Permit (26) CITY OF TIGARD ELECTRICAL PERMIT
1111 II COMMUNITY DEVELOPMENT Permit#: ELC2017-00192
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/20/2017
T I[. I<.[� g Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9522 SW WASHINGTON SQUARE RD H07
Project: Pink Victoria's Secret Subdivision: None Lot: None
Project Description: TI-(1)400 amp service,(65)branch circuits&(2)low voltage systems,audio/stereo&HVAC
Contractor: ADVANCED WIRING SERVICES INC Owner: PPR WASHINGTON SQUARE LLC
PO BOX 644 PO BOX 847
CLACKAMAS, OR 97015 CARLSBAD, CA 92018
PHONE: 503-310-3655 PHONE:
FAX: 503-698-6372
FEES
Quantity Description Date Amount
1 ea Services or Feeders-201 to 03/20/2017 $133.56
Specifics: 400 amps
65 crt Branch Circuits w/Purchase 03/20/2017 $482.30
Type of Use: COM Service or Feeder
Class of Work: ALT 2 ea Signal circuit or Limited 03/20/2017 $150.00
Energy Panel
Type of Const: 1 ea 12%State Surcharge- 03/20/2017 $91.90
Occupancy Grp: Electrical
Total $857.76
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 .ppli -ble law. All work will
be done in accord-0•- with approved plans. This permit will expire if work is not started within 180 days of issuance, • f work is su-•ended for more the 180
days. ATT. ' ION: Orego law requires you to follow the rules adopted by the Oregon Utility Notification Cen Tho-- r -s are set forth in OAR
952-001 0010 through OAR 9 --r Si-,090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.19= or 1.800. :2 344.
Issu=• By: r/Oce__ ✓ _eA_of , Permittee Signature: C �� :�/'
OWNER INSTALLATION ONLY /
The installation is being made on property I own which is not intended for sa ,lease or rent.
OWNER'S SIGNATURE /2 J Date:
r;rr, C. ' - •CTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' �/ -oar7 _' Date: �A 7
LICENSE NO. / CI( 7C- 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 Folk()U)1( t: l SI.0y1.1
s,
1 s Received
City of Tigard '/� E./.4,,,,,,...-
+, ' _z t
Date/B / Permit#: i� � �9
II/ 13125 SW Hall Blvd.,Tigard,Ok 97223 Plan Review
. C Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 l; ( it Ready Date/By: Juris: MI See Page 2 for
1IGARI) Mils2
Internet: www.tigard-or.gov ' / Notified/Method: Supplemental Information
TYPE,qFprAt4f, fiGARD PLAN REVIEW
pNew construction ❑Additipp1alteration/replacement;-.•- 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 0 Other:` where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling A Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amp0 Multi-family ❑Master builder ❑Other: Fire form all other installations. Insbutallation
El pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION / ❑Emergency system. larger separately derived
Job#: 2 Job site address: 2z_5-61,, / `C 7./� 0 Addition of new motor load of system.
o2U!7. I q� ibm- ,3, .lf / G� 10OHP or more. ❑
O/2 ! 0 Six or more residential units. occupancy.
City/State/ZIP: T� Recreational vehicle parks.
/r 0Health-care facilities. 0 P ks.
Suite/bldg./apt.#: / c.' -7 I Project name: /7/4)/( 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: FEE SCHEDULE
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: I 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
/V(w "I L Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
0 PROPERTY OWNER I ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
Address: 201 amps to 400 amps / 133.56 /3J.54, 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) I 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
CI
APPLICANT ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee, (� q
each branch circuit 7.42 {�/"' 2
Contact name: B.Fee for branch circuits without —_ — __ _
Address: service or reeaer see,nrst 56.18 2
branch circuit
City/State/ZIP: Each add'1 branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: Reconnect only 67.84 2
CO RACTOI ,.. Pump or irrigation circle 67.84 2
/ 7
Business name: /< / f4 7/ //2/ �r2LY rf' AVC. Sign or outline lighting 67.84 2
Address: 1 1 Signal circuit(s)or limited-energy iliSee Page 2 /6-0 60 2
�� � _panel,alteration,or extension.
City/State/ZIP: Each additional inspection over allowable in any of the above
ty ��� �� < �� Additional inspection(1 hr min) 66.25/hr
Phone:(0 y) F7rl.'- p.c./g)e) Fax:( ) Investigation(1 hr min) 90.00/hr
Email: . &Ng/ /// / T 7L Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: ' Electrical Lic.: 7 Suprv.Lic.: j/r specifically listed('/z hr min)
/6<S t / p `o ?J s ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: 52-6-4 An/4 Date: F-20.-/7 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE: 4$57 7.
This permit application expires if a permit is not obtained within 180
Print name: 5r- .‘„7 AitifrA Li Date: 9ga-/ 7 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc R 6/17/2015 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 DescriptionI Qtr. I Each I Total I
3r Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 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
❑ 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:
❑ 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'~-PERNIIT FEES
COMMERCIAL WORK ONLY: .:u. .
Subtotal Enteron Page 1):
Fee for each commercial system: $75.00 * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
2Audio and Stereo Systems
In 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
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9522 SW WASHINGTON SQUARE RD H07,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2017-00192
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor