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Permit LA :11 . ://Apt ✓L , / r��-„ /.%\/6 7 i� 41 CITY OF TIGARD ELECTRICAL PERMIT ` g COMMUNITY DEVELOPMENT Permit #: ELC2010 -00698 TIG ARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/17/2010 Parcel: 1S1260000300 Jurisdiction: TIGARD Site address: 9718 SW WASHINGTON SQUARE RD F05 Project: CATHY JEAN Subdivision: WASHINGTON SQUARE MALL Lot: 0 Project Description: Electrical for TI. 1/21/11, Reprinted permit to include (2) low voltage systems: audio and data telecommunications. Contractor: JC ELECTRIC INC Owner: PPR WASHINGTON SQUARE LLC 118 NW 184TH STREET 2235 FARADAY AVE STE #0 RIDGEFIELD, WA 98647 CARLSBAD, CA 92008 PHONE: 360 - 887 -7889 PHONE: FAX: 360- 887 -5584 FEES Quantity Description Date Amount 18 crt Branch Circuits wo /Purchase 12/17/2010 $182.32 Specifics: Service or Feeder 1 ea 12% State Surcharge - 12/17/2010 $21.88 Type of Use: COM Electrical Class of Work: ALT 2 ea Signal circuit or Limited 01/21/2011 $150.00 Energy Panel Type of Const: 18 12% State Surcharge - 01/21/2011 $18.00 Occupancy Grp: Electrical Total $372.20 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 OA: •52 -001 -0090, You may obtain a copy of the rules • - • • - .tions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued ByL I ®� Perm ittee Signature: t zv ALr / � / may( 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 I' - 1 COMMUNITY DEVELOPMENT Permit #: ELC2010 -00698 ITIGA D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/17/2010 I Parcel: 1S1260000300 Jurisdiction: TIGARD Site address: 9718 SW WASHINGTON SQUARE RD F05 Project: CATHY JEAN Subdivision: WASHINGTON SQUARE MALL Lot: 0 Project Description: Electrical for TI. Contractor: JC ELECTRIC INC Owner: PPR WASHINGTON SQUARE LLC 118 NW 184TH STREET 2235 FARADAY AVE STE #O RIDGEFIELD, WA 98647 CARLSBAD, CA 92008 PHONE: 360- 887 -7889 PHONE: FAX: 360 - 887 -5584 FEES Quantity Description Date Amount 18 crt Branch Circuits wo /Purchase 12/17/2010 $182.32 Specifics: Service or Feeder 1 ea 12% State Surcharge - 12/17/2010 $21.88 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $204.20 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 throe•. ' ' 952- 001 -0090. Yo may obtain a co. of • - es o direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. o Issued B :dm/ Permittee Signature: . — % � �:� �— �/i 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. 01/21/2011 08:47 3608875584 J.C. ELECTRIC, INC. PAGE 02/03 Electrical Permit Applicatio 1 4,,b To FOR OFFICE USE clnl.1 w City of Tigard 2.0v) o1b . 11 ,'I _, PenultNo.: i. 7....a t 0_ ct y r 13125 SW Hall Blvd., '1 OR 9 23 rlan Review 14 ' Phone: 503.7) 8.2439 Fax: 503.598. 60 Q Goal I i a[e(By: Other Permit: TIG Inspection Line: 503,639.4175 ___ Date ReadyBy: Julie: ® Sec Page 2 for Internet; www.tigard or.gov Notified/Method: p SupplementalIoformation ;j I 'il',' {�;` "� 'I ;1 " �1 l 8 '` i ` � E tli 11111111111117N. t. �. ) , . , i , ,E ! ., , , "I . _ t#1 S 4 inF , E k 1 _ } �f I a � , -t 4 .t . i. , . II � ; ' il! El New construction ©Addition/alteration /replaeemdi l 1 1t : Please check all that apply (submit 2 sets of p w /items checked below): L,. ' 7 "a l7 Service or feeder 400 am s or more ❑ Buildin eri over three ates. ❑ Demolition ❑ Other: ,�� t Q P. 4� ' -, where the available fault cement ❑ Marinas and boatyards. i i % 9 fIi(ut ,ar P { l ' i i � �. [ � > a' p exceeds 10,000 amps ar 15 v olts or ❑ Floating buildings. I .. ,� .,t. i i(, ; I , ,i ill I # n�l ( ' , A i1 I" r it P g g hRl 1i1 ?l i, T , IA{ rtA t k . �a n Q tl, less to ground, or exceeds 14,000 ❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Acces-O .utid`m �° ❑ bu ldin cial -use agricultural g amps for all other installations. buildings, © Multi ❑ Master builder ❑ Othe}`, / nE Tlfa L• n 0 Fire pump. ❑ Installation of 75 KVA or d ti ! ! l t ( d t I t t gyp{ a e n � Mi 0 Emergency system. larger separately derived system, ilia!! i i�f I if 1! 1l,l11 €ij! try , , ,_ . ppj do tin, drip t u t 1. t nt f! ,111t } �fit t Gi�� I ■ igf II f�� ll iii "�}jJp i ❑ A/1di6bn of nrnv motor load of Job no.: 2010123 Job site address: 9718 SW WASHINt 1 SQUARE RD 100HP or more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle pence. City /State /ZIP: TIGARD OR 97223 ❑ Health - care facilities. ❑ Supply voltage for more than El Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: F05 Project name: CATHY JEAN ['Service or feeder 600 sos s or more To Cross street/directions to job site: WASHINGTON SQUARE MALL 1 �� � A :' A li d�H a sl ,t a �i 'H lg I Total i; {��� {�'•'g' pan { Ob Fee. tl . 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'l 500 sq. ft or portion 33.92 1 • Tax map /parcel no.: s" ' 'ii r rnan * u>ur s al �,, i �, III ( pp p �irnited energy, residential 75.00 2 l€ ll { 9 [t, 'l1Et� l it i "i El { °m �' TE ;rl II I' ii,[( ( with above sq. ft) Limited energy, multi - family 75.00 2 ADD (2) COMMERCIAL SYSTEMS TO EXISTING PERMIT ELC2010 -00698 residential (with above sq. ft,) Services or feeders installation, alteration, and/or relocation [1 AUDIO & STEREO AND 1 DATA TELECOMM INSTALL) 200 amps or less 100.70 2 � liii' }I } tliti! l fi "���,,,�c, , q� €l i . fti 9 i . i i• f ii iii i 1 II � ) , r Pill y I .611 "l; . is �s, i i iii /il 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 /o City /State /ZJP; r 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 401 amps to 399 amps 168.54 • 2 intended for sale lease, rent, or exchange, according to ORS 447, 449, 670, and 701. firanch circuits - new, alteration, or extension, per panel Owner signature: _ Date: A. Fee for branch circuits with f ; {{ 't' t i' I IIII,` lr tt' l n ' �I , € € € ' [ �j •�ir {`1 i • m , +1 P am t sl gnla p il ahgva service of i eder fee. 7,42 2 . li f I t k ill #, ` ut1 ll�inel:i, f �;f 1 !LI� %�i {!' {IIEI d{� itntltiit)ttR�ti) each branch circuit Business name: 1 B. Fee for branch circuits wit qu` - - - service or feeder fee, first 56.18 2 Contact name: branch circuit -^- �- - Each add'l branch circuit 7.42 2J Address: Miscellaneous (service or feeder not included) _ Each manufactured or modular City /State /ZIP: dwelling, service and/or feeder 67.84 2 R econnect only 67.84 2 Pllolle: ( ) Fax: : ( ) ^--- m Pump or irrigation circle 67.84 2 E -mail: !Ili1li l lifi = +fl�ili`:ll:! :11!!f!I!f !!TN 11111 {!I ! l ' t � 9' n i t i u :� I I1 : ( IF i !! Itlsl {€!(l p� p tj{ � )j p q}jfq � Sign or outline lighting 67.84 2 ilil,i;nl, Gm., ligi � 1 ! I'.! 1tr, " siilltm n IF 1 I; 11111.'Ytl'llltlf5'I Signal eircuit(s)or energy Business name: JC ELECTRIC, INC. panel, alteration, or extension. 2 Page 2 150 2 Each additional infection over allowable in any of the abov Address: 118 NW 184 ST Additional inspection (1 hr min) 66.25/ hr Investigation (1 hr min) 66.25/ hr City/State/ZIP: FtIDGEFIELD WA 98642 �• Industrial plant (1 hr min) 78.18/ hr Phone: (360) 887.7889 Fax: (360) 887.5584 Inspections for which no fee is 90.00 / hr ^^ - s . ificall listed Ys hr min CCB Lic.: 118452 Electrical Lie.: 37 - 724C Suprv. Lic.; 4289$ inli111fM1RliEllfllll ; t r' " ' j i •a 1,1, %s.:i.1 jI 'i / Suprv. Electrician signature, required: Subtotal: 150.00 • � . - . _Al _ _ Plan review (25% of permit fee): Print name: JON COULIMORE Date: 1/21. /1l State surcharge (12% of perrnit fee): 18,00 TOTAL PERMIT FEE: 168,00 Authorized Signature: T This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name. t Date: Number of inspections allowed per penult. • l'Illuitdir "Permite\Er.C- PetalitApp.doc 07/01/10 440- 4615T(11ro5 /coMlwaa 12/17/2010 08:58 3608875584 J.C. ELECTRIC, INC. PAGE 01/02 Electrical Perrnit Application FOR ilf `t iCE usr oNLI City of Tigard °� Received I It pate/$ : / Fitt Permit No.: —etc (y t?0fPl_ • 13125 SW Hall Idlvd., Tigard, OR 97223 Plan Review ®` - Phone: 503,718.2439 Fax: 503,598.1960 � 010 Date/By: Other Permit: ' 0,4109-6) /d — T '1' 1 t� A F.1? Inspcctiom Line: 503.639 • 1 Date Ready/By: Jlitis; See Page 2 for !� Internet: www.tigard- or.gov O , e ! otified/IVlethod: # f Su/ t tewental Information i 1 ' , +� 1 di !t - 1 't t t r ! atQit I 1 v !! u l i �#ttll' " toil i r i Il j i1:! ,t�eq�p ! i + ,l # ji, A : l i# ,1 lull i i � iffEM tt # 1 ;� RSOlieitEig IMEENNINEN n �l .IH 1,,, ri + i�IMI ; . Y New construction ❑ Addition/alte]ation/rt p p � g � Please check all that apply (submit a sets of plans w /items checked below): �L✓" ❑ Servicr of teedmt 400 ampa or more ❑ Building overtures stories, ❑ DCmolition ❑Other: where Ti available fault current ❑ Marinas and boatyards, 'HIP : ja i; + + } t furl p ep �tm' lmAmn n �t , t tl + 'lt [ f (�{ ( j!l ! ( [ j�{f exc 10,000 amps 150 volts or Cl Floating buildings. 1 I+ 1 I! i ` ++ , I + 1 ' i , ut!' ' tE lm O 0 a I, A t iii { 1111 I ilni a il fUfMO �'.� ;1= f 1 N1ML - exce P S g 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. 0 Multi -family ❑ Master builder 0 Other: 0 Fire pump. ❑ installation of 75 KVA or t + iG nt n { �al latWl:.. ?n t] t t s I ❑ merB�icy system, larger separately deriv d system. 1 illi (' } t I d , rTttlYWttla : R r'` t ff�'ltF i j� j (E k# jE t 1 rl t 11 1 I I � lit It + : hi S t A al 11:t �u , 71 1/ I11ti1ll ltl� �1h41' IH34t _ 6 ❑Addition oRx e., motor load of CI - A", Er <`t 2 ", `<3-3' . Job site address' 1001 or more. occupancy. Job no.: 1(31 kt mW " aril txc - � . t"11 ❑ Six or more residential traits. ❑ Recreational vehicle parks. City/State/ZIP: '� r v,t� V Flealtb� are facilities. 0 Supply voltage for more than fc— Q Hazardous locations. 600 volts nominal. Suite/bldg./apt. nu.; vco t Project name: r -m■i , t.esik ❑ Service or feeder 600 ant s or more. 111E1111111 11' 1111111 #'i11.31 t« 11013 ?', €`111111 I 1 Cross street/directions to job site: De,cri ortou 1117201 r« . rata p New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision; Lot no,: 1,000 sq. 8. or less 168.54 Ea. add'l 500 sq. ft. or portion 3392 Tax map/parcel s j � 1 t10.= }� . Limited energy, residential wi s . f� 1if911i;iii 1 nri n e� 'rclp Glut r iiifi' ` 1 �1� $ . hill with above s r , ft. 1.11 75.00 _® Limited energy, multi -famib / 75.00 2 w e420--- residential (with above so. ft.) Services or feeders installation, alteration and /or relocation ]( 1 { ` ]pp 200 amps or Tess 100.70 , a #E li ',; `= IIrM � tls m 1 �h�k �t �e l n'n ti ' f i [ l 1111''' E i E 11 "',1 A ll �` m 131i11 + j # 9I' 111Ei n 201 amps to 400 amps 133,56 1 401 amps to_600 amps 200. Name: 601 amps to 1,000 amps 30 1.04 si Address: Over 1,000 amps or volts El 552.26 13 City/State/ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 . ili 201 amps to 400 amps 125.08 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 El intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new, alteration, or extension, per panel Owner signature: _ A. Fee for branch circuits with T # : , K f 11 l girrr }1 0 Q above scrvioo or feeder fee, 7.42 2 4 i U; 1 i 1 1E � halal 17 t1I,'nifil . �' 1111 3 ililELE ii #t+i E i lill i Ei Me m ata + a ilia each branch circuit Business name: B. Pee for branch fir ,, oils without service or feeder fee, :first 56.18 Sb.1 Contact name: branch circuit • Each add'1 branch circuit FEN 7. 42 ' -1. , 2 Address: Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular ill 67,84 il dwellin • service and/or feeder _ Phone: ( ) pax:: ( ) Reconnect only 1.111 67.84. 2 Pump or irrigation circle Ill 67.84 ' ii E Sign or outline lighting 67.84 II f+ # f 1r .p i ! i I tire. t1 ', '1 ; i 1 Signal ) a� k 1��� ! �,�E�j lt��.it.,s.�1 #f{;�i, ��u�� r +l� ��� 1 ! ' { . Si al circuit(s or limited-energy II Business name: ,noel alteration or extension. II Pa: e2 C. A P(.`T2•� rho_ ,., Each additional ins I ection over allowable in an of the above Additional inspection (1 hr min) - 66.25/ hr CirylStatc/ZIP: • t , - Investigation (1 he min) IN 66.25/ hr ■ �� o � l Industrial plant (1 hr min) • 78,18/ hr �■ Phone: () C` • � l' ax: () Inspections for which no fee is 90.00/ hr . s ifreall listed (i' lir min CCB Lic.: Super '. a� 5 BROMM i ! x� .1 ?. r ; #! 1 iilG' +Gil` f� #� i i;'' ''( Suprv. Electrician signature, required: 0r+� r.�•r (25% Su fee) , �.— _ Plan review of permit fee): l'.-. �,�/ �, ;- - -: State surcharge (12% of permit ft c); �II i' , 0 0 Print name: 4, t it , 1- -').,A b✓ 18 �. 4Y TOTAL PERMIT FEE: ., .. Authorized signature: �,� � This permit application expires ifs permit is not o • ined within 180 days after It has been accepted as complete. Print name: • ' -•.+ Cca.11.1 Date: V)71 , '4 , • Number of inspections allowed per permit. 1: \Building'Pwmit,' LC- t'�ro4tApp.doc 07/01/10 440- 4615T(11 /05/COr�I/tT'.EB 01/21/2011 08:47 3608875584 J. C. ELECTRIC, INC. PAGE 03/03 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: I r t '1r sn'S ' 1 111 '11 '� , ,I� {1 � () , ip t {{ . � �I I� 1S,.`i:. IP+�.ml alt . i I . P s F�� f , � i Fee for 1al residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* n Burglar Alarm ❑ Garage Door Opener's ❑ Heating, Ventilation and Air Conditioning System* • 7 Vacuum Systems* Other: 'i' a u4P � r ; „1,, � , 11 {i 1 � i , ? }t ap i;sn11 w s ,me. m n5c d' nlnti w �'za� � ' 111 F � '1�.1;1,�11�1�i,���u €IlII6i,i Fee for _east commercial $75.00 system (SEE OAR 918 -309 -0000) Check Type of Work Involved: 0 Audio and Stereo Systems Boiler Controls ❑ Clock Systems ® Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC I Instrumentation ❑ Intercom and Paging Systems ❑ L andscape Irrigation Control* n M edical fl N urse Calls n Outdoor Landscape Lighting* n Protective Signaling n Other Total number of commercial systei 2 *No licenses are required. Licenses are required for all other installations 1:\ Eui ldingermit; \tLC- PermitApp.00c 07/01110