Permit CITY OF TIGARD ELECTRICAL PERMIT
,
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00541
TtGARD 13125 SW Hall Blvd., Tigard OR 97223 503 718.2439 Date Issued: 09/30/2011
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9585 SW WASHINGTON SQUARE RD Y06
Project: Auntie Anne's Subdivision: Lot:
Project Description: Kiosk.
Contractor: FRAHLER ELECTRIC CO Owner: PPR WASHINGTON SQUARE LLC
11860 SW GREENBURG RD BY THOMSON PROPERTY TAX SERVICES
TIGARD, OR 97223 ATTN HILARY RAYMOND
2235 FARADY AVE, STE 0
CARLSBAD, CA 92008
PHONE 503 - 639 -4627 PHONE
FAX: 503 - 639 -4673
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 09/30/2011 $100.70
Specifics: amps or less
3 crt Branch Circuits w /Purchase 09/30/2011 $22 26
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea Signal circuit or Limited 09/30/2011 $75 00
Energy Panel
Type of Const: 1 ea 12% State Surcharge - 09/30/2011 $23.76
Occupancy Grp: Electrical
Total $221 72
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All work will
be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days ATTENTION' Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952 - 001 -0010 through OAR 952- 001 -0090 You ma o n a coo .f the rules or direct questions to OUNC by calling 503 232 1987 or 1 800 332 244.
1
Issued By: r �
� Permittee Signature:
� OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Application NACC5) , . . . .
FOR 'OFFi(OE USE ONLY
City of Tigard Received t
r� DateBy• / Z/ il.Ar Permit No •F LC dI? `a s
- 13125 5 g SW Hall Blvd., Tigard, O' ,yy,
e1 .t
1 LO \ Plan Review
r' `" 1'` Phone 503 718 2439 Fax: 503 `'....,e. O Date /By Other Permit
Inspection Line 503 639.4175 J Date Rea /By buns
,T,IGARD C Q Q Y H See Page 2 for
. - Internet. wwwtigard or.gov S � \J \l S ' Notif / Method
� Supplemental Information
`,. »; �;',._ ;ring µ r„ .,�_ - - te } , - .,;�_:,`,�, -;`:> w * a"rX` =v, �r.::`..:,,.,
.. �.,:� :, >< . ,. „� . , . >- �•� . Wit: ; „�: >wPlr �., -�._
- ;,�<a,,, ; _ ...< �,• -: ,., -.h�. >.: � " �,, <�. *S;I� ,:�.���>i�,,.<... �'�.< -�; _ _ �,�,�.�r�:t�M �.��:� ;;�n��.�?��`= t$;;m:t'
El construction ® Addition /alteration / r� *fl rent 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
`aa -as' , -1 , 5 , 4, n,- _ is-, _ - - _ - R l,
.'.,x`"`- =-axe_ x' `";� - 't:�7-u ` -`,- <�:. ;,•.o,; -, -.x - __.,. *- _ - . - ' t° •�s::cs
( .4 ; 1V,t'` ` ' "w_ i704r1'*EGORY, +RT °'C AI O' r exceeds 10,000 amps 150 volts or Floating buildings
��;, � - ;i�<.,.�, : O]VSTRI7CTION., w . -r`� -�� "z�.�- ._ �.�:;z�� p ❑ b f,
...,,7 r �.<4.cmi^•C' h,. -x =- 3.,.;. . ., > „..,: a. x< >1s�.:.: - :i=C..^' °., s,'f``""..J$2F-. =`7:..,
less to ground, of exceeds 14,000 ❑ Commercial-use agrmulhnal
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations buildings
❑ Multi- family ❑ Master builder ❑ Other ❑ Fire pump ❑ installation of75 KVA or
; n i'r X $ .,=' ,V`lz- - r qn ^ -x° : x > r < ❑ Emergency system larger sepaiately derived system
- - JOB :SITE`°'][N,FO� - k „;i - f': enc t lb p Y
µ �� =� �.; °� , . €�' -' e RNiATI01\A1VD�LOCATiO
_._.�,_ _,_ v T _ >,����r mo : „ _, o. , . >s. ' xs �YZr�,i„ ❑ Addition of new motor load of ❑ -v "
"A'•
Job no.. 68827 Job site address 9585 SW WASHINGTON SQUARE RD 100HP or more occupancy
❑ Six of 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.: IOU Project name AUNTIE ANNE'S KIOSK ❑ Service of feeder 600 amps or more
< - . : __5
. z , ,._x ;FS_. `; `> = « ='
Cross street/directions to job site' Description I Qtv I Fee. ! Total
-- New residential single- or multi - family dwelling unit.
includes attached garage.
Subdivision: Lot no.: 1,000 sq ft or less 168 54 4
Tax map /parcel no.:
Ea add'l 500 sq ft. or portion 33 92 1
Limited energy, residential
{ ". ' f y �: A j-, r - _ N= tom - = ` ;. w °''t, - < '3 sx.> °'
. - , F ,t ,,,,' ° ~12sA.,t b ESGRIP,TtflN: -OF WORK` = _ s ' = '°-, (with above sq ft 75 00 2
POWER AND DATA FOR KIOSK IN FRONT OF GUEST SERVICES. Limited energy, multi family 75 00 2
INSTALL SUBPANEL FOR KIOSK residential (with above sq ft )
n Services or feeders installation, alteration, and /or relocation
V o . s k 06 , r 1 ) Services
amps or less 1 100 70 I 100 70 2
Kz ., _PJ2()P12 =IOWNI R;= .- w : " ` �E "t`" ;,,as M 207 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
1 1 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 401 amps to 599 amps 168 54 2
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: Date A Fee for branch circuits with
r,< „r �, �; _ -_ aboveserviceorfeederfee, 3 2226
*> . l 1?: - r: ; , ”; `''F at,. 7 42
ltfli K . , .a -. =,. _. -_ Z -r -, . , - ft . ^'l _ <® ` CO N,T AC T P;ERSO „_ : each branch circuit
2
> , , , �t ,� ` �.•,�.�-- � . - '�- r band lcult
Business name: B Fee for branch circuits without
service or feeder fee, first 56 18 7
Contact name: branch circuit
Each add'l branch circuit 7 42 2
Address: Miscellaneous (service or feeder not Included)
Each manufactured or modular 67 84 7
City /State /ZIP: 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
I 0 -ye7W_ rig.- ..Acti >Ce(N7RACTOR, -. _ = �:= fir,, -< A ifp �cp Signal circuit (s) or limited-energy
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 mm) 66 25/ hr
- _- _ _ . Investigation (1 hr min) 66 25/ hr
City/State /ZIP: TIGARD, OR 97223 Industrial plant (1 hr mm) 78 18/ hr
Phone: (503) 639 -4627 Fax: X03 639 -4673 Inspections for which no fee_rs_ ._ _ '
( ) specifically listed (A hr mm) 90 00/ hr
CCB Lic.: 37410 Electrical Lie. 34- - 0S 1 . x "y�` -” '- EALEGTR1C "z : ::;- = " x:F'
l3C Suprv. Lic . 511 _ ,.:�:` PER]ViIT,-hFEES�;,;, �.`.`;_• _ „
Subtotal 197 96 } -
Suprv. Electrician signature, required: dl ( -- ' Plan review (25% of pennit fee)
Print name. ADAM ETHERINGTON Date 09/29/11 State surcharge (12% of pen fee) 23.76
TOTAL PERMIT FEE 221 72
Authorized signature. This permit application expires if a permit is not obtained within 180
days after it has be •n accepted as complete.
Print name. Date ^ Number of inspections allowed per permit
1 \Buddmg\Permts\ELC- PermiApp doc 07/01/10 440- 4615T(11/05/COM/'EB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
§ibt:N:010 NOTOMEnanWaeSiM
• Fee for all residential systems combined ..... $75.00
. • "
Check Type of WO,rlanVolVed: • .
_ -
17 _Audio and Stereo Systems*
I I Burglar Alarm
fl Garage Door Opener*
•
fl Heating, Ventilation and Air Conditioning System*
Vacuum Systems*
Other:
tICQ-NWR,:g-MiWcfn iQ , MIWIWAtaA%tRIZ=1;1 4 Akalt
Fee for each commercial
$75.00
system
(SEE OAR 918-309-0000)
Check Type of Work Involved:
_ _ •
I I Audio and Stereo System's
•
fl Boiler ContrOls •
. - - - — - -
Clock Systems -
El Data Telecommunication Installation
I Fire Alarm Installation
HVAC
. _
Li Instrumentation
. .
7 Intercom and Paging Systems
Landscape Irrigation Control*
I I Medical
7 Nurse Calls
L i Outdoor Landscape Lighting*
I I Protective Signaling
I I Other
Total number of cornrnercial systems:
*No licenses are required. Licenses are required
for all other installations
I \BuddIng\Perinds\ELC-PeTrodAop doc 07/01/10