Permit CITY OF TIGARD ELECTRICAL PERMIT
'91 o COMMUNITY DEVELOPMENT Permit #: ELC2010 -00412
T I G AR b 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/09/2010
Parcel: 1 S135BA00100
Jurisdiction: Tigard
Site address: 10205 SW WASHINGTON SQUARE RD
Subdivision: WASHINGTON SQUARE TOO Lot: 0
Project: Thirsty Lion
Project Description: Electrical for TI.
Owner: FEES
PPR SQUARE TOO LLC Quantity Description Date Amount
BY THOMSON PROPERTY TAX SERVICES,
2235 FARADAY AVE STE #0 44 crt Branch Circuits 08/09/2010 $375.24
wo /Purchase Service or
PHONE: Feeder
1 ea Signal circuit or Limited 08/09/2010 $75.00
Energy Panel
Contractor: 1 ea 12% State Surcharge - 08/09/2010 $54.03
CENTURY ELECTRIC LLC Electrical
PO BOX 10646
PORTLAND, OR 97296
PHONE: 503 - 241 -8020
FAX: 503 - 244 -7041
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $504.27
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 O. ' 952-001-0100. You may obtain a co• of the rules E questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
•
Issued By: / _ �i1 �� � Permittee Signature: - - ✓7. %1 --
'/ r
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 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 ADDlication AuG 4 201° Mit 111•1•1( USI
City of Ti gard .. ''
• -- u ., Tigard, OR 97223 (') V • .‘ ,„: ', - ',.• t ;2 ,p 1:1 1: twil6 R ived „,.,„ Virfilr3.172 Pennit Nv.; - "el - C - 4113 W —
IN -- 13125 SW Hall Blvd ).
• . Phone; 303,639.4171 Fax: 503 ` ' .598.1960, ; ; • ' ' "' ' ') ■, .' '..,', Data/B : Other Permit: P j A, i N. ',
. t
.l 1 ` ' > . '
_
' 1 t . . . Alt 1., Inspection Line: 503.639,4175 . Date Ready/By:
Internet vo.vw.tIgard-or.gov Notified/Metbod: ION r. ,.,..P....gctazilfrform.,;..
, ..&:;,.yttT.A. , :..x- , ;gm. , 4„:„.„,.....,,,,t,3,...„..,*-,-4.f„.,,,,:.. .... .. :.,....-7....„....1„...,,,...„...„....t.:v_.:,,e,.477,. :......‘,....:„..,,,,.,..,.:..k.,,.,..„...:,..,::.,.. ..,,...,.....,...,............,:....,.,,,„....,.....„:..
I] New constructirm Addition/alter ation/replacetnent meals cheek all that apply (aubmit a sets ef plans wiitems checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
D Demolition 0 Other, Wbeire the available fault current M Marinas and bo styarda.
exceeds lopoo amps at 150 volts or LI Floating buildings.
loss to ground, or exceeds 14,000 0 Commercial-use agricultural
E 1- and 2-family dwelling )21 Commercial/industrial 0 Accessory building Amos for all other installations. buildings.
C] Multi-family 0 Master builder p Other: 0 Fire pump. 0 Installation of 73 KVA or
ieffii4tiratitils 2 E , . d of larger separately derived system.
i','„, .., . i......,..01.,i4 i:.,y.t ;..4,.....mli ..4r; 4,..1 A mon or nem Inc or .oa o MI "A'' "E" "1-2",
Job no.: Job site address: /0 20 (1 U1251.4 ,, ut HP Or MOTO,
rf r /494"eirkl sv, . of more residential units. et:Gummy.
El Recreatiocol vehlc le parks.
C i ty/State/Z IP : 1 1 1 E.. 9`7Z13 0 Health-eare facilities, 0 Supply voltage more
1:11-Ittardous location.' far Ciao
600 volta nominal,
Suite/bldg./apt. no.: Project name: 7 t y 1. i dA/ :,
D Service or feeder 600 amps or more.
Cross street/directions tojob site: 1..)tot 21 7 7-2) 6144zeiii bu Imo-intim 1 ow. r Pee Totnt 1 '
i New residential a inglt or tnuiti-family dwelling unit,
n_ jA.414/LL Wilijigie 54ttite_ ROCLCI. Includes attached garage.
Subdivision: .. 1 Lot no.: , 1.000 sq. ft. or less 168.54 4
Ea. addi 5005q. ft or ponion 33.92 I
Tax map/parcal no.: Limited energy, residential
75,00 2
4. ', • .1 $ 4 it' 4 1 4 ,* t',!'!l , ntr.-.7.7.—:r.T.,aLtni,^ ' (with above eq. ft‘)
Limited energy, multi-thrnily
75,00
X ibi pm usonAl2 . 4$ r 71 'rail/ L to 11 residential (with above ea. ft.) I 2
Services or feeders insrallation„altaration, and/or relocation _
pub j 6-r I Ct._ : 200 amps or lets 100.70 2
1 : i i .. g.Ti , M: , Z 3t0 f0 4 : 1 ***.V.V.I i' AFfkif17 4' 1 :7 1 : Tintat,RiNt7;i 1.. :ja;;:' 201 amps t°4°° ttnIP/ 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
`• Temporary services or feeders Installation, alteration, and/or
City/State/ZIP: ! relocation
Phone: ( ) Fax: ( ) . 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
i
a 168,54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 mps to 599 amps
, Branch circuits -new, alteration, or extension, per panel
Owner signature: Date: A. Fee tbr branch circuits with
..: ';...1:::;;;; v7, .:,;,t'tjSilrjitr:tt'ttglArr., '•.i.....:,•::Y.',': above service or fbedes fee. 7,42 2
each branch circuit
Business name: e ru ..: ELG_cinedc, LC-C . R. Fee for branch circuits withoar
service or feeder fee, first I 56.18 ,,S7 I 2
Contact narlie: .. = . 4/.0 .3 e_.L" 01.41. 41, , branch circuit
Each add'l branch circuit Li 3 2,42 3 1 q,4 2
Address: ?c, act,x. /0 (qt.; Miscellaneous (aervice or feeder not Included)
Each manufactured or modular
City/State/ZIP: ?b., el-14 e./3 9, 296 dwell 67.84 2 ing, service and/or feder
Phone: (59 zeij - ro zc> F.: : (.5-D3) 2 11 - '7 9 i Racormem only 67,84 2
Pump or inigation circle 67,84 2
E-mail; 7',151.t0 e e Aeks Py 5.-to C. . fle- i" , , Sign or outline lighting ..,
. 67.84 2
Ithqt Z:Ii:O.,..t:',.! :T;T.....::' Signal circuits) or limited-energy 1 ;
panel, alteration, or oxtension. I Page 2 .._ 1.. Ic.
Business name: e ..,,, Lu. , fe E Lgc,-T-e C. 6 t _ a
Each additional Inspection over allowable In any of the above 2
Address: p 0 g, ox /06-c/6 Additional inspection (1 hi min) 66 25/ hr
Investigation (1 hr min) 66 25/ hr
City/State/ZIP: ?bori-iat4 4 i 0 IL. 97z,f6 Industrial plant (1 hr min) 78,1g/ hr
Phone: (5 2 1 " 2i'd xa Fax: $2,3) ztiq • 70q I Inspections for which no fee is 90.00f hr ,.
specifically listed (Si hr mi)
Cal Lic.: 4 6 if 7 ft 1 Electrical Lic.: ..5 C Suprv. Lic..fig0q5 '..,..;.:'•:.::',,•,,,::::;;.:..'.;-..,.,:i;EttOtitia0, ttitilirlitAg .......1.•;;'
Subtotal: qa zy
Suprv. Electrician signature, require000:1
Plan review (25% of permit fee):
Print name: 7r,m1,1 1 g... Jewel ki. Date: 8.- q - lc) State surcharge (12% of permit fee): SY, 0
Authorized signriture: .‘..1,-
/:0,r9 TOTAL PERMIT FEE: 5z;ty,z
ccupt
h
Tis permit application expires it a permit is not obtained within ISO
Print namer y j, el /A, 1 nate: Ey ._ y _.. tv , e . N.,berof in da st yLo ti lltar on, ti o hal bean a as emplate.
E:13.1ildiostPormitatELC-PonnitApp doo 07/01/10 440.461ST(11/0//COM/WEEI
1 . 4 XUA 13C8391:11 dH 82:SI 0102 SO 2nU
Electrical Permit Application - City of Tigard E Other
Page 2 - Supplemental Information Total number of commercial systems:
LIMITED ENERGY PERMIT FEES: *No licenses are required. Licenses are require
for all other installations
Fee for all residential systems $75.00
combined
Check Type of Work Involved:
7 Audio and Stereo Systems*
7 Burglar Alarm
E Garage Door Opener*
I: Heating, Ventilation and Air Conditioning
System*
E] V acuum Systems*
E] O ther:
Pee for each commercial $75.00
system
(SEE OAR 918-309-0000)
Check Type of Work Involved:
11 Audio and Stereo Systems
E Boiler Controls
E Clock Systems
Data Telecommunication Installation ( Lejt 43 4 -So-
• Fire Alarm Installation
LJ HVAC
71 Instrumentation
7 Intercom and Paging Systems
• Landscape Irrigation Control*
Li Medical
El Nurse Calls
11 Outdoor Landscape Li
7 Protective Signaling
i as \ AELC-Pet ml tArp.doo D7/01 /10
2d XU. 13rd3SU7 dH 82:T 0102 SO 2nu