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Permit
CITY OF TIGARD ELECTRICAL PERMIT 'I II COMMUNITY DEVELOPMENT Permit#: ELC2014-00455 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/10/2014 Parcel: 1 S135BA00102 Jurisdiction: Tigard Site address: 10230 SW WASHINGTON SQUARE RD Project: Panera Bread Subdivision: OAKBURG Lot: 9 Project Description: Electrical work to convert a portion of former bookstore into a Panera Bread restaurant.No low voltage on this permit. Contractor: ASSURED ELECTRIC LLC Owner: PPR SQUARE TOO LLC 7138 MARLEY LANE S PO BOX 847 SALEM, OR 97306 CARLSBAD,CA 92018 PHONE: 503-871-4637 PHONE: FAX: FEES Quantity Description Date Amount 4 ea Services or Feeders-200 12/10/2014 $402.80 Specifics: amps or less 124 crt Branch Circuits w/Purchase 12/10/2014 $920.08 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea Plan Review Electricial 12/10/2014 $330.72 Type of Const: 1 ea 12%State Surcharge- 12/10/2014 $158.75 Electrical Occupancy Grp: Total $1,812.35 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 d in accordance . .h appr• - plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 d s. ATTENTION: Oregon I requi-s you to follow the rules adopted by the Oregon Utility Notification Center. Those rr-s are s-t forth in OAR 9 2-001-0010 thro gh OAR 95 01-00• oU may obtain a copy of the rules or direct questions to OUNC by calling 503.232. . 1 :00.332 44. Issued By: �� Permittee Signature: ,...„...,......„-- 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: C C. TRACTOR INSTALLATION ONLY SIGNATURE OF SUPR.ELEC' _ • -� / -at LICENSE NO. �T' / .-?"fliii Call 503.639.4175 by 7:00 a.m. he 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 Applicati1ECEIVEfl FOR OFFICE USE ONLY City of Tigard Received , , 7 �QO ✓ g DateBv: rrt, Permit No.. �-e s 13125 SW Hall Blvd.,Tigard,OR 972M r 1 8 2014 Plan Review '`�� Cril Phone: 503.718.2439 Fax: 503.598.1 DateB : iymil, Other Permit: f 1 G A R I) Inspection Line: 503.639.4175 Date Ready/By: Julia ® See Page 2 for Internet: www.tigard-or.gov ( ITY OF TIGARD Notified/Method: 4'/(//f♦.W Supplemental Information TYPE NI '�1�I,` .j I I I O/ ` 1d PLAN REVIEW ❑New construction ®Addition/alteration/repl2rement Please chec all that apply(submit 2 sets of plans w/items checked below): ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑ Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. less to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑ 1-and 2-family dwelling ® Commercial/industrial ❑Accessory building amps for all other installations. buildings. ❑Multi-family ❑ Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or ❑Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION ❑Addition of new motor load of Job no.: I Job site address: 10230 SW Washington Square Rd Iixormo more occupancy. ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP:Tigard,QR 97223 ❑Health-care facilities. ❑Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: I Project name:Panera Bread El Service or feeder 600 amps or more FEE SCHEDULE Cross street/directions to job site:SW Greenburg Road Description 112,7. 1 Fee. 1 Total 1 New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 102 1,000 sq.ft.or less 168.54 4 Ea.add]500 sq.ft.or portion 33.92 l Tax map/parcel no.:Tax Map 1 S135BA Limited energy,residential DESCRIPTION OF WORK (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 TI of a portion of a former bookstore for a new Panera Bread restaurant. residential(with above sq.ft.) Renewable Energy ❑ See Page 2 Services or feeders installati•n,alteration,and/or ocation ❑ PROPERTY OWNER + 0 TENANT 200 amps or less 100.70 4P(?).•7 0 2 201 amps to 400 amps 133.56 2 Name:Panera,LLC 401 amps to 600 amps .t. :: 2 Address:3630 S.Geyer Road,Suite 100 601 amps to 1,000 amps/ A . 301.04 2 Over 1,000 am. • • •y!y�"a.r.aattt�t�wt.14. a City/State/ZIP:Sunset Hills,MO 63127 Temporary services or feeders installation,alteration,and/or Phone:(314)984-1000 I Fax:(314)909-3300 relocation 200 amps or less 59.36 1 Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2 Owner signature: Date: Branch circuits—new,alteration,or ension,per pa el /167 ❑ APPLICANT I 0 CONTACT PERSON A.Fee for branch circuits with /' " /ry 5t above service or feeder fee , Business name:Panera,LLC each branch circuit 7.42 cfr' B. Fee for branch circuits w,ho t „fa, "�� Contact name:John Sturges service or feeder fee,fiat v 56.18 2 branch circuit /�t>��"� Address:3187 Airway Avenue,Suite A Each add'I branch circuit 1.---sr5 City/State/ZIP:Costa Mesa,CA 92626 Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 2 Phone:(714)966-9400 I Fax: :(949)258-5655 dwelling,service and/or feeder Reconnect only 67.84 2 E-mail:rsi.johns @gmail.com Pump or irrigation circle 67.84 2 C C TO R Sign.outline lightin �naa 67.84 2 Business name: ...co J� /P C �/�C 2G i n.)7 : �'owVo -- / tl F�f! zr � . «i i` Address: 7/3 G Gt,./e / 4e s Each additional nspection over allowable in any of the above City/State/ZIP: Sate/ .) ( �� ( 73© L Additional inspection() hr min) . 66.25/hr 4/ ! Investigation(I hr min) 66.25/hr Phone:(67;" ) 87/. °o'3 7 Fax:( ) Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr Lic.: 1460te/ I Electrical Lic.: 95- Suprv.. Lic.: /3©� specifically listed hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: �� ,0y,_.,L�- Subtotal: ,1.345 /7 • ' Print name: �/ e Q / Z/m t� Date: /��p/ZD/�► Plan review(25%of permit fee): 336 "�. d ' / State surcharge(12%of permit fee): 164"' srtkr•3 a< Authorized signature: „A.---s----. TOTAL PERMIT FEE: tsar Print name: / Date: /2//c/24:31 This permit application expires if a permit is not obtained within 18 00 /e Et,p` /#.91 Y days after it has been accepted as complete. • Number of inspections allowed per permit. I:\Building\Pernits\ELC_PermitApp ELR_ERE.doc Rev 05/21/2013 440.46t5T(I1/05/COM/WEB Electrical Permit Application —City of Tigard Page 2-Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined $75.00 Description I Qty. I Fee ( Total Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 ❑ Burglar Alarm Wind generation systems in excess of 25 kva: 25.01 to 50 kva 301.04 2 ❑ Garage Door Opener* 50.01 to 100 kva 552.26 2 >100 kva(fee in accordance with 552.26 2 111 Heating, Ventilation and Air Conditioning OAR 918-309-0040) System* Solar generation systems in excess of 25 kva: Each additional kva over 25 7.42 3 El Vacuum Systems* >100 kva—no additional charge 0.0 3 ElOther: additional inspection over allowable in any of the above: Other: Each additional inspection is 66.25/hr charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(Y hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system $75.00 Subtotal: (SEE OAR 918-309-0000) Plan review,if required(25%of permit fee): State surcharge(12%of permit fee): Check Type of Work Involved: TOTAL PERMIT FEE: • This permit application expires if a permit is not obtained within 180 ❑ Audio and Stereo Systems days after it has been accepted as complete. Number of inspections allowed per permit. ❑ : s Her Controls ❑ Clo Systems ❑ Data Te -communicatio nstallation El Fire Alarm I tallatio HVAC ❑ Instrumentation ❑ Intercom and P.ging System �� V ❑ Landscape Ir igation Control* ❑ Medical \v ❑ \\1.( - Nurse C. is ❑ Outdoo Landscape Lighting* ❑ Prote• ive Signaling El Other Total number of commercial systems: 2 *No licenses are required. Licenses are required for all other installations l:\Building\Penaits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 10230 SW WASHINGTON SQUARE RD, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical final PASS - No C of O ELC2014-00455 Jeff Grove Violation Summary: Inspector Contractor