Permit CITY OF TIGARD '.<f" ELECTRICAL PERMIT
•
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00694
• Date Issued: 12/16/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439^
Parcel: 151260000300
Jurisdiction: TIGARD
Site address: 9530 SW WASHINGTON SQUARE RD H10
Project: Apple Store Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project Description: (1) feeder and (6) branch circuits. 1/27/11, reprinted to add (2) additional branch circuits and low voltage for fire
alarm.
Contractor: FRAHLER ELECTRIC CO Owner: PPR WASHINGTON SQUARE LLC
11860 SW GREENBURG RD 2235 FARADAY AVE STE #0
TIGARD, OR 97223 CARLSBAD, CA 92008
PHONE: 503 - 639 -4627 PHONE:
FAX: 503 - 639 -4673
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 12/16/2010 $100.70
Specifics: amps or less
6 crt Branch Circuits w /Purchase 12/16/2010 $44.52
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 12/16/2010 $17.43
Electrical
Type of Const: 2 crt Branch Circuits w /Purchase 01/27/2011 $14.84
Occupancy Grp: Service or Feeder
1 ea Signal circuit or Limited 01/27/2011 $75.00
Energy Panel
0 ea 12% State Surcharge - 01/27/2011 $10.78
Electrical
Total $263.27
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 cordance wi - pproved 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. AT ENTION: Oregon I- re• you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001- 010 through OAR 952 -00 :590. Yo y obtain a copy of the rules or direct questions to OUNC by cal _ "1987 or 1.800.332.2344 .
Issued — �T �` Permittee Signat • / .t
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.
CITY OF TIGARD ELECTRICAL PERMIT
r - COMMUNITY DEVELOPMENT Permit #: ELC2010 -00694
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/16/2010
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9530 SW WASHINGTON SQUARE RD H10
Project: Apple Store Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project Description: (1) feeder and (6) branch circuits.
Contractor: FRAHLER ELECTRIC CO Owner: PPR WASHINGTON SQUARE LLC
11860 SW GREENBURG RD 2235 FARADAY AVE STE #O
TIGARD, OR 97223 CARLSBAD, CA 92008
PHONE: 503 - 639 -4627 PHONE.
FAX: 503 - 639 -4673
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 12/16/2010 $100.70
Specifics: amps or less
6 crt Branch Circuits w /Purchase 12/16/2010 $44.52
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - , 12/16/2010 $17.43
Electrical
Type of Const:
Occupancy Grp:
Total $162.65
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 t i Frer•irect questions to OUNC by calling 503 .1987 or 1.800.332.2344.
Issued By: Permittee Signature: f .
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.
_ - RECEIVEy . ___ , . . . .
Electrical Permit Application • FOR oFf ICE USt✓ ON •
City of Tigard JA 2 E ry ?f 1qq 1 Received �
Date /B : /�� - e 1 - :: C201'0 =00694
a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.( OF TIGA� Date /B : Other Permit:
TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready /By: Juris: RI See Page 2 for
. • . Internet: www.tigard- or.gov Notified /Method: Supplemental Information
PLAN REVIEW , ,
�"' �" � i ,M v k, xTYP OF WORK � s o z s� ,�� 1 <
❑ New construction ® 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.
exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
' , 4 ..,, ,,i CATEGORY r OF 'CONSTRUCTION :. ' ' '. _ P g
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling /1 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.
..
z -X 7 ;, JOB STTE rINFORMATION tliOC . El Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", • Job no.: 68093 Job site address: 9530 SW WASHINGTON SQUARE RD IOOHP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
. City /State /ZIP: TIGARD, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: APPLE BREAKROOM ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: `s^ 1,,FEE SCHEDULE ,' s.; y
J Description I Qty I Fee. I Total
New residential single- or multi - family dwelling unit.
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
- , . ± ,' { r''Sr� ` t :DESCRIPTION,OF - WORK'' .,, _5 (with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
PROVIDE WIRING FOR FIRE ALARM SYSTEM residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
ADD TO PERMIT #ELC2010 - 00694 200 amps or less 100.70 2
1 ®PROPERTY OWNER 4 u Y TEN ANT 201 a to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: •
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
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
N
- PPI ICATy ti above service or feeder fee,
.i: . ,. A , .._ .. _ " z . :. ® ' ON. 7.42 2
each branch circuit
Business name: . B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: branch circuit
Each add'I branch circuit 2 7.42 14.84 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City /State /ZIP: dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E
Sign or outline lighting 67.84 2
g
n ),i k . „ . ;; ? AM„,;:,, CON ?x. >; ; ,;. .. Si circuit(s) or limited- energy
1
Business name: FRAHLER ELECTRIC COMPANY panel, alteration, or extension. Page 2 75.00 2
Each additional inspection over allowable in any of the above
Address: 11860 SW GREENBURG ROAD Additional inspection (1 hr min) 66.25/ hr
City /State /ZIP: TIGARD, OR 97223 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 639 - 4627 Fax: (503) 639 - 4673 Inspections for which no fee is 90.00 / hr
specifically listed (%I hr min)
CCB Lic.: 37410 Electrical Lic.: 34 -13C Suprv. Lic.: 5110S . TELECTRICALrPERMITAFEES =
Suprv. Electrician signature, required: "40e ° 1087_ A o Subtotal: 89.84
Plan review (25% of permit fee):
Print name: ADAM ETHERINGTON Date: 01/26/11 State surcharge (12% of permit fee): 10.78
TOTAL PERMIT FEE: 100.62
Authorized signature: This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
Number of inspections allowed per permit.
I:\Building\Permits\ELC - PermitApp.doc 07/01/10 440.4615T( 1 1/05 /COM/WEB
•
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Rec eived DateBy: ;, /fr .11 Permit ^ UI
. �G--Uj r 1 19
q
13125 SW Hall Blvd., Tigard, OR °ire •-
CR4 Plan Review
;` Phone: 503.718.2439 Fax: 503.5':. `6pa D ate /B : Other Permit:
TIGARD Inspection Line: 503.639.4175 1 6 2010 Date Ready /By: luris: 0 See Page 2 for
Internet: www.tigard - or.gov EC A Notified /Method:
D �� % �p Supplemental Information
- TYPE OF WO KN f�k �n1mPLAN-REViEW
❑ New construction El Addition /alterati tlAn1 t ')'— Please check all that apply (submit 2 sets of plans w /items checked below):
El Demolition ❑Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories.
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
JOB SITE INFORMATION AND :LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ",
Job no.: 68093 Job site address: 9530 SW WASHINGTON SQUARE RD 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: TIGARD, OR ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: APPLE BREAK ROOM ❑ Service or feeder 600 amps or snore.
FEE SCHEDULE
Cross street /directions to job site: Description 1 Qty. 1 Fee. 1 Total
— New residential single- or multi - family dwelling unit.
_. _ _- _-- - -- --- Includes .attached_earane. -
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
• Ea. add' 1 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION: OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi- family 75.00 2
ADD (5) LIGHTS AND (12) RECEPTACLES FOR BREAK ROOM residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
ADD FEEDER AD D SUB - PANEL 7 r ��I r - f 10 200 amps or less 1 100.70 100.70 2
❑ ,PROPERTY 'OWNER - °❑ - TENA 201 amps to 400 amps '133.56 2
' . 401 amps to 600 amps 200.34 2
Name:
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
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 blanch circuits with
.0 APPLICANT 0 CONTACT PERSON above service or feeder fee, 6 7 42 44.52 2
each branch circuit
Business name: B. Fee for branch circuits without
• service or feeder fee, first 56.18 2
Contact name: branch circui
Each add'l branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Cite /Stare /ZIP: _ Each manufactured.or modular 67.84 - 2
dwelling, service and /or feeder
Phone: ( ) Fax:: ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: • Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited - energy
Business name: FRAHLER ELECTRIC COMPANY panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
.Address: 11860 SW GREENBURG ROAD Additional inspection (I hr min) 66.25/ hr
City/State /ZIP: TIGARD, OR 97223 investigation (1 hr min) 66.25/ hr
industrial plant (1 hr min) 78.18/ hr
Phone: (503) 639 - 4627 Fax: (503) 639 - 4673 Inspections for which no fee is 90.00 / hr
specifically listed ('A hr min)
CCB Lic.: 37410 Electrical Lic.: 34 -13C Suprv. Lic.: 1816S ELECTRICAL PERMIT FEES -
g �i j l _ o Subtotal: 145.22
Suprv. rv. Electrician signature, re ed: a ViG'..S�
Plan review (25% of permit fee):
Print name: R. W. FRAHLER Date: 12/15/10 State surcharge (12% of permit fee): 17.43
TOTAL PERMIT FEE: 162.65
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: * Number of inspections allowed per permit. .
I:\Building \Permits \ELC- PermitApp,doc 07/01/10 440 -461 ST(1 I /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
=',:fOiStOONTM*OititiONLYOK:ir:P:',*§Ma
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*
n Vacuum Systems*
Other:
COM : IAL{WORK :0$1[X61 ` „
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*
n 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.doc 07/01/10