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Permit
711CITY OF TIGARD ELECTRICAL PERMIT ' . COMMUNITY DEVELOPMENT Permit ELC2016 00526 T[CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued:#: 0 /28/2016 Parcel: 151260000300 Jurisdiction: Tigard Site address: 9355 SW WASHINGTON SQUARE RD T19 Project: Lululemon Subdivision: None Lot: None Project Description: (1)service,(25)branch circuits and low voltage for audio/stereo Contractor: A&A ELECTRICAL CONTRACTORS INC Owner: PPR WASHINGTON SQUARE LLC 1588 SKY TERRACE PO BOX 847 SALEM, OR 97306 CARLSBAD, CA 92018 PHONE: 503-949-3193 PHONE: FAX: 503-378-9085 FEES Quantity Description Date Amount Specifics: 1 ea Services or Feeders-200 06/28/2016 $100.70 amps or less 25 crt Branch Circuits w/Purchase 06/28/2016 $185.50 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 06/28/2016 $34.34 Electrical Type of Const: 1 ea Limited Energy 06/28/2016 $75.00 Occupancy Grp: 0 ea 12%State Surcharge- 06/28/2016 $9.00 Electrical Total $404.54 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. ATTEN •, •regon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0. 0 through OA-.952-0.1-0. . You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1. 02.2344. \ i � . Issu By: i i 0 ( y/ Permittee Signature: �� OWNER INSTALLATION ONLY t (I ii,,," 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: C/ O //eele,Ui 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 roiz OFFICE I:sI.ONI.I City of Tigard k'5.'' 1;r 1 K r( Received /.... ( r/ME Permit#: .11.,;()//v—00521 , 13125 SW Hall Blvd.,Tigard,OR 97223 Date/B : (fJ b Y� ill =, 14 g Plan Review Related Permit#:i t Phone: 503.718.2439 Fax: 503.598.1960 Date/B 1 ` Inspection Line: 503.639.4175 e 1 IN 9 8 ?!11 r Ready Date/By: kris: EI See Page 2 for T i G A R D Internet: www.tigard-or.gov ``''L Notified/Method: Supplemental Information TYPE 0 +440F El(/'A ill) PLAN REVIEW 0 New construction ►AdditiowJt 'at&on/T e t Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition ❑Qtly; where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. El 1-and 2-family dwelling Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATIONAND LOCATION 0 Emergency system. larger separately derived Job#: Job site address: g3s— bi/`S/ ❑100Add111oo of new motor load of system. ! it t��3Y� �1t-it�P IOOHP or more. ❑`•A» `•E» ••1.2» `•l_3" (((/// 0 Six or more residential units. occupancy. City/State/ZIP: G� {/ Recreational vehicle parks. 1 t / a.-c /1.-74„ ❑Health-care facilities. 0 Suite/bldg./apt.#: r / `y Project name: L. titLu le-04_O Y• 0 Hazardous locations. 0 600 SupMy voltage olts nominal.for more than ❑Service or feeder 600 amps or more. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential (with above sq.ft.) 75.00 2 ( 4 A G,,,,,t (�, ;i-‘l)‹.44.-,—e—t. Limited energy,multi-family residential(with above sq.ft.) 75.00 2 9 PROPERTY OWNER ❑ TENANT Renewable Energy 0 See Page 2 Services or feeders installation,alter tion,and/or relocation Name: 200 amps or less / 100.70 2 Address: 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 301.04 2 Phone:( ) 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, +yr' each branch circuit L+�j 7.42 2 Contact name: B.Fee for branch circuits without Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add'I branch circuit 7.42 2 Fax: : Miscellaneous(service or feeder not included) Phone: ( ) ( ) 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: f"« A i j 5. 2 /�©s' T(,J ,.,G Sign or outline lighting 4 67.84 2 l — Signal circuit(s)or limited-energy // Address: t r t 'N 0 t.-- "-'. _ panel,alteration,or extension. See Page 2 7j 2 City/State/ZIP:ti Each additional inspection over allowable in any of the above e . — Additional inspection(1 hr min) 66.25/hr ( ) % ,-> 9 '�),!1,Fax:`;V,.)`�7 y n g..---- Phone: Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr �-% / ,:374 3 FC Inspections for which no fee is 90.00/hr CCB Lie.: j Electrical Lie.: Suprv.Lic.:v% S specifically listed(%Z hr min) Suprv.Eleccian signature,required: ELECTRICAL PERMIT FEES Subtotal:_ 3(p/Electrician �� Print name: (3 _...e Date: 0 Plan Review Required(25%of permit fee): ----' - i State surcharge(12%of permit fee): 113, 3q Authorized qAuthorized signature: TOTAL PERMIT FEE_ /ro q,dJ-- -_ This permit application expires if a permit is not ob...`h o wane....,, Print name: / Date: days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_Pami R�ERE.doc Rev 06/17/2015 440-4615T(11/05/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 Qty. Each I Total 3' Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 133.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 n Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: n Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(/hr min) ELECTRICAL PERMIT FEES COMMERCIAL WORK ONLY: Subtotal Enteron Page 1): Fee for each commercial system: $75.00 y * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015