Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT ELECTRICAL
ELC2009 -00180
T I G AR O 13125 SW Hall Blvd., Tigard OR 97223 503.639 4171 Date Issued: 04/23/2009
Parcel: 1 S126CB00500
Jurisdiction: TIGARD
Site address: 9300 SW WASHINGTON SQUARE RD
Subdivision: Lot: 0
Project: Macys
Project Description: Install (3) branch circuits for (2) floor boxes, and relocation of cashwrap.
Owner: FEES
MACY'S DEPARTMENT STORES INC Quantity Description Date Amount
ATTN: TAX DEPT, 7 WEST SEVENTH ST 3 crt Branch Circuits 04 /23/2009 $60.15
CINCINNATI, OH 45202 wo /Purchase Service or
PHONE: • Feeder
1 ea 12% State Surcharge - 04/23/2009 $7.22
Contractor: Electrical
ACCURATE ELECTRIC
P.O. BOX 873425
VANCOUVER, WA 98687
PHONE: 360- 944 -7001
FAX: 360 - 944 -7013
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $67 37
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 rf work is suspended for mom 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 AR 952 -0p.1 -0100 You may obtain a copy of the rules or direct questions to OUNC by calling 5 46 6699 or 1 800 332 344.
f
Issued By: 6\ n l not Permittee Signature: 9 �. • , ca-VOVN
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'N Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an Inspection that business day.
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.
APR - 23 -2009 09:09 Accurate Electric, Inc. 3609947013 P.001
Llla...aa ...NA a S,a ally. A at" 1./lla.N all/11.1 • ._ - •
' - - `, g _� City of Tigard Received Lt - ^� • O" 1. t n A f C ^ c ` COE Q ^ O
• `'��
Date/By: D a te/ B y: 4 � Per //7
13125 SW Hall Blvd., Tigard, OR ' j r v Plan Review ILIA
Phone: 503.639.4171 Fax: 503.59 ' I • Other Permit:
TI G A K D Inspection Line: 503.639.4175 Date Ready /Ay: Juts B See Page 2 for
Internet: www.tigard - or.gov ^ p q D 3 'ZO09 Notified/Method: '') Supplemental Information
TYPE OF WORK x pn PLAN REVIEW
❑ New construction RAddition/altentr [lucON Please check all that apply (submit 2 sets of plans w /items checked below)-
❑ Demolition ❑ other: g�l1LDIN �S� three ❑ Service or feeder 400 amps or more ❑ Building over t stories.
where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling A Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other. ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION
El Emergency system. larger separately denved system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "1.3 ",
Job no.: lD A , Job site address: Q , 6 NA.) . .a �U a , • ` • t or more. occupancy.
❑ Six x o or r more residential units ❑ Recreational vehicle parks.
City / State/ZIP I(n 1r(A /) � q 1 ZZ 3 ❑ Health -care facilities. ❑ Supply voltage for more than
u — ///��� l q ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 1 Project name. 14 a CA 1 ' S ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145 15 4
Ea. add'I 500 sq. ft. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
'v/�� �y1 / t� Limited energy, multi - family 75 00 2
P J r A d 1. (tip r bio xt s * t t . I_ b c( ,t residential (with above sq. R)
C r` � 'S Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY O El TENANT 201 amps to 400 amps 106.85 2 -
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits — new, alteration, or extension, • er panel
Owner signature: Date:
A. Fee for branch circuits with
❑ APPLICANT ( ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name' B. Fee for branch circuits
without service or feeder fee, QC� 2
Contact name: first branch circuit
46.85 y/„
Address: Each add'I branch circuit 2 6.65 13.30 2
Miscellaneous (service or feeder not Included)
City/State /ZIP: Each manufactured or modular 90 90 2
dwelling, service and/or feeder
Phone:
( ) I Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: Accurate Electric, Inc. energy panel, alteration, or
Address: P.O. Box 873425 extension. Describe: Page 2 2
City/State /ZIP: Vancouver, Wa. 98687 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (360) 944 -7001 I Fax: (360) 944 -7013 Investigation per hour (1 hr min) 62.50
CCB Lic.: 158875 I Electrical Lic.: 37 -1029C Suprv. Lic.: 5094S Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: J Subtotal: ( 0 0 . i 5
• (' _ 2 � Plan review (25 %ofptrmit fee):
Print name: Ken Sweo ((//���� Date: "�
State surcharge (12% of permit fee): - 1 - 2 . 2.-
•
Authorized signature: TOTAL PERMIT FEE: /,, Z
Print name: Debi Watts ' 1 �^ � `� This perm application expires If a permit Is not obtained within 180
Date: ` i L days after it has been accepted as complete.
s Number of inspections allowed per permit.
I Buddmg•Petmns•ELC- PermnApp doc 05 440- 4615T(II.05,COMMWEB