Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00558
Date Issued: 10/07/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 718 2439 Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9585 SW WASHINGTON SQUARE RD OFFICE
Project: Washington Square - Summit Food Court Subdivision:VASHINGTON SQUARE ESTATES NO Lot: 108
Project Description: Located in Summit Food Court - Add power and data floor boxes.
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
3 crt Branch Circuits wo /Purchase 10/07/2011 $71.02
Specifics: Service or Feeder
1 ea Signal circuit or Limited 10/07/2011 $75.00
Type of Use: COM Energy Panel
Class of Work: ALT 1 ea 12% State Surcharge - 10/07/2011 $17.52
Electrical
Type of Const:
Occupancy Grp:
Total $163 54
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 a - • • - law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952- 001 -0010 t .ugh OAR 952 -0.1 -' •0 u may obtain a copy of the rules or direct questions to OUNC by callin . 1987 or 1 800 332 2344
Issued By. At -41L- 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' 1.» ; ec j —,_ 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 .. FOR OFFICE USE ONLY
City of Tigard Received O
Date /By / � l/ i / 11 11. . Penult No et Aiii -ili 5
13125 SW Hall Blvd , Tigard, OR ! 2 ='
Plan Review
Phone' 503.718 2439 Fax 503. a ft % ii 1 Date /By Other Penult
TIGARD Inspection Line 503 639.4175 11 Date Ready /By tuns lid See Page 2 for
Internet: www tigard -or gov t ' 6 Notified /Method Supplemental Information
TYPE"�` O � —c,
I =ate
,.
..... W�O Y � � . -
t A REY. IEW
❑ New construction ® V p n Addition /alterati�7 QI, Please check all that apply (submit 2 sets of plans whims checked below)
❑ 1 \�
Demolition ❑ Other ' n 1 ❑ Service of feeder 400 amps of mole ❑ Building over three stories
where the available fault cun'ent ❑ Mai nas and boatyards
,,' 4i's < - _ '' ,4 .1".., , h. - ,. . _ _
s, : h`CAT.EGO OF -:CO T w N .= 1 - _-` ,_ ^s` r V i s '= OO amps at I �O volts or Floating
s�it;;;a ..;'�� �',,�r,•, -�..i o__.,, -,.- ._. z _. „ii,', I -
_ .,.�:;, : >,�',_ � e viceeds 10,0 I ❑ �buildmgs
less to ground, of eviceeds 14 000 ❑ Commercial -use agricultural
❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations butldmgs
❑ Multi -family ['Master builder ❑ Other• ❑ Ftte pump ❑ installation of75 KVA oI
- - ❑ Lmncy system large! separately derived system
,` J s'S IT E , . IN F ORM AND, �L;OCATIOIS.
Job no. 68826 Job site addr W WASHINGTON SQUARE
� . ❑ Add n of s new st moto! load of ❑ "A" "E" "1 -)" .' I -4"
• � _ � RD 100HP or more occupancy
❑ Si v oi more residential units ❑ Recreational vehicle parks
City /State /ZiP. TIGARD, OR 97223 ❑ Health -cafe facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite /bldg. /apt no.: Project name: SUMMIT COURT ❑ Service oi feeder 600 amps or more
Cross street /directions to job site: = - `a FEE- SCHEDULE,: ; '-izq - ' = ,'-
Description I Qtp. I Fee. I Total I -
New residential single - or muiti-tarnily 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.: Limited energy, residential
;=`D OF`:W 75 00 2
' �_..�. _ - - ,,_. _, _ I 0 , 9 ; _ _ (with above sq ft )
Limited energy, multi - family
ADD POWER AND DATA FLOOR BOXES residential (with above sq ft) 75 00 2
Services or feeders installation, alteration, and /or relocation
200 amps or less - ' - - 100 70 2
4_< ®' <PROPER , -
TY�OWINE'I2�'° - �- - 201
..... ... :;;s> z ;rv` ®'- TENt11VT ' :_•:,,, to400am s .13306
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 I 552 26 2
City /State /ZIP: -- - - - Temporary services or feeders installation, and /or
relocation
Phone' ( ) F ax: ( ) 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
- ® - ;APPLIANT`" ,x - ab ove service or feeder fee,
n w = C k [H`GOIVTACT:hPER >.'; fd f 7 42 2
each branch circuit
Business name' B Fee for branch circuits without
service or feeder fee, first 1 56 18 56 18
Contact name' branch circuit
Address. Each add'l branch circuit 2 7 42 14 84 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 67 84 2
dwelling, service and /or feeder
Phone: ( ) F ax: • ( ) Reconnect only 67 84 2
E - mail:
Pump or irrigation circle 67 84 2
nrrµ _ Sign or outline lighting 67 84 2
t , -;� � �� r - ;' =�' , �.� = H „ «: _ : ' ,,s - ,.., � . . _ _ , , - _ - -7, -. Signal circuit(s) or limited-energy
Business name FRAHLER ELECTRIC COMPANY panel, alteration, or extension 1 Page 2 i 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 _
City /State /ZIP: TIGARD, OR 97223 - Investigation (1 hr mm) 66 25/ hr
Industrial plant (1 hr min) : 78 18/ hr . - 1
( ) - Fax - (503) 6394673 - Phone: 503 639 ...... _ Inspections for which no fee is - • - i. 90 00/ • '° '
- :specifically listed ('L hr mm)
CCB Lic.• 37410 _ _ Electrical Lic : 3434 13C • Supi Lie. 5110S `- s "^ ' =s, ;;=;'ELECTRICAL x;PERMIT`'FEFS ^ ",',: -,) <` s ,.:,
Suprv. Electrician signature required: Subtotal 146 02
Plan review (25% of permit fee) _
Print name. ADAM ETHERINGTON Date: 10/05/11 -- - - State surcharge (12% of permit fee) 17.52
Authorized signature - TOTAL PERMIT FEE 163 54
This permit application expires ,1 a permit is not obtained within 180
Print name. Date:
after it has been accepted as complete.
Date: * Number of inspections allowed per permit
i \budding \Permits \ELC- PermitApp doe 07/01/10 440- 4615T(1 I /05 /C0M /WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
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 Au Conditioning System*
Vacuum Systems*
Other:
P-9:W RCI W— QAKONL. " ¢ "' - ` ,
Fee for each commercial $75.00
system
(SEE OAR 9 18- 309 -0000)
Check Type of Work Involved:
fl Audio and Stereo Systems
n Boiler Controls - . -
I I Clock Systems
® Data Telecommunication Installation
Li Fire Alarm Installation
n HVAC
fl Instrumentation
I1 Intercom and Paging Systems.
fl Landscape Irrigation Control*
I I Medical
7 Nurse Calls
I Outdoor Landscape Lighting*
I I Protective Signaling
7 Other
Total number of coininercial systems: 1
*No licenses are required. Licenses are required
for all other installations
I \Bwidmg\Permits\ELC- PermitApp doc 07/01/10