Permit CITY OF TIGARD ELECTRICAL PERMIT
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COMMUNITY DEVELOPMENT Permit#: ELC2019-00136
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/28/2019
TIGARD Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9753 SW WASHINGTON SQUARE RD D02
Project: 85C Bakery Subdivision: None Lot: None
Project Description: Electrical for new tenant improvement.
Contractor: FRAHLER ELECTRIC COMPANY Owner: PPR WASHINGTON SQUARE LLC
11860 SW GREENBURG RD PO BOX 847
TIGARD, OR 97223 CARLSBAD, CA 92018
PHONE: 503-639-4627 PHONE.
FAX: 503-639-4673
FEES
Quantity Description Date Amount
2 ea Services or Feeders-200 05/21/2019 $201.40
Specifics: amps or less
106 crt Branch Circuits w/Purchase 05/21/2019 $786.52
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 05/21/2019 $118.55
Electrical
Type of Const:
Occupancy Grp:
Total $1,106.47
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 may obtain a copy of the rules or direct questions to OUNC by calling 503.2232.1987 or 1.800.332.2344. -
Issued By: Permittee Signature: d � ��l✓l
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.Application i :t i c U e t t I t I I ,-It v t ,
City of Tigard Received
111/ u 13125 SW Hall Blvd.,Tigard,OR 97223 Pleur Review
g I=
Phone: 503.718.2439 Da:-: :
Email: TigardBuildingPennits@Tigard-or.gov Ready Date/13y: kris: ®see Page 2 for
Inspection Line: 503.639.4175 Internet: www.tigard-or.gov Notified/Method: Supplemental Information
. TXPE OF WORK PLAN. '1EViF
❑New construction Q Addition/attimation/replace ant Plane chock all that apply(submag sets of plans w/iteme checked):
D service or feeder 400 amps or more D Building over tines stories.
❑Demolition 0 Other where the available Teak current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION. exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑1-and 2-family dwelling Q Cornercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ( .Commercial-use apleulmml
amps for all other installations. buildings.
0 Multi-family Q Master builder .. 0 Other:. . D Fine pump. D installation of 150 K,VA or
• JOB SITE.INFORIVMATION AND•LOCATION / . D erg�y system lamer separately derived
Job#: Job site address: 7 753 5, 4/�f5pi,n ,. .Cr
z.„.. D 'tion of o emfr load of system.10011P o mmore.. D"A"."E"."1-2","1-3",
City/StateJZIP:. ofel 0 Six ur ewer residential units. ncy.
D Health-care facilities. D Recreational vehicle parks.
Suite/bldg./apt# Project name: D Hazardous locations. D Supply voltage for more than
0 Service or feeder 600 snips or mom. 600 volts rwmmal.
Cross street/directions to job site: • .FEE SCHEDULE •
De:40m 14th. I Earl. I Teted I +
New residential single-or maid-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
1,000 sq.S.or less 168.54 4
Tax map/parcel#: Ea add'l 500 sq.ft.or portion 33.92 1
,DESCRIPTION OF WORK - Limited energy,residential
(witb above Kt JO
CUC i 9.+2Ae*t)� `k( iVOC`O' -Limited energy, ulti-family 75 00 2
s c. `o f'Lo.--Ai residential(with above sq.ft.) 75.00 2
❑.PROPERTY OWNER el V Renewable Energy D.See Page 2
0 TENANT • &niece or feeders installation,alteration,and/or relocation
Name 200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 enges 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Over 1,000 amps or volts 552.26 2'
Email: Temporary services or feeders Installation,alteration,and/or
relocation •
Owner installation:This installation is being made on property that I own which is not 200 amps or bees 59.361
intended for sale,lease,rant,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 16834 2
❑ APPLICANT 0 CONTACT PERSON c Branch circuits-new,alteration,or extension,per panel
{ [� A.Fee for branch circuits with
�
Business name: z.4C{�„ I f e, 14./ g 1/e`ryl e_ W above service or feeder fee, 7.42 2
h branch chcuit
Contact name: 1 'B.Fee far branch circuits without
U S`1 to Y A /� service or feeder fee,first
Address: 011 ' '�0 $L,/ e -eer7Sv ltd. branch circuit 56.18 2
City/State/ZIP: 't`/ lit Z( , :) 1 70?_ 3 Each sats'l blanch circuit 7.42 2
Miscellaneous(service or feeder not Included)
Phone:(5U3) C 31-1- to, Z 7 Each manufactured or modular 67.84 2 .
idwelling,service and/or feeder
Email:
Jo,s+4 et c F .c i. eAe G'-'1.- C Or'7 Reconnect only 67.84 2 ,
CONTRACTOR'. Pump or irrigation circle 67.84 2
Business name: Sign or outline lighting 67.84 2
Signal chemit(s)or Hulked-energy S 2 2
Address: panel;alteration,or extension. Om
Each additional inspection over allowable in any of the above
City/State/ZIP: Additional inspection(11r min) 66.25/hr.
Phone:( ) Investigation(I hr min) 90.00/hr.
Email: Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 1(71 7 Z Electrical Inc.: C$61 Suprv.Lic.: S 11,E s specifically listed(h hr nm)
ELECTRICAL.PERMIT FEES
Suprv.Electrician signature,required: Ze `=/c Subtotal:
Print name:i gins /'„H� �..wt Date: 511$r i lr D Plan Review Required(25%of permit fee):
` J State surcharge(12°x6 of permiit fee):
Authorized signature: TOTAL PERMIT/.EE:
This permit application expires if a permit Is not obtained within 180
Print name: Date: days after it baa been accepted as complete.
* Number of inspections allowed per permit ,