Permit a CITY OF TIGARD ELECTRICAL PERMIT
i
':' :: ° COMM DEVELOPMENT Permit #: ELC2009-00179
Date Issued: 04/29/2009
.T t GAR[ 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S1260000300
Jurisdiction:
Site address: 9724 SW WASHINGTON SQUARE RD F06 & F07
Subdivision: Lot: 0
Project: GAP
Project Description: Ti - Low voltage systems: data and audio /stereo.
Owner: FEES
PPR WASHINGTON SQUARE LLC Quantity Description Date Amount
BY THOMPSON PROPERTY TAX SERVUCES, 2 ea Services or Feeders - 200 04/29/2009 $160.60
2235 FARADAY AVE STE #O amps or less
PHONE: 1 ea Services or Feeders - 201 04/29/2009 $106.85
to 400 amps
Contractor: 72 crt Branch Circuits w /Purchase 04/29/2009 $478.80 rs
JC ELECTRIC INC Service or Feeder •
118 NW 184TH STREET 2 ea Signal circuit or Limited 04/29/2009 $150.00
RIDGEFIELD, WA 98647 Energy Panel
PHONE: 360-887-7889 1 ea 12% State Surcharge - 04/29/2009 $107.55 v i)
FAX: 360 - 887 -5584 Electrical
K. 0 5 ` NM .
Type of Use: COM BO x C,ov
Class of Work: ALT Type of Const:
Occupancy Grp: - 7:1_ e - Z - C7 ION ID 11 l 0 J • 4
• ,— - IkS)
I 3 • CAM-►NG- COVc(Z_rA1
5I23lnq
G-. sJ b6 Le Total $1,003.80
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 -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'N Date:
LICENSE NO.
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.
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ELC2C0';-CC1713 9724 WASHINGTON SQU... F06 & F07 Issued Inspections 04/23/2009 TI - Low voltage s. -
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Inspection Type Scheduled Scheduled Inspector Inspection Result Result Comment F gi
Date Time Date :Ell
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ELC2CC,C4-GC1,7c; 9724 WASHINGTON SOU._ F06 & F07 Issued Inspections 04/23/2009 TI - Low V a I t a g e
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Inspection Type Address Case #
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120 Electrical rough 9724 SV,", SQUARE RD F06 & F07 ELC2009
Request Date Request Time Requestor's Phone Number
05/12/2009 01:22 360-772-2702
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Scheduled Date Scheduled Time =7
05/13/2009 12:00 AM
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Inspection Date Inspection Time Result Department Inspector
uol :3/2009 09:30 :=ART Building Herb Stabencw
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Result Comment
includes 2 undergrounds and dressing room hard ceilings and storefront except storefront module
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CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2009 -00179
Date Issued: 04/29/2009
IL GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639 4171 Parcel: 1S1260000300
Jurisdiction:
Site address: 9724 SW WASHINGTON SQUARE RD F06 & F07
Subdivision: Lot: 0
Project: GAP
Project Description: TI - Low voltage systems' data and audio /stereo.
Owner: FEES
PPR WASHINGTON SQUARE LLC Quantity Description Date Amount
BY THOMPSON PROPERTY TAX SERVUCES,
2235 FARADAY AVE STE #0 2 ea Services or Feeders - 200 04/29/2009 $160.60
PHONE: amps or less
1 ea Services or Feeders - 201 04/29/2009 $106 85
to 400 amps
Contractor: 72 crt Branch Circuits w /Purchase 04/29/2009 $478.80
JC ELECTRIC INC Service or Feeder
118 NW 184TH STREET 2 ea Signal circuit or Limited 04 /29/2009 $150 00
RIDGEFIELD, WA 98647 Energy Panel
PHONE: 360-887-7889 1 ea 12% State Surcharge - 04/29/2009 $107.55
FAX: 360 - 887 -5584 Electncal
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $1,003.80
Required Items and Reports (Conditions)
This permit • - • - • ect to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All work will
be dor - 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 •ays ATTENTION Orego - •• re tyres you to follow the rules adopted by the Oregon Util • on Center Those rules are set forth in OAR
95 •- 001 -0010 th ••ugh OAR • , s - 0 0 1 - 0 p A t ( 4 0 1 o u may obtain a • py of the rules or direct questions to O • ' C by ca mg r . • • • • 1.800,332 44
t
I sued By: ! �1�1 I� Permittee Signatut � f llif = � /e5L---"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 INST LATIO ONLY
SIGNATURE OF SUPR. ELEC'N --401 fggliri;/5` --e Date:
LICENSE NO. 1 /g0
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.
04422/2009 09:44 3608875584 J.C. ELECTRIC, INC. PAGE 02/04
,
Electrical Permit Application �(1�1 �t,, FO r VICE USE °NI.Y
City of Tigard ( v , ]Jt
Date/B hi °`� O Permit No . Eke, j f
1111
— - 13125 5W Hall Blvd , Tigard, OR 9 J Plan Review
* Phone: 503 639.4171 Fax. 503.59 Date/By; Other Permit:
F 1(;.A R I) Inspection Line: 503.639.4175 q 61 V Date Ready/By. suns El See Page 2 for
Internet: www tigard - gov P— N , Noufied/Method Supplemental Information
.,.n: .i '! rtlll' •,• ;� ,,,,,,;,. „ p ,v 'iqi � i ti 'Ei'n 514r •'.i' 'r,',: ;t;t•!'�,r';l..i,; !!+• . •;;• ir ;°ls('�., li i'rflk:i
, (,,, l 1 , h I I i I;1 c;il � a ,; ° I': i. ! v, i � °�� ,,,I -P I t +„ • L'1' i' i i� . 1; .,• .. • I i i1 i , ,r, r,' , ,
, ; ".i ?i•� �lx. il� ,li'Ili! 1 �fin�r'i ,l �.l.�'. i`itl!'1`UI`a � ,'� !I , Lli�tifJl-, I, Slfi� ,ll��lfillt����I� { !.! i! II,, III11r�, i� ,lll�h�Nif,i'i�l,n,i�
[ New construction ❑ Addition/alter : 11 - . • t 1 Please check all that apply (submit 2 sets of plans w /items checked below)
❑ Demolition ❑Other:
B 1 a ® Service or feeder 400 amps or more CI Building over three stories
where the available fault current ❑ Marinas and boatyards -
I p, .I ri i p ,; iai �i,i II a ! 4'" i , , I l` 1i 71I , ; +° m exceeds 10.000 amps at 150 volts or El Floating buildings
,ii.i itl►1!!!;Iq r; ;� I'} il1`II11111{I,!'!'I I 3 ,
},,;,� „� „' �;.1,� Vi i,il blld �u �' , l:;l , , f o �' � ,,,,,,,,.,: n ,1, f,,;d,.;. n! „� I 1, il,lll,il,vli,iilll� l(�Il�, I IIii;L less to ground, or exceed: 14.000 ❑ Commeroial -use agricultural
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Aecessury building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
,' ,” ” 1 P +1;1!1' ; 1. r' , ° ,r4,u r q,•, ,h l ; y +, i, ! n{ „ n; `I ❑ Emergency system larger separately derived system
ii i,ii I ,,! ,Ii :Y.i,,, ;. f ?I iailt. ' �;. -' , ';n H ti ,.•� ; ;, ,, tt ' .. . . l ,!4 l i l i •.;, l, „ Addition of new motor load of
a n ; • _ ` , 1 ❑ dd t ❑ "A "F•' 1 5 •• "1 �••
nett. 100} or more
occupancy
Job no.: �OalG7(5C Job site address SW �� , e \rPk El Recre ational vehrele arks
❑ Sue or more rca, dcntual ,m,b p
City /State /ZIP: (• � °I-4-1/1 CI Ho facilities ❑ Supply voltage for more than
❑ Hazardazardous us locations 600 volts nominal
Suite /bldg. /apt. no.: c 9 b Project name: Gp / ,- P - ❑ Service or feeder 600 amps or more
— l
�Ma 1 R!{q' +59'41 Iflglli li+ 'i ` 1 II; 1' i� '' ��i 'i' „ '��4ili � i3`I�,;11��lif / IlilliI
Cross street/directions to job site. �
Ili, iihli ; {I {Ilh ?iii' ou + llli llia!i, , ,�l 1'' i
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Dmcrlptlon Q�v. � Fee sculls
New residential single- or multi - family dwelling unit.
Iticludea attached garage.
Subdivision: 1 Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Limited add'l 500 sq. ft, or portion 33,40 1
Limited energy, residential
:Pill 1 t 3 I$ i �! ill • I i1 I I i;l i11 kll I j IjjII l lllf 1 ji1/,,, ,:,• •,::,:,•: , I;,` ` IIIhGI'IIIIlil11111r;11;1,n;:n II;I IPh�i I fl ijji 'f with above s ft 75 00 2
1
,, ,.,,, 14 .1.. „i „ i! fa.l!•;� „I ? .. ?`,E! :,: .,,,,. ,;:: .•,!!,, ul !I!,,!,! „!IIII!1,,;,1 „1.1,,,,t, i , ( q )
Limited energy, multi -family 75.00 2
F A u, {� residential (with above sq ft )
Services or feeders Installation, alteration, and/or relocation
200 amps or less 2 80.30 160.60 2
�';I!j�;l 5' ^;'' ? lf
,. !l ll i n` i li „ I II i i i e r
i :, 1 �. 0* , i,il i,l,ii.li llil'lli ,, llil if !' i'Il ' i l►1; i11 1120 „ , 0 11 :10111 11 1 � 11111:"10 Il 201 s to 400 5 1 106 85 106 85 2
•irl•i!.'ninr;:,:d1:: •;,J,,.o.,• u•,n, n , ra,,,y�,udd•,(;,,,1• p,f, ,„,,, - . 04,,, , »,,,,x , ,IIL 3 ,,1l,3,, 111
Name: 401 amps to 600 amps 160 60 2
601 amps to 1.000 amps 240 60 2
Address: Over 1,000 amps or volts 454 65 2
City /State /ZIP' Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66 85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100 30 2
intended for sale, lease, rent, or exchange. according to ORS 447, 449. 670, and 701. 401 amps to 599 amps 133.75 , 2
Branch Circuits - new, alteration, or extension, er panel
Owner signature: Date: A Fee for branch circuits with
ildlli ;'IIi'� {' ilir.,;, r „•,• �,•u',,',ne• .,'pP,' .::,,r n , n a•;t• ; :; v c: C •'u1,I,,. ,•. +y ^,;, t:•,'rnn �li
1i �, I, �, ' 4 it r I i� 4 it 1, i i e� , i � !� above service OT f eeder fee, 72 4 78.80
�''
i`• Ei 1, ,,,I, Iii, ��,�4! Ili ! l; Ri i liiill9,diiillii fill!Piiil ` r;~i4 i1 ,��i � llilill;hll!n(lil 6 65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee. 46 83 2
first branch circuit
Address: Each add'I branch circuit 6 65 2
Miscellaneous service or feeder not included)
City/State /ZiP: Each manufactured or modular
dwelling, service and /or feeder 90 90 2
Phone: ( ) Fax. : ( ) Reconnect only 66 85 2
E -mail: Pump or irrigation circle 53 40 2
.i4 i::: 1: 4! i:! i, ii';; li; 1: 1(:! '!! !' 1!, i�2li i:;:,;: ;il?!:1,:1i1!!•1'i:+l%rfi!P!: • ii t t y y�. kiu!!! ll! i!! !l•U,`!!Ill!I;PPF,T, i'r;ldi?! n:',p {llfDlllil'lli ■i!11 `Sig or out
, ” Jli'!, e.. rs !"Ipline,iilAl;,i'n dlM',11-.^•1W,!a9h ^?,, ° ;AFT p rI ndl.,•;, i, f, i; 1,, i •,,,Aillf!�, ∎pv LIIP6,1,Midi.Ilrnl hn lighting .3 .a —
Business name: Signal circmt(s) or limited-
_ Z.0 - E tCiit , 1 energy panel, alteration, or
Address ) ) �
2 ,n --� extension Describe: 2 Page 2 150 2
City /State /ZIP: A Each additional inspection over allowable in any of the above I
c? No; 1�\ �''� °fbb4-��. Per inspection 62,50 I
Phone: (/V rt f kp ....—+% Fax: (\ ' T% ” - ' ' \ Investigation per hour (1 hr min) 62.50
CCD tic.: \NSS'a5•), Electrical tic.; '11_ ”
- q Suprv Lic - � ey v i Industrial plant per hour 73.75
;,,i , ,,; 1•• ,• �J41,' ;,,,; , I ll I ,f ! '�1 , it ,
..r "' e, Il, Iii „,act g r, hlg , ; - { !,•,. 11 -- -
Suprv. Electrician signature, required: Pri / /, /To Subtotal 896.25
0' 'I 1 f I I 1 u!lirr!an!i,1,,1, 1, , • — —
Print name: �� 1 ; - ,� U / Plan review (25% of permit fee)
--01\ Cq)L1l Ca = 1br 0 9 State surcharge (12% ofpetmit fee) 1 07 55
Authorized signature:
� � �
TOTAL PERMIT FEE. -rao
M1
u
Print name: This permit application expires if a permit is not obtained within ISO
Date. ‘‘,0/001 � � days after it has been accepted as complete. 0
” Number of inspections allowed per permit /003
I •,nwlding\Permas\ELC- Perm,tApp doe 0523/06 440- 4615T(11 /05 /COMM1VI'EB r
1 0er/22/2009 09:44 3608875584 J. C. ELECTRIC, INC. PAGE 03/04
Electrical Permit Application - 'ity of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY
1 PERMIT FEES:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
Fee for each commercial $75.00
system
(SEE OAR 918 -309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ 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: 2
No licenses are required. Licenses are required
for all other installations
I: V3uild :reermitaL.C_Perm,tApp.doc 03!23/06
ti
` 04'28/2009 12:11 3608875584 J.C. ELECTRIC, INC. PAGE 02/02
J.C. Electric, Inc
° rfe 118 NW 184 St.
'j ,' Ridgefield, WA 98642
II ' �' ' 360- 887 -7889
''.
"."4 'f n 360 -887 -5584 Fax
April 28, 2009
City of Tigard
Attention: Gary Noble
13125 SW Hall Blvd
Tigard, OR 97223
Gary:
GAP STORE
WASHINGTON SQUARE MALL
SPACE F06
9677 SW WASHINGTON SQUARE RD
TIGARD, OREGON 97223
AIC RATING AT PANEL IN SPACE = 8877.917 AMPS
Supervising Electrician: JOB Coulimore
4289S
J.C. Electric, Inc.
360 - 887 -7889
Thank you!
Jill Consiglio
Secretary
118 NW 184 Street Ridgefield, WA 98642 Fax: 360-887-5584 Phone: 360 -887 -7889