Permit p CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
11111 COMMUNITY DEVELOPMENT Permit #: ELR2012 -00021
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/03/2012
TIGARD g Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9636 SW WASHINGTON SQUARE RD G10
Project: Buckle Subdivision: Lot:
Project Description: Audio system.
Contractor: STONER ELECTRIC Owner: PPR WASHINGTON SQUARE LLC
1904 SE OCHOCO BY THOMSON PROPERTY TAX SERVICES
MILWAUKIE, OR 97222 ATTN HILARY RAYMOND
2235 FARADY AVE, STE 0
CARLSBAD, CA 92008
PHONE: 503 - 462 -6500 PHONE:
FAX: 503 - 659 -4968
FEES
Description Date Amount
Specifics: Restricted Energy Permit 02/03/2012 $75.00
12% State Surcharge - Electrical 02/03/2012 $9.00
Type of Use:
Class of Work:
Total Number of Systems:
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: N
HVAC: N Instrumentation: N
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N Total $84.00
Other Desc: 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 co• of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ....410 - - .� =�r= Permittee Signature: �� i6 /. A
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.tn. - 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.
Feb. 2. 2012 12:28PM Stoner Electric Group No. 1278 P. 1
Electrical Permit ApplicationRECENCI FOR OFFICE 1 ESE ONLY
--- II C 131IS o W f l-f T nl i l g B a lv r d d ., Tigard, OR 97223 FEB — 202 1 NE , Other Permitp 0 if—up .
1,...., 1 m ite ph co nit iv e e yi d ew ,
Dater13 : 0 AVAMS CELIMMEg _...'
;
Phono: 503,639.4171 Fax: 503.598.1960 r t Di
11 ,11
Inspection Line: 503.639.4175 Data Ready/By: n See Page 2 for
TIGARD
Internet: www.tigard-orgov CITY OF TIGARD N"GaiNiethul: Supplemental Information
i , topW..:44101:64::i§:q:1 Tig, , ,:. : :; ;: . :;;I5,4 ;;;::?, ,
please cheek ell that apply (Mani! 2 tat of plans whiems the-ekedbelow):
D New construction ..kildition/alteration/replacement
ci service or feeder 400 nowt or more 0 Wilding over three stories.
J Demolition 0 Other: where the available fault cnnent 0 Marinas and boatyards.
' — ',"'"* ' . • • : ; . xr,ce.,L, 10, amps ei 150 vollt Or n Flonbildin.
atig ugs
.CATOOA ror
•-4 ..-.• , ' n r „,
0 1- and 2-family dwelling 41.,Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: ['Fire pump, Installation of/5 KvA or
E
Emergency system .
LageggiagYjkatilD ITSWWWX ::, :' : •',:,.;:;:: Addition of new motor load of 0 larger separalely derived system"A",
_ .. . .
Job no.; /4( 0 03V Job site address j' 4.415/ 1 Six more residential units,
100HP or more. occupancy.
M Recreational vehicle parks.
0 or
City/State/ZIP: 91P34' 0 Health facilities. El Supply voltage for mom than
El Hazardous locations. 600 volts nominal.
1.. g±pt. no.'-/ Cr Project name: x</L_E-- ID Service or tbeder 600 amps or more.
Ogg ;:•:: :
Cross street/directions to job site: Dearripoo4 I 01y j Pe. I Total T •
New residential single- or multi-family dwelling unit
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
FA, add'1500 sry, ft. or portion 33.92 1
Tax map/parcel no.; Limited energy, residential
75.00 2
4;s1kig,Ai'07.S.E.;.:AlklORthiCO: Or -wokx, : , :: : :;":::q•;1,1. , ;,,'"., , ,A: , ,,t :.; i,., (Nyilll Above sq ft) , .
Limited energy, multi-family 75.00 2
.4 / C>A7 SI meiti-- ,44-)SI-4t7-69,1-1 resit:Lei-Mat (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 1 100.70 2
..'" ':' '" " i." " ' ,‘• 201 amps
''gfigniglEYAROVIA7 I: .01 :::..:: .:: . :EI:l.i.N.).■ .7*t . L. ,, Y ,,, ' , .::. , : . :: :; to 400 amps P 133.56 2
.• ‘ ._ -
401 amps to 600 tempo 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; ( ) I Fax: ( ) 200 amps or leas 59.36 1
Owner Installation: This installation is being made on property that I own which is n01, 201 amps to 400 amps 125.08 2
401 amps to 599 nmp5 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. - Branch amen circuits - new, alteration, or ell lellSi011, per panel
Owner signature: " Date: A. Fee for branch circuits wirh
i1:17 4..irgl.,ETiVf Is.: EgV17: al CONTACT . ,. ..11,,;.. above servicenr feeder fee.
'..4: .r-,;. : : kl.ta,' ''' ':' e Irn - - g - - • ' ..= kk iL 742 2 '''''. "' each branch circuit
Business name; B. Fee for branch circuits terrhoia
service or feeder fee, first
56.18 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP; dWellin 67,84 2
service and/or feeder
Phone: ( ) I Pax: : ( ) Reconnect only 67.84 _2
Pump or irrigation circle 67.04 2
&mail:
. ,. . Sign or outline lighting 67.84 2
' , . .;*',..r.,!:;;',":':...•: ,_ , ,.:,,, Signal circnit(s) or limited-energy I )
panel, alteration, or extension_ on 1 / 7 f i a ° Ae r' 2 - 2
Business name: STONER ELECTRIC, INC.
' Each addltIonat inspecti over allowable in any of the above
Address: 1904 SE OCHOCO Additional inspection (1 hr min) 66.25/ hr
Investigalion (I lir min) 66.25/ hr
City/State/ZIP: MILWAUKIE, OR 97222 Industrial plant (1 hr min) 78,18/ hr
Phone: ( 503) Fax: ( 503) 6594968 Inspections for which no ice is
specificall listed % hr min , „ ., 9 () .00/ h
, r
CCB Lie.: 44823 Electrical Lie.; 26-122C suprv-Lio-! 3496S
, subtotal; 7500
Suprv. Electrician signature, required; pitid4 ,L,./..-..„ Plan review (25% of permit fee): irri-
Print name: MICHAEL FALCONER nate: z / s b z _ Sate surcharge (12% of pennit fee): 9. 6
, - TOTAL PERMIT FEE: 0,5,,A,00
Authorized signature:
This permit application expires HP permit 4 not ()Whined withih 100
days After it has been accepted as complete,
Print name: I Date: 4 Number ofinapeetions allowed per permit.
1.1Duildineermi0ELC-PeratitApp.dw 07/011I0 44 0-46l ST(11/05/COMIWEB
Feb. 2. 2012 12:28PM Stoner Electric Group No.1278 P. 2
•
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
y
Pee for a residential systems combined.,,.,,,, $75.00
Check Type of Wotk Involved:
[] Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
Fee for ragll 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
❑ IIVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protccrive Signaling
K� Other /0 / l v/41, ---
Total number of commercial systems:
*No licenses ate required. Licenses are required
for all other installations
L1BuildingTemdislELC- PertnilAppdoe 07/01/10