Permit (142) CITY OF TIGARD ELECTRICAL PERMIT
114 ° COMMUNITY DEVELOPMENT Permit#: ELC2016-00183
T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/09/2016
Parcel: 1 S126CB00500
Jurisdiction: Tigard
Site address: 9300 SW WASHINGTON SQUARE RD
Project: Macy's Subdivision: None Lot: None
Project Description: (11)branch circuits for LED can lights in ceiling.
Contractor: TRI STAR ELECTIC INC Owner: MACY'S DEPARTMENT STORES INC
PO BOX 231175 ATTN:TAX DEPARTMENT
TIGARD, OR 97281 7 WEST SEVENTH ST
CINCINNATI, OH 45202
PHONE: 503-860-3838 PHONE:
FAX: 503-590-2302
FEES
Quantity Description Date Amount
11 crt Branch Circuits wo/Purchase 03/09/2016 $130.38
Specifics: Service or Feeder
1 ea 12%State Surcharge- 03/09/2016 $15.65
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $146.03
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. ATTENTI• : -.on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 rough OAR •5 •• 0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B : ' 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:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' ` � ��, �. Date:
Jo
LICENSE NO. 3' - 5
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 I(1 R ()I l i( 1. I l (l v 1.1
City of Tigard Receivedat , Q /G ��r7 Permit#: fl—4.1„0/4,_AO/g
U 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review /,� �
• Phone: 503.718.2439 Fax: 503.598.1960 Date/ : Related Permit#: .0 &--(XX, ,
Inspection Line: 503.639.4175 Ready Date/By: kris- B See Page 2 for
I I e':\R a Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service 0apes ❑Building over three stories.
Demolition 0 Other: where
available feeder
current 0
Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately deriYed
Square Rd ❑Addition of new motor load of system.
Job#: 15053 Job site address:9300 SW Washington
IOOHP or more. ❑`A',`E","1-2","1-3",
City/State/ZIP:Tigard,OR 97223 0 Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Macy's Lighting 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:Hall Blvd FEE SCHEDULE
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage. 1
' 1,000 sq.ft_or less 168.54 4
Tax map/parcel#: Ea_add'l 500 sq.ft.or portion 33.92 I
DESCRIPTION OF WORK Limited energy,residential
Install new LED recessed cans in hard ceiling. (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
0 PROPERTY OWNER ® TENANT Services or feeders installation,alteration,and/or relocation
Name:Macy's 200 amps or less 100.70 2
Address: 12100 SE 82od Ave 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Happy Valley,OR 97086 601 amps to 1,000 amps 301.04 2
Phone:(971)563-6032 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
0 APPLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
7.42 2
each branch circuit
Contact name: B.Fee for branch circuits without
service or feeder fee,first 1 56.18 56.18 2
Address: branch circuit
City/State/ZIP: Each add'(branch circuit 10 7.42 74.20 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax::( ) Each manufactured or modular
-
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Tri-Star Electric,Inc. Sign or outline lighting 67.84 2
Address:PO Box 231175
Signal alcteration,
n or extension.
0 See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Tigard,OR 97281 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:(503)860-3838 Fax:(503)590-2302 Investigation(1 hr min) 90.001hr
Email:debbiem@tri-starelectric.com ladQvQIndustrial plant(1 hr min) 78.18/hr
--- Inspections for which no fee is 90
CCB Lie.: 153559 II t}4ll1e Electrical Lic.: 34-620C Suprv.Lie.: 38325 specifically listed(A hr min)
/44 ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:
Subtotal: 13338
Print name: Rich Metzler Date: 03/08/2016 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 16.01
Authorized signature: TOTAL PERMIT FEE: 1149'391
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has bees accepted as complete.
* Number of inspections allowed per permit. �.r(
I:�BuildingTermits�ELC_PermitApp_ELR_ERE.doc Rev 06/17/201S 440-46I5T(l I/05/COM/WEB Y
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
9300 SW WASHINGTON SQUARE RD, TIGARD,
OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2016-00183
Chip Barnett
Violation Summary:
Inspector Contractor