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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2014-00626 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/06/2015 Parcel: 151260000300 Jurisdiction: Tigard Site address: 9650 SW WASHINGTON SQUARE RD G15 Project: Iviwa Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S Project Description: Relocation of existing electrical panel(201 -400 amps)and(35)branch circuits for new lighting&power receptacles. Contractor: SQUARE 1 ELECTRIC INC Owner: PPR WASHINGTON SQUARE LLC 10117 SE SUNNYSIDE RD., STE. F-216 PO BOX 847 CLACKAMAS, OR 97015 CARLSBAD, CA 92018 PHONE: 503-867-2423 PHONE: FAX: 503-914-0432 FEES Quantity Description Date Amount 1 ea Services or Feeders-201 to 01/06/2015 $133.56 Specifics: 400 amps 35 crt Branch Circuits w/Purchase 01/06/2015 $259.70 Type of Use: MF Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 01/06/2015 $73.33 Electrical Type of Const: 0 ea 12%State Surcharge- 01/06/2015 $-26.14 Occupancy Grp: Electrical Total $440.45 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 - . •-• - 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. • ' ENTION: Ore.•n law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-00 -0010 through OAR•. -.01 00' You may obtain a copy of the rules or direct questions to OUNC by calling . 2.1987 or 1.800.332.234 r / Issu•• By: �� _ Permittee Signature: i cam` 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: //64.,e,----6 /h LICENSE NO. 5 3 7 7 S can 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. Jan.01.2011 12:00 AM Square 1 Electric, Inc 5039140432 PAGE. 1/ 1 Electrical Permit Application y I 1,i< e 11 I le I I .t /,,,I , City of Tigard _�; '� ,, $ / : ��i� xr 020/ O- 13125 SW Hall Blvd.,Tigard,OR 9 I Plan Review ' Phone: 503.718.2439 Fax: 503.598..7. DmdB : Other Permit: I ,,,lc i, Inspection Lore: 503.639.4175 I J DateReadyBy: Internet: WWW.tlgard-Or,gOv `/ Notified . ,rMethad: t TYPE OF WO)Rl IQ\N 6 20 15 PLAN REVIEW ❑New construction Addition/alt l t e Please Ned(all that apply(submit 2 seta of pram wthesna checked below): ''Q�� ��GnRD ❑where the.nilable huh current 0 MaMarinass owr three stories bar ❑Demolition ❑Other: �1 CATEGORY OF frOIV1SiOT' exceeds 10,000 amps al 15o volts or ❑Pluming buildings. less to pound,or eaoeeds 14,000 ❑Commaael.use agricultural ❑ i-and 2-Illrnily dwelling Commercial/industrial 0 Accessory building amps for all other installations buildings. ❑Multi-family Master builder ❑Other: ❑Fire Duna. 0 insmllatioa of 75 KVA or . CI Emergency system. larger seperalely derived system. JOB SITE INFORMATION AND LOCATION ❑Addition ofoew motor load of 0"A","E","1-2","1.3", Job no.:, i Job site address:q(p Se)Sa.) Ld._ .1_' E• IoolrPor more. y v rrJ t�htsin-a Si L7 Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: --rp rr x,,-44 © (. Gi i 22,3 jj ❑Hazardous oc facilities. ❑Supply volts is onu for more than '..'1`"_ Q Heaardaua location. 600 vela nominal. Suite/bldg/apt.no.: 1 Project name: On , . � , • ❑ or feeder 600 amps o Hare, �._. _.._� FEE SCHEDULE Cross strcet/dircctions to job site: Ite.erlatl.a I Os,. I 14 r. 1 T•1a1 I r New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4 Ia.add'I 500 sq.ft.or portion 33 92 1 Tax map/parcel no.: _ Limited energy,residential DESCRIPTION OF WORK _ (with above sq.RI 75.00 2 ��J'� r Limited energy.multi-fhmily 75.00 2 1 Go .. ..... . , ,,,,,' /, i e, it -Pile./vt residential(withaboveaO.It.) ` Services or feeders Installation,alteration,and/or relocation 1" E 1.-C, 2 0 14 • 000-2-, (.P Y40 (. VDl t 200 empe or less 100.70 2 ❑ PROPERTY OWNER (L1 st s�. 201 amps m 400 amps 133.56' i 33 sg, 2 t O 401 amps to 600 amps 200.34 2 Name: 601 amps to 1,000 amp, 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders Installation,alteration,and/or City/State/ZiP: relocation Phone:( ) Fax:( ) 200 amps or less 59.36 1 I 201 amps to 400 amps 125.08 2 Owner installation:This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 • intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. Branch circuits—new,alteration,or extension, r panel Owner signature: Date: A.Fee for branch circuits with ❑ APPLICANT J ❑ CONTACT PERSON above service or feeder fee, g_Sf. 7.42 57'b 2 sect,branch circuit Business name: B.Fee fbr branch circuits without service or feeder fee,find 56.18 2 Contact name: branch circuit, Each add'l branch circuit 7.42 2 Address: Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 2 City/State/ZIP: dwelling,service and/or feeder _ Phone:( ) Fax::( ) Reconnect only 67.84 2 r Pump or irrigation circle 67.84 2 E-mail: /A Te [s ,51.`LL EC i C•ee M Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s)or limited-energy panel,Business name: S1 f-e 1- E Le ,. ,C' , Each alteration,l i extension. Page 2_ 2 r�Cr Each additional iaapeetion over allowable in any of the above Address: I 0 I ("1 .c S A.4- n LiS( Rd, ATE 1�- -2,1 Additional inspection(1 hr min) 6625/hr (� (� Investigation(1 hr min) 66.25/hr City/State/ZIP: ( QGk x.,,0.5 1 0" q 1 0 15" Industrial pilau(I hr min) 78.18/hr Phone:(503) $(p~1- 2.'12 3 I Fax:(503)q I A-OK-1 32- Inspections for which no fee is 90.00/hr specifically listed(%,hr min) _ CCB Lic.:t 9 Ele:eritasl Lie.:G s 2.(, Suprv.Lie,: 53115 ELECTRICAL PERMIT FEES ��.. ..._.__ 39.3,E Suprv.Electrician signature,required: ..,2 Subtotal: -- -- ., 1 j Plan review(25%of permit fee); Print name: -, ?R&A.}� Date: j/5 j I IS- S _ state surcharge(12%of permit fie): Au / TOTAL PERMIT FEE: tie)e 5 - Authorized signature: 0 . 115 .av"�- tits permit epp&*lloa esplvm its permit b not ebtalaad witle IN \) days after it hes bees aerapte d as complete. Print name: Date: • Number of inspection allowed per permit. Illaildiaelr dtstll.C.PannitApp.dnc 07/01/10 4 U4415T(u/ei/COMMIX ey-LL mei_Ly 503 —er6 7 --?ya.3 k)h ,may n /°9-y °N1-1/14 --- — is 6 /7 'eV ,6-72--/v/T 7O /h u-y Electrical Permit APP1icatillECEIVED Received FOR OFFICE USE ONLY City of Tigard Date/B : l0 30 IL/ Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 ✓� ��/ _� 8 Phone: 503.718.2439 Fax: 503.598.1;+ Plan Review T 3 0 2014 Date/B : Other Permit: Ape/ 400, j I WAKE) Inspection Line: 503.639.4175 Date Ready/By: Juris: 63 See Page 2 for Internet: www.tigard-or.gov cliv OFT[GARD Notified/Method:�� y iy Supplemental Information TYPE Oft, ING nivisloy PLAN REVIEW ❑ New construction ®Addition/ teration/replacement Please check 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 ❑ I-and 2-family dwelling ®CommerciaUindustrial ❑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. 96,Sp JOB SITE INFORMATION AND LOCATION ❑Addition of new motor load of ❑"A","E","1-2","1-3", Job no.: Job site address:t�6SS.W.Washington Square Rd l� or more. occupancy. ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP:Portland,OR 97223 ❑Health-care facilities. ❑Supply voltage for more than ��tt ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: a(� Project name:Ivivva Washington Square ❑Service or feeder 600 amps or more SCHEDULE Cross street/directions to job site:S.W.Scholls Ferry Road peso,don I Qty. I Fee. I aal I . New r• •.•ntial single-or multi-family dwelli.: nit. Includes atta . :,rage. Subdivision: Lot no.: 1,000 sq.ft.or less Al 168.54 168.54 4 Tax map/parcel no.: 1S1260000300 Limited add'l 500 sq.ft.or ponio 33.92 33.92 1 Limited energy,resi.....1 75.t't 2 DESCRIPTION OF WORK (with above :. '.) Limited-. gy,multi-family 75.00 Relocation of existing electrical panel and installation of new ligting,sound r•'.ential(with above sq.ft.) enewable Energy ❑ See Page 2 system,power receptacles and security system Services or feeders installation,alteration,and/or relocation ❑ PROPERTY OWNER ® TENANT 200 amps or less 100.70 2 201 amps to 400 amps I 133.56 M.Sit 2 Name:Lululemon Athletica Canada,Inc. 401 amps to 600 amps 200.34 2 Address: 1818 Cornwall Avenue 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP:Vancouver,BC V6J1C7 Temporary services or feeders installation,alteration,and/or Phone:(604)732.6124 Fax:( ) 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 extension,per P anel ® APPLICANT I ® CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, 7.42 2 Business name:MBH Architects/DH Architect each branch circuit B.Fee for branch circuits without Contact name: Lilly Sippel service or feeder fee,first -1---' -56 718' 2 branch circuit �.�y yC Address:2470 Mariner Square Loop Each add'I branch circuit 3 7.42 15'1.28 2 City/State/ZIP:Alameda,CA 94501 Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 2 Phone:(501)814.3457 Fax: :(510.)865.1611 dwelling,service and/or feeder Reconnect only 67.84 2 E-mail:lillys @mbharch.com Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 1, 67.84 ' 67.84 2 Business name:TBD c16A,r �9-l°r°L.e�T70,J Signal circuit(s)or limited-energy See panel,alteration,or extension. /� Page 2 /'5ô' 2 Address: //ti ` Each additional inspection over allowable in any of the above City/State/ZIP: / Additional inspection(1 hr min) 66.25/hr Investigation(1 hr min) 66.25/hr Phone:( ) Fax:( ) Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.0W hr CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed(1/2 hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: 6578-.16-(q/•tf> Print name: Date: Plan review(25%of permit fee): .49- State surcharge(12%of permit fee): .69.43 73.33 Authorized signature: TOTAL PERMIT FEE: 7229 - / This permit application expires if a permit is not obtained within 180 Print name: IA I `�, (l>i9.e l Date: /pi t Gf/ `� days after it has been accepted as complete. �,.ti.2 6 "} f ■ Number of inspections allowed per permit. ` <1 I:\Building\PermitsWELC_Pem»tApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(11/05/COM/WEB l{�