Permit :q CITY OF TIGARD ELECTRICAL PERMIT
' 13 :.'- COMMUNITY DEVELOPMENT
Permit #: ELC2010 00050
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/02/2010
T t G A Parcel: 1$1260000300
Jurisdiction: TIGARD
Site address: 9483 SW WASHINGTON SQUARE DR AO6B
Subdivision: Lot: 0
Project: Pac Sun
Project Description: Install (1) 200 amp and (1) 100 amp panels.
Owner: FEES
PPR WASHINGTON SQUARE LLC Quantity Description Date Amount
2235 FARADAY AVE STE #O
CARLSBAD, CA 92008 2 ea Services or Feeders - 200 02/02/2010 $201.40
amps or less
PHONE: 1 ea 12% State Surcharge - 02/02/2010 $24.17
Electrical
Contractor:
FRAHLER ELECTRIC CO
11860 SW GREENBURG RD
TIGARD, OR 97223
PHONE: 503- 639 -4627
FAX: 503 - 639 -4673
Type of Use:
Class of Work: Type of Const:
Occupancy Grp:
Total $225.57
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 AR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: 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' Q n *9i) Date:
LICENSE NO. �[J�
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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 RECEIVED Iolz, i., lc 1 titil o�
City of Tigard Received .. ► Permit No.: • `. V `` 0
a 13125 SW Hall Blvd., Tigard, OR 97223 JAN 2 9 2010 Plan Review
-, Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Penni t! �l l �(G ��q q
Inspection
www.tigard-or.gov Line: 503.639.4175 C ITY OF TIGARD Date Ready /By: y: .1 : ® See Page 2 for
I IC. Kp 1 Supplemental Information
BUILDING DIVISIO t
.
TYPE OF WORK • PLAN REVIEW
❑ New construction E Addition/alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
• less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "1 - 2 ", "1 - 3 ",
Job no.: 67296 1 Job site address. 100HP or more. occupancy. W WASH SQUARE ROAD ❑ Six or more residential units. ❑ Recreational vehicle parks.
3 - - - - i ❑ Health -care facilities. - - ❑ Supply voltage for more than
City / State/ZIP: TIGARD, OR 97223 ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt` no.: I Project name: PAC SUN ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to jo • site: De .lion L•i17!•ll —s'r'
New residential single- or multi- family dwelling artit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less - 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map/parcel no.: Limited energy, residential
67.84 2
DESCRIPTION OF WORK (with above sq. ft.)
• Limited energy, multi - family
NEW 200A SERVICE IN "A" BLOCK AND NEW 100A FEEDER TO OLD residential (with above sq. ft.) 67.84 2
Services or feeders installation, alteration, and/or relocation
SUBPANEL 200 amps or less 2 . 100.70 201.40 2
❑ PROPERTY OWNER ❑ TENANT - . ' 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City / State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT _ ' ` ❑ CONTACT PERSON above service or feeder fee, 7.42 2
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee, 56.18 2
Contact name: first branch circuit
Address: Each add'I branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) . Fax: : ( ) Reconnect only 67.84 2
E -mail: Pump or irrigation circle 67.84 2
CONTRACTOR . Sign or outline lighting • 67.84 2
Signal circuit(s) or limited -
Business name: FRAHLER ELECTRIC COMPANY
energy panel, alteration, or
Address: 11860 SW GREENBURG ROAD extension. Describe: Page 2 2
City/State/ZIP: TIGARD, OR 97223 . Each additional inspection over allowable in any of the above
Per inspection 66.25
Phone: (503) 6394627 Fax: (503) 539 -4673 Investigation per hour (1 hr min) 66.25
CCB Lic.: 37410 Electrical Lic.: 34 -13C Suprv. Lic.: 1816S Industrial plant per hour 78.18
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, bred: 4„/ ' ` ,(, " Subtotal: 201.40
Print name: R. W. FRAHLER Date: 01/26/10 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 24.17
Authorized signature: TOTAL PERMIT FEE: 225.57
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
•
F
11/.■