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Permit (36) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT IIIIIsi: COMMUNITY DEVELOPMENT Permit#: ELR2017-00225 T f aAFt D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/19/2017 Parcel: 1 S126CC00100 Jurisdiction: Tigard Site address: 9700 SW WASHINGTON SQUARE RD Project: Nordstrom Subdivision: None Lot: None Project Description: Fire alarm. Contractor: WESTERN STATES FIRE PROTECTION Owner: PPR WASHINGTON SQUARE, LLC 17500 SW 65TH AVE C/O NORDSTROM LAKE OSWEGO, OR 97035 ATTN: TAX DEPT PO BOX 2229 SEATTLE,WA 98111 PHONE: 503-657-5155 PHONE: FAX: FEES Description Date Amount Specifics: Restricted Energy Permit 10/19/2017 $75.00 12%State Surcharge-Electrical 10/19/2017 $9.00 Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio&Stereo: 0 Boiler Controls: 0 CCTV: 0 Clock Systems: 0 Data&Telecommunications: 0 Fire Alarm: 1 HVAC: 0 Instrumentation: 0 Intercom/Paging: 0 Landscape/Irrigation: 0 Landscape Lighting: 0 Medical: 0 Nurse Calls: 0 Protective Signal: 0 Security Alarm: 0 Other: 0 Total $84.00 Other Desc: 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 matey obtain a co of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: 'C G' Permittee Signature: % ,t .?'i2{23 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 A• •lication FOR OFFICE USE ONLY City of Tigard !ceived IN v 13125 SW Hall Blvd.,Tigard,OR 97223RECEIVE lae/B : / % Permit#:GGA /�_!„� `� Phone: 503.718.2439 Fax: 503.598.1960 Plan Review !t (,��7(iC Inspection Line: 503.639.4175 Date/By: Related Permit# TIGARD Internet: wwne: 50d 39.41 fl Jung. 1117 ReadyDate/By I 1 9 U Notified/Method: r See Page 2 for �- µ,Vi,, I Supplemental Information -.�-w- .hi ate"'S-�� r # �'7`�-a�Y ' ',°�1�;�`G #�� _ .. _ ❑New construction ®Addition/alteration/rtg: e �� ' I � a che'k , ��a � m necked) Please check all that apply� �"` ❑Demolition1 (submit 2 sets of plans w/items checked): o Other: { y , DIVISION ❑Service or feeder 400 amps or more ❑Building over three stories. �'q�a rrwhere the available fault current E` 1 ' i,00N y ❑Marinas and boatyards. ❑ l and 2-family dwelling �i .',-;---:',;-::i ' ' 1 exceeds 10,000 amps at 150 volts or ❑Floating buildings. ®Commercial/industrial 0 Accessory buildingless to ground,or exceeds 14,000 ❑Multi familyam s for all other installations. ❑Commercial-use agricultural ❑Master builderp ❑Other buildings. AV.if,t t ``x �'„ j1 t1 1 ❑Fire pump. }`, 0 Installation atoly 150 KVA or Job#: � 'K� � ,� JEmergency system. larger separately derived Job site address:9700 S.W.Washington Square Rd ❑Addition of new motor load of system. /State/ZIP: 1001001-1P or more. Cit ❑"A","E","I-2","1-3", Y Tigard,OR 97223 ❑Six or more residential units. occupancy. Suite/bldg./apt.#: ❑Health-care facilities. ❑Recreational vehicle parks. Project name:Nordstrom 2"d floor cs ❑Hazardous locations. 0 Supply voltage for more than Cross street/directions to job site:Washington Square Nordstrom 0 Service or feeder 600 amps or more. 600 volts nominal. 5 : fir' W iT1 : [ r ` Description - l Qty. 1 Each ., ,- Total,1 F,;;_= 1 " Subdivision: New residential single-or multi-family dwelling unit. I Lot#: Includes attached garage. Tax map/parcel# 1,000 sq.ft.or less 168.54 4 ' „ }� Ea.add'l 500 sq.ft.or portion 33.92 Alter fire alarm for tenant TI ' " ' Limited energy,residential (with above sq.ft.) 75.00 2 Limited energy,multi-family residential(with above sq.ft.) 75.00 2 RenewlE ❑ SPe Name: Services aboer feedersnergy installation,alteratioeen,agand/o2r relocation 200 amps or less 100.70 2 Address: 201 amps to 400 amps 133.56 2 City/State/ZIP: 401 amps to 600 amps 200.34 2 Phone:( ) 601 amps to 1,000 amps 301.04 2 Fax:( ) Over 1,000 amps or volts Email: 552.26 2 Temporary services or feeders installation,alteration,and/or relocatin Owner installation:This installation is being made on property that I own which is not 200 amps or less intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 25.06 1 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 �nBranch circuits—new,alteration,or extension,per panel Business name: "" A.Fee for branch circuits with above service or feeder fee, Contact name: each branch circuit 7.42 2 B.Fee for branch circuits without Address: service or feeder fee,first City/State/ZIP: branch circuit 56.18 2 Each add'l branch circuit 7A2 2 Miscellaneous(service or feeder not included) Phone:( ) I Fax: :( ) Each manufactured or modular Email: dwelling,service and/or feeder 67.84 2 C© 1 Z TtAO> Reconnect only 67.84 2 Business name:Western States Fire Protection Pump or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 Address: 17500 S.W.651h Ave Signal circuit(s)or limited-energy panel,alteration,or extension. ® See Page 2 75 2 City/State/ZIP:Lake Oswego,OR 97035 Each additional inspection over allowable in any of the above Phone:(503)407-0279 Additional inspection(1 hr min) 66.25/hr Fax:( ) Investigation(1 hr min) 90.00/hr Email:William.Stewart@wsfp.us Industrial plant(1 hr min) 78.18/hr CCB Lic.: 104570 Inspections for which no fee is Electrical Lic.: CLE 108 I Suprv.Lic.: 2525LEA specifically fisted(%hr min) 90.00/hr Suprv.Electrician signature,required: - g1, t ' �' _ r � Subtotal: �s�� Print name: William T Stewart Date: 10-19-17 0 Plan Review Required(25% �� f of permit fee).: '-- ��C-�L State surcharge(12%of permit fee): P Authorized signature: TOTAL PERMIT FEE: ��1'/!7� • ' Print name: William T Stewart I This permit application expires if a permit is not obtained within 180 I Date: 10-19-17 days after it has been accepted as complete. L\Building\Perini[s\ELC_PermitApp_ELR_ERE.doc Rev 06/t7/2015 * Number of inspections allowed per permit. 440-4615 T(I 1/05/COM/waB Ei'ctrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: * Fee for all residential systems combined: $75.00 Description Qty. Each Total I 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 ❑ Garage Door Opener* 50.01 to 100 kva 552.26 2 >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 ❑ Heating, Ventilation and Air Conditioning System* Solar generation systems in excess of 25 kva: 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 specifically listed(%hr min) 90.00/hr Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): (SEE OAR 918-309-0000) * Number of inspections allowed per permit. Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC n Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ® Protective Signaling ❑ Other: Total number of commercial systems: 1 *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015