Permit ten' 4 � CITY O F TIGARD ELECTRICAL PERMIT
.9 :_ • COMMUNITY DEVELOPMENT Permit #: ELC2011 -00321
- TIGARIY 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Date Issued: 06/10/2011
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9585 SW WASHINGTON SQUARE RD 041
Project: Washington Square Mall - Food Court Kiosks Subdivision: WASHINGTON SQUARE MALL Lot:
Project Description: Install (4) branch circuits and (1) low voltage system for data to (2) kiosks located in the food court between the
escalators. •
Contractor: FRAHLER ELECTRIC CO Owner: PPR WASHINGTON SQUARE LLC
11860 SW GREENBURG RD BY THOMSON PROPERTY TAX SERVICES
TIGARD, OR 97223 ATTN HILARY RAYMOND
CARLSBAD, CA 92008
PHONE: 503 - 639 -4627 PHONE:
FAX: 503 - 639 -4673
FEES
Quantity Description Date Amount
•
4 crt Branch Circuits wo /Purchase 06/10/2011 $78'.44
Specifics: Service or Feeder
1 ea Signal circuit or Limited 06/10/2011 $75.00
Type of Use: COM Energy Panel
Class of Work: ALT 1 ea 12% State Surcharge - 06/10/2011 $18.41
Electrical
Type of Const:
Occupancy Grp:
Total $171.85
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 ough OA 952 -0 ��00 You may obtain a copy of the rules or dire it questions to OUNC by calling 4 3.232.1987 or 1.800 332.2344.
Issued By: • — - 4e / Permittee Signature • r ,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.
. Electrical Permit Application p e p wry ` , y = p g �6 tI oR oFFICE`USEoNLl
City of Tigard Received, ,
y �j� . � ' �,. P No.: Eie: '7.. 0 3 n 1
° 13125 SW' Hall Blvd., Tigard, OR 97223 Plaii.Revtew
Date/By:
Phone: 503.639.4171 Fax: 503.598.1960 JUN 24��' Other Permit:
Inspection Line: 501639.4175 Date Ready /By`. • qu-is: . ® .See Pa a 2`foi•
TIGARP;
S'„
' ,a Internet: www.tigard-or.gov . pplenieiital;Informatiog ,
CITY OF TIGRD
Notified /Method: Su
xz
a., :,.;r�'- .��:., .,.. ., .,�fi4,.P a. :�. ..,i ;,.,..; , .. � ,: . -`"- ; .a .- r,�, ° ��t,,;� y ; .�- ,:�,. `:d; ? °;a: k:�nc:•. G._a�.;' -�:.'s -•bra- �=.: '�; ��,, ..
;aaY ..ti„?.:,x -.-, .;. q. -,*r. :.- t. Ct ;V�� 19.11 an; g ^ t,, `z ,` ."t ,,,w,+
�;:�.. ��.t,.�.. A - :,;�•� _ ,TxYPEw�OR "TWO 'l�i���lll � = ,��: _���. .�:�...,• �,.�.),5 ,. :N?�" r, >.� �'�sr�,; >t,,r� ., ,�- .�� P�I7A RE ..'� '. € °^� �;,-,
- ,E'New, construction RAddition /alteration /replacement .. s: , . '' ` -. -- �. ' Please ch`eck a11{tliatlapply ( submit 2 sets,of,plans,w /items checked below).
Demolition - ❑ Service onfeeder 400amp or more .
• s ['Building ov er, three stones.
❑' Other: - where'the available fault'current ._., ❑ Marinas and boatyards:
is 'S` M'l:RM, - t : ' ' a e : Xik , : >. l- �v d
excees100 0, ' buildin
t n , - `' ` *54-4,�a�4" CA'TEGORY.OF� CONSTRUCTION ->+ .'' .. a .-4-"-41-'4'-'-'-'7' , _ _ 0 amps ed ,1 volts ` ' ❑ Floating g
' less to ground,�or exce 14:000 ❑ ❑ Commere {al- u`se'agriculntral!
l - and, 2- family dwelling si Commercial /industrial ❑ Accessory. building ' - ampstfor all other installations. - buildings. - - ''
0' Multi= family` " 0 Master'builder ❑ ^ ' ❑Fire pump. . _ ❑Installationof 75 KVA or
=it .1 •?sa,� � �. - - - - - - - - -- - - -- .- . r�s ❑Emer enc ' stem. .jar erne aratel ,deriveii�s stem "'
,3it ..,3P g- Y Y g P Y y -
� t- .t , JOBITE- sINF � � "� ='
f�..- ..`.�`..r,. _ �.,.,�;; � � : S ORIVIATION, "AND`�`IOCATION`� •�;�.:,�.,,;,,,{?,,
�,aa .,, - - I4_,.h .,r:b _,.� �'. *' -i.< >;.nav- r .:,�:,? ❑ Ad d ition of newmotor.Ioad ❑ "A'',-"E",..`" 1_Z„ . 3 „
Job•no.: Job site address: / .100HP or,more. occupancy.
'eD ►�� � ✓�a ✓ �✓ �L -,,, 1 ` ! jf '' ❑;Six ormor "eresidentialunits 0 Recreational vehicle arks.
City /State /ZIP:, 3 ` . rJ O He care , _ ❑ Supply voltage for more than - '
I volt il
s.nomna.
� r cot,* ❑Hazardous locations,
600
Suite /bldg /apt. nu.: Project name: r'I , rJ 5 . . t ❑_Service or feeder 600 amps or more.. -
F� '" 'u NIVE E�'„SC
',FEHEDUIE`" - k :
.'.
• Cross street/directions to job site: Description _ _ _ _ qtv. I F ee. -I 1 Total i_t,
• New residential single- or multi - family dwelling unit.
Includes attached garage.
• Subdivision: • Lot no.: 1;000 sq: ft. orless . • 168,; 4
' Ea. add'l 500,sq. ft or portion 33•.92 ' 1
• Tax,map /parcel no:: _
may Limited energy;,residentiat 75.00`.
3 a at a a. r n 2!.
i , -_ .. ,mow e- : 6 c- ' '+ , ... DESCRIP'i'I6N 0F( :41/i s aitit . ° - ,.. • - (with abov sq ft.)
L energy,.multi'- family 75:00 2,;
PrliY71. __A) ■ U G� 0 . iT 4...* .4 residential(with abovesq: ft:)
/ ` 1 Servicesdr feeders' installation, alteration, and /or-, relocation.
C2) �.0. 1 l pGs�t:Gns r g, �1 2; Q ( d: _� p�" j 4 ,4- '..92,,,A e...,,i- 200 amps or less. ' 100:70 •2
. . l ..e ® .PRO P RTY ,, 0° t s 4 s n a - . 201 a s i 4
#� � '�2_,_._ . E° a OWNER - � �; a Q t , ®�;�'I'ENANT - - � � n � � _ mp a 00 amps, _ 13356 2
401 amps to 6 amps, .. ' 200 2
. • , ;'.`Name: - .
601 amps to 1,000 amps, - : . , , ', , 301.04 : • 2
1 , Ad'lress: • Over 1,000 amps or. volts - _, ' 552.26' ' 2
Temporary services or feeders installation`,alteration, and /or
., •i • /State /ZIP: relocation "``` `�
^Rhone:( ); Fax: ( ) 200 _ - 59.3 1 1
t 201 amps "to 400 amps 1 2
:O.wner installation : 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 eztension,.per panel
Owner signature Date A. Fee for branch circuits with
t° " t �'n , n*a� 'ryr; t �.,4 a f ` ^ 0 ` Pr RS 9 `' above service or feeder fee., I • 7 42-
_ _...x_a, n Y - - .-_.. . .. .. �,^ , -. . . _... _ .. „ , . _ . - . each branch circuit 2 -
Busines s name: B. Fee forbranch circuits without
service or feeder fee, first 1' 56.18 / 2
Contact nam_ e_ : branch circuit ✓�'l`$
Each add'i branch circuit 3 7.42 Z2 ,' 2
Address:_ Miscellaneous (service•or feeder not included)
Each manufactured or modular•
C ity /State /ZIP: • . . - 67.84 - - 2
dwelling„service fee
Phone: ( ) Fax: : ( ) ReconnedtOnly, „, 67.84. 2
Pump or' irrigation circle - 67.84 2
Email: Sign 2 ,
or -out me lighting - 167:84
. r..- >�, _ n: COIVTRAGT R ;.. rv;,�. „' ;s. " �: °,
., _> a .t =_ ->. t r - •;... Si cucuit(s) o r limit - energy ,
Business name et4 W 1 / C - panel - alteration,. - or extension. age 2 i 2
�� Each additionalinspection over allowable in:any'of the'above
Address: 51 Additional inspection (1 hr.min) 66'25/ hr, .
���,f ����� Investigation (1 hr min)' 66.25/.hr
. ' City/ ,6 State /ZIP: . 1 1 p . I : 4 - 1' Industrial plant (1 hr min) 78.18/ hr -
Phone: 6)3 ) L/ Fa ( 3) 1 3e . qe - Z Inspections for which no fee is 90.00 / hr
LiC.: Elect Lic.: r cev ( J / T(t7 �/ specifically listed (' // hr mm)
CGB
1174 �3C� Suprv. Lic.: 57 (05 __.. -c.: _ ELECTRICAL" PERMI•T'=F,EES' ra. '; ,,
Suprv. Electrician signature, required: AL �j Subtotal: � 3
�""° c� Plan review (25 %,of permit fee): ,
' .Print name:. Date: /(/ — — State surcharge (12% of permit fee)
Authorized signature:
� � r) TOTAL PE FEE: 11 $c
T his perm applicat 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- PemitApp.doc 07/01/10. 440- 4615T(11/05 /COM/WEB
•
Electrical Application .; City of Tigard • - •
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES: •
RESIDENTIAl. WORK ONLY
. .
• • "" • —'"
- Fee for: $75 00
Check iWork:ItiVoived:
. _
.Audio 'and Stereo SyStems* •
0 Burglar Alarm '
Garage Door Opener*
7 Heating, Ventilation and Air Conditioning System*
• 0 Vacuum Systems* , . •
. ,
0 Other:
•
Fee for each commercial $75.00
system
. (SEE OAR 918-309-0000)
Check Type of Involved:
7 Audio atid-S.teteo Systems
7 Boiler Controls
0 Clock Systems
7 Data Telecommunication Installation
7 Fire Alarm Installation
HVAC
Instrumentation
Intercom.and Paging Systems
Landscape-Irrigation.Control*
•
0, Medical - - .
Nurse,Calls
•
0 Outdoor Landscape Lighting* •
7 Protective Signaling • •
Li Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for- all other installations
1:■Building \Permits \ELC-PermitApp.doc 07/01/10 •
•