branch circuit, — new, alteration, or extension, per panel
Owner signature: _ Date: _ A. Fee for branch circuits with
? ;•' above service or feeder fee,
` : p Af,PL[CANT ". ..:.. ,;,�,,, • ' t COi`TiAcT PERSON 7.42 2
each branch c
Business name: Efficient Communication Solutions, Inc B. bee fur branch circuits wirhniu
service or feeder fee, first 56.18 2
Contact name: Sabrina Smith branch circuit _ _
Each add'l branch circuit 7.42 2
Address: 3702 West Valley Highway N #302 Miscellaneous (service or feeder not included)
City/State/ZIP: Auburn, WA 98001 awe ing, service manufactured ur modular 6784 2
Y dwelling, service and,or feeder
Phone: (253) 886-5400 Fax: : (253) 886 -5450 Reconnect only _ 67.84 2
— Pump or irrigation circle 67 84 2
E -mail: Sabrina.Smith @ecsolutionz.com
YY ti;' : 1.;11 q 061 ' A(445ii art ,, +� a ss _e �5t : 5: ; .. .
Sign or outline lighting 67.84 2
:. .,.,.rr , r , .. �_: .�- . / Signal circuit(s) or limited-energy
Business name: Efficient Communication Solutions, Inc. pone], alteration, orextcnsion. 1 Page 2 75 ' � 2
Each additional inspection over allowable in any of the above
Address: 3702 West Valley Highway N #302 Additional inspection (I hr min) 66.25/
City /State/ZiP: Auburn, WA 98001
Investigation (1 hr min) 66.251 hr
_ Industrial plant (I hr min) 78.18 /11r
Phone: (253) 886 -5400 Fax: (253) 886 -5450 inspections for which no fee is 90.00,/ht
/ specifically listed (V1 hr min)
CC13 Lie.: 171062 $ I 1, 1I41 Electrical I.ic.: CLE 17 Sprv. Lie.: 4436L.1 A „ 'r F1i;ii.tif }JC y, itkM1'1' PJ* S '.,.;::. ;r7,,;,,t
Suprv. Electrician signature required: Sezobli MA Ay Subtotal: 75.00
Plan review (25% of permit fee):
Print name: 'Irian Mihalck Date: 02/15/2013 State surcharge (12% of permit Ice): 9.00
TOTAL PERMIT FEE: 84.00 /
Authorized signature: LIVN This permit application expires if a —
permit is not obtained within 180 _ e ..
days after it has been accepted as complete. /�I
Print name: Sabrina Smith Date: 02/15/2013 • Number of inspections allowed per permit.
t'Iill imp \ Penn its \L•LC- PermitA pp.dae ornlnn 410- 46157t11/05/COM /WEB
253-886-5450 To:503-598-1960 5035981960 (3 of 4) 02-15-2013 11:26 AM -0800
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
111 Audio and Stereo Systems*
D Burglar Alarm
ID Garage Door Opener*
ID Heating, Ventilation and Air Conditioning System*
E l Vacuum Systcrns*
LI Other:
COMMERCIAL WORK Q?LY
Fee for each commercial $75.00
system
(SEE OAR 918-309-0000)
Check Type of Work Involved:
LI Audio and Stereo Systems
Li Boiler Controls
LI C lock Systems
Data Telecommunication Installation
ri Fire Alarm Installation
LI H vA c
El Instrumentation
[1] Intercom and Paging Systems
E jl Landscape Irrigation Control*
I M edical
El Nurse Calls
El O utdoor Landscape Lighting*
LI P • rotective Signaling
LI Other
Total number of commercial systems: 1
*No licenses are required. Licenses are required
for all other installations
IMiulklinke.Permas'ELC•PerrniiApp.doc 07/01/10
253 -886 -5450 To:503- 598 -1960 5035981960 (1 of 4) 02 -15 -2013 11:24 AM -0800
To City of Tigard - Electrical Permit
Phone Fax 503 - 598 -1960
From Sabrina Smith
Company ECS Fax 253 -886 -5450
Subject Electrical Permit Applica Date 02 15 2013
,
Message
We are scheduled to start the cabling for this on Sunday
02/17/13. Can we please get a copy of the Permit faxed to
253 -886 -5455?
Please feel free to call me with any questions.