The URL can be used to link to this page

Permit 1111 CITY OF TIGARD ELECTRICAL PERMIT $. COMMUNITY DEVELOPMENT Permit#: ELC2015-00174 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/23/2015 Parcel: 1 S 135BA00102 Jurisdiction: Tigard Site address: 10218 SW WASHINGTON SQUARE RD Project: Noodles&Co. Subdivision: OAKBURG Lot: 9 Project Description: Electrical for TI:(1)200 amp feeder and(62)branch circuits. Contractor: MARK ADAMS ELECTRIC INC Owner: PPR SQUARE TOO LLC PO BOX 2748 PO BOX 847 CLACKAMAS, OR 97015 CARLSBAD, CA 92018 PHONE: 503-557-8543 PHONE: FAX: 503-557-8508 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 03/23/2015 $100.70 Specifics: amps or less 62 crt Branch Circuits w/Purchase 03/23/2015 $460.04 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 03/23/2015 $67.29 Electrical Type of Const: Occupancy Grp: Total $628.03 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 952-001-0090. You ma obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.80344. Issued By: ermittee 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: 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. Electrical Permit Application 1,0R Ot 11( t I SI:0\IA City of Tigard ` ' © Received ,. DateB MAIM Permit No. .�41 S • IN • 13125 SW Hall Blvd.,Tigard,OR 97 Gen Plan Review Phone: 503.718.2439 Fax: 503.5'"P 'Or �� DateB': Other Permit. irk /�/s 0, 1 I t ,1,n Inspection Line: 503.639.4175 Al �Q Date Ready/By: H See Page 2 for Internet: www.tigard-or.gov Mr.- p Q Notified/Method: Supplemental Information TYPE OF W O R K � PLAN REVIEW ®New construction ❑Addition/alterati4010nC Please check all that apply(submit 2 sets of plans w/items checked below): n 1J 11 ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: V where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. ❑ 1-and 2-family dwelling Commercial/industrial less to ground,or exceeds 14,000 ❑Commercial-use agricultural y g ® ❑Accessory building amps for all other installations_ buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. ❑Addition of new motor load of ❑`A,°E", 1-2 , 1-3", Job no.:2900 I Job site address: 10218 SW Washington Square RI) 100HP«more. occupancy. ❑Six or more residential units. ❑Recreational 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.: I Project name:Noodles store#819 ❑Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site:Washington Square Road naeripttna I Qtr, I Fee. I Total I • 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'l 500 sq.ft.or portion 33.92 1 Tax map/parcel no.: Limited energy,residential 75.00 2 DESCRIPTION OF WORK (with above sq.ft.) Noodles Restaurant TI Limited esent residential above ft.) 75.00 2 - Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation ❑ PROPERTY OWNER ❑ TENANT 200 amps or less J 100.70 /0.70 2 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 Address: 601 amps to 1,000 amps 301.04 2 , , Over 1,000 amps ovolts 552.26 2 City/State/ZIP: ?Cif...,I `/K e,Temporary services or feeders installation,alteration,and/or Phone:( ) Fax:( ) U`' 17)10 relocation • Owner installation:This installation is being made on property that I own which is rfot 201 amps to 400 amps 125.08 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 1J 401 amps to 599 amps 168.54 2 Owner signature: Date: Branch circuits-new,alteration,or extension,per panel 0 APPLICANT I ❑ CONTACT PERSON A.Fee for branch circuits with / � rr N, above service or feeder fee, ( 742 't/lom/.C 2 Business name: Mark Adams Electric,Inc each branch circuit B.Fee for branch circuits without Contact name: Mark Adams branch circuit Address:P.O.Box 2748 ___ City/State/ZIP:Clackamas,OR 97015 Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 2 Phone:(503)557-8543 I Fax: :(503)557-8508 dwelling,service and/or feeder Reconnect only 67.84 2 E-mail:mark @markadamselectric.com Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name:Mark Adams Electric,Inc. Signal circuit(s)or limited-energy See panel,alteration,or extension. Page 2 2 Address:P.O.Box 2748 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr City/State/ZIP:Clackamas,OR 97015 Investigation(1 hr min) 66.25/hr Phone:(503)557-8543 I Fax:(503)557-8508 Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 9000/lir CCB Lic.: 174094 I Electrical Lic.: C248 prv.Lic.: lOS specifically listed(/s hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: 7. Subtotal: -56871.8---- r,A Print name: Mark Adams Date: 3/ /15 Plan review(25%of permit fee): - State surcharge(12%of permit fee): —WM 47 Authorized signature: /�� TOTAL PERMIT FEE: -636'34• G 2..03 Print name: / ' Date: This permit application expires if a permit is not obtained within 180 w�� .- t,ws (4, .5— days after it has been accepted as complete. ' Number of inspections allowed per permit. I1 BuildingU'ennits\ELC_PennitApp_ELR_ERE.doe Rev 05/21/2013 440.4615TO1/05r vEB 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 10218 SW WASHINGTON SQUARE RD, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical ﬁnal PASS - No C of O ELC2015-00174 Jeff Grove Violation Summary: Inspector Contractor