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Permit (40) CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2016-00788 t GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/11/2016 Parcel: 1S1260000300 Jurisdiction: Tigard Site address: 9577 SW WASHINGTON SQUARE RD B07 Project: Oakley Subdivision: None Lot: None Project Description: (1)branch circuit and(1)data telecommunication for TI Contractor: PARAMOUNT ELECTRIC CO Owner: PPR WASHINGTON SQUARE LLC 39085 PIONEER BLVD STE#203 PO BOX 847 SANDY, OR 97055 CARLSBAD, CA 92018 PHONE: 503-703-2571 PHONE: FAX: FEES Quantity Description Date Amount Specifics: 1 crt Branch Circuits wo/Purchase 10/11/2016 $56.18 Service or Feeder 1 ea 12%State Surcharge- 10/11/2016 $6.74 Type of Use: COM Electrical Class of Work: ALT 1 ea Restricted Energy Permit 10/11/2016 $75.00 Type of Const: 1 ea 12%State Surcharge- 10/11/2016 $9.00 Occupancy Grp: Electrical Total $146.92 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through •.• • -001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 5039.1987 r . 0.332.2344 Issued By: - t ek r _ Permittee Signature: `" OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale,lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR.ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 4 Electrical Permit Application City of Tigard nu I. J ?[M6. Reeei'3ed/0�/��/� CL �9 't Data�lx, Pcunit � �� ��� 13125 SW flail Blvd..Tigard.OR 972 3 Phone 503.7182439 Fax 503.59,$If)6(fe, Plan Rcvier� Dalc/Bv. Related Permit;l: Inspection',Inc: 503.639.4175 1. TIGARD Ready Date/By: Juns ® &•c Page 2 for a Internet yy�cw.tigd-or.goy j a i - a �-a Notified/Method: `.t 7 , Supplemental Information TYPE OF WORK ` PLAN REVIEW ❑Ness construction [ Addition/alteration/replacement Please check all that apply(submit 2 sees of plans w atcres checked): ['Service or feeder 400 amps or more 0 Building or athree stories. El Demolition El Other: Where lire an ailable faall carienl ❑Marinas and boatyards. CATEGORY OF CONSTRCCTION exceeds 10,000 amps at 150 volts ' 0 Floating buildings. ❑ I-and 2-liunily dyyelling EA Commercial/industrial III Accessory building or ❑commercial-ase igiicuhurd 111 MUIh-11'17111y less to ground,or exceeds 14.000 buildings. LIMaster builder ❑Other: amps for all other installations. 0 Instill pion of IxO hVA or JOB SITE INFORMATION AND LOCATION 0 rile pump_ lamer separately dem ed Job Job site address: 7? W 50/S44 ❑Pmergcncv system. system. Q --"- t �17 y�Q�a .❑Addr tion of tics motor load of ❑".v-, F . I-2,. 1 City/State/1IP: ti a-t-d , 0 k 97,1- -3 I 1(10HPoi more. occupancy. �c J JJ ❑Sisorinure residential units. ❑Recreational vehicle parks . Suite/bldg./apt.0: Project name: Oct 14.f.� "1t e, Di -crre facilities. @,,�� 0 supply vohage Cot more Than Cross street/directions to job site: 0 Hazardous locations. 600 colts nominal_ ❑Service or feeder 600 amps or more_ Suhdicision: FEE SCHEDULE Lot 0: Description Qh Each total I ax nu5/parcel.: New residential single-or multi-family dwelling unit. DESCRIPTION OF WORK Includes attached garage. 'I-Mg-02 y-M - 1( I Q�4 .1 d1 000 sq_I( or less 16854 4 `FCp b 4aet,h uv� t a_add'I 500 sq_ft.or portion 33.92 I D'ild i ()J1 kd0 to 3>isriaci �"Y 4T�� Limited energy.residential (von]ffi a hoy e sq.0.) 75.00 _El �f PROPERTY OWNER I ❑ TENANT Limited mere),multi-fanuly Name: residential(With above sq_ft.) 75.00 Address: Renewable Energy ❑ Sec Pagc 2 City/State/71P: Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 Phone:I ) 1 Fax:( ) 201 amps to 400 amps 133.56 2 Email: 401 amps to 600 amps 200.34 5 601 amps to 1,000 amps _ 301.04 2 I Owner installation:This installation is being made on property that I own which is not Over 1,000 gulps orvolrs 552 26 2 intended for sale, lease.rent,or evchange,according to ORS 447.449.670.and 701. Temporary services or feeders installation,alteration, Ovv`ner signature: Date: and/or relocation 0 APPI,ICANT 200 amps or less 59.36 I ❑�CONTACT PERSON 201 amps to 400 amps 125.08 Busies'name: 2 401 amps to 599 amps 16854 Contact name: Branch circuits-.new,alteration,or extension,oer panel A.Pee for branch circuits wi!h Address: above service or feeder fee, each branch circuit 42 �C. ity Stale/71 P: B.Pee six branch circuits PhonC:( ) n'ilhntt!service or feeder lee, f Fax: ( ) first branch circuit 50.18 2 I_nuul: Each add I branch circuit 7.42 2 Miscellaneous(service or feeder not included) CONTRACTOR Each ntanulactured or modular Business name: dwelling,sari ice and/or feeder 67.84 Pa ramo F(e..414Q Co Reconnect only 67 84 2 Address: 905.. SE �a em,e-m kJ. Pump or irrigation circle67.84 2 City/State/1.1P: 1G �eeaQ. ©k (�zorSign or outline lighting I 67.84 2 •7 Signal circuit(')or limited- 0 Phone:( �7 q > ��)[f�3"'pe.�7 I Fax:( ) energy panel,alteration,or See Page extension. I 2 .mall' Each additional inspection over allowable in any of the above t/1 03 Additional inspection(1 hr min) 66.25/hr CCB l.ie.: [e� CS Electrical Tic,: C,Si Suprv. Lie.: 1/8)4 S 7y,'///7 Investigation(I hr min) 9000/hr Suprv,Ilectrician signature.required: /7 s� / Industrial plant 1 hr min) I 78 18/hr Inspections for which no fee is Print name: fro(ii�f � r €-eeV Qate t(7-1/ j�j specifically listed C�hrmm1 > 90 OO,r hr ELECTRICAL PERMITFEES Authorized signature: Subtotal. Print name: 0 Plan Review Required(25%of permit Date: I lee): State surcharge(128'0 of permit fee): I hiadiiiiksiaiis1 ITC PennApp LLR FRL.dee Res 86'172015 l-lo-lrlsnlPOS (OM;W LB • TO Al.PGRMI l FEF.: 'Phis permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Numberr oC inspections allowed per permit_ I..le,rdip lPemvi,dVtCI( Penn11,1pp_EI.R ERF doc Re,06;.17:_01., 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 Descriplion Qty F0eh rota, Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 I I Audio and Stereo Systems* 5.01 to IS kva 33.56 15.01 to 25 kva 200.34 2 II Burglar Alarm Wind generation systems in excess of 25 kva: 25.01 to 50 kva 301.04 2 1 I Garage Door Opener* so 01 to loo kva 552 26 -100 kva(fee in accordance Heating. Ventilation and Air Conditioning svithOAR918-309-0040) 552-'� System* Solar generation systems in excess of 25 kva: Fach additional kva over 25 7.42 3 Vacuum Systems* -i oo kva no additional charge 0.03 H Other; Each additional inspection over allowable in any of the above: F,ach additional inspection is I charged at an hourly(1 hr min) 66.25/hr 1 Inspections for Which no fee is COMMERCIALWORK ONLY: specifically listed(/h1 Olin) 90.00/hr Fee for each commercial system: $75.00 ELECTRt al PER �►�P FEES (SEE OAR 918-309-0000) Nsubbtottal per per page I)_ I * umber of inspections allowed r pernnl. Check Type of Work Involved: I I Audio and Stereo Systems B• oiler Controls I Clock Systems 7 D• ata Telecommunication Installation P1 Fire Alarm Installation I I HVAC I I Instrumentation ri Intercom and Paging Systems Li Landscape Irrigation Control* Medical 1-1 N• urse Calls I Outdoor Landscape Lighting* ri P• rotective Signaling Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I'13uilJinn'.Prnnils�GLC_Pcrnu(App EER ERE doe Ree 06/17206 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 9577 SW WASHINGTON SQUARE RD B07, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical final PASS - No C of O ELC2016-00788 Herb Stabenow Violation Summary: Inspector Contractor