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Permit `CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2002 -00143 i DEVELOPMENT SERVICES DATE ISSUED: 4/2/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S126C0 -01107 SITE ADDRESS: 09591 SW WASHINGTON SQUARE RD B -10 SUBDIVISION: WASHINGTON SQUARE ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: Install Euromax at door (1) Tenant Improvement - Job No.172144 -85164 RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: 1 LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL: MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: PPR WASHINGTON SQUARE LLC COCHRAN ELECTRIC P.O.BOX 21545 BROADWAY ELECTRIC SEATTLE, WA 98111 626 SE MAIN PORTLAND, OR 97214 Phone: Phone: 234 -6564 Reg #: LIC 77942 SUP 3184S ELE 37 -546C FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT CTR 4/2/02 $53.40 2720020000( Elect'I Final 5PCT CTR 4/2/02 $4.27 2720020000( Total $57.67 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to • • .dopted by the Oregon Utility Notification Center. Those rules are set fort in OAR 952 - 001 -0010 through OAR 952-001-01:e. You may obtain sies of these rules or direct questions to Permit Signature: , Issued By: / 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 639 -4175 by 7:00pm for an inspection the next business day .sue t � ' ' IV� ii s.4 ELc Leo r j3 Electrical Permit Application . Datereceived: Permit no _11; A i I Cit ity O Tig : , l .. _ - .. Project/appl. no Expire date: ' • Add 1125 SW Hall Blv• ! 2 City of Tigard '_ ■�.-- ® Date issued: • By: Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 - Case file no.: - . Payment type: . _ _.. . MAR 2 9 2002 Land use approval: - - _. . - . • TYPE OF PERMIT ' ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: - V - ❑ Partial . JOB SITE INFORMATION ' Job address: .' ' 1/4SU) MISVSM Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: Block: Subdiv* on: Project name: jL , ‘a 'S ' Description and location of work on premises: K6 .► ► Estimated date of completion/inspection: t , CONTRACTOR APPLICATION FEE SCI IMULE Job no: 2-1 q--- e5 ( • Fee Max Business name: C-pc_4� r • c , ( 1&, � . - Descri lion Qty. (ea) Total no. insp New residential - single or multi- family per Address: C � Mc..." dwelling anit . Includes attached garage. lariaaffATMI- State: O'R ZIP: • Service included: MIMI Phone653 23 _ 6 Fax: 2-38.2dt ; E-mail: 1000 sq. ft. or less 4 Each additional 500 sq. ft. or portion thereof __ CCB no Z - 2 Elec. bus. tic. no: '3 - _ C. Limited energy, residential ___ 2 City /metr• lic. n..: Limited energy, non- residential ___ 2 3/1V _ • r a-' Each manufactured home or modular dwelling ■■. Signature of su. rvising electrician (required) Date Service and/or feeder 2 v ' License no: 3 S Services or feeders - installation, alteration or relocation: II PROPERTY OWNER .: 200 amps or les 2 Name (print): 201 amps to 400 amps I= MI 2 401 amps to 600 amps ___ 2 Mailing address: 601 amps to 1000 amps MN __ 2 City: State: ZIP: Over 1000 amps or volts ___ 2 Phone: Fax: E -mail: Reconnect only .111M� 1 Owner installation: The installation is being made on property I own Temporary services or feeders - • which is not intended for sale, lease, rent, or exchange according to iattallatioo ,alteration, orrelocation: 11111 200 amps or less 2 ORS 447, 455, 479, 670, 701. 201 amps to 400 amps ___ 2 Owner's signature: Date: 401 to 600am.s 1111.1. 2 ENGINEER Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit City: State: ZIP: B. Fee for branch circuits without purchase of service or feeder fee, fast branch circuit: ■■ 2 Phone: Fax: E -mail: Each additional branch circuit: __ PLAN Rl?VIEWV (Please check all that appI) - Misc. (Service or feeder not included): • ■■ O Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 2 ❑ Service over 320 amps -rating of 1&2 ❑ Hazardous location Each sign or outline lighting ::: 2 family dwellings CI Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2 ❑ Building over three stories ❑ Feeders, 400 amps or more sDescri .tion: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable In any of the above: ❑ Egress/lightingplan ❑ Other: Per inspection MOM. Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other , Not all jurisdictions accept credit cards, please call junsdiction for more information. Notice: This permit application Permit fee $ 7C ❑ Visa ❑ MasterCard V expires if a permit is not obtained Plan review (at _ %) $ Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ lo — Expuea accepted as complete. TOTAL $ $1 Name of cardholder as shown on credit card $ - Cardholder signature Amount 440-4615 (6/00/COM) ... , Electrical Permit Fees: Limited Energy Fees: ., .�� TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Complete Fee S chedule Below: Restricted Energy Fee $75.00 Number of inspections per permit allowed (FOR ALL SYSTEMS) ., q, Service Included: - Items Cost Total 4, Check Type of Work Involved: Residential - per unit . -- - - --- - - -- - - - - 1000 sq. ft or less $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq. ft. or -- portion thereof $33.40 .1 ❑ Burglar Alarm Limited Energy-,... - . - . - ' . . $75.00 Each Manufd Home or Modular �- Dwelling Service or Feeder $90.90 -- 2 ❑ . Garage Door Opener Services or Feeders ❑ Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less $80.30 2 ❑ Vacuum Systems 201 amps to 400 amps $106.85 2 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 ❑ Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders ' • • .. - TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system - $75.00 200 amps or less $66.85 2 (SEE OAR 918 -260 -260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, ❑ see "b" above. Audio and Stereo Systems Branch Circuits ❑ Boiler Controls New, alteration or extension per panel a) The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. I � 1 I Each branch circuit $6.65 2 1 Data Telecommunication Installation b) The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46.85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous ❑ I nstrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 ❑ Intercom and Paging Systems Each sign or outline lighting / $53.40 orb Signal circuit(s) or a limited energy ❑ panel, alteration or extension $75.00 Landscape Irrigation Control Minor Labels (10) $125.00 ❑ Medical Each additional inspection over • the allowable in any of the above ❑ Nurse Calls Per inspection $62.50 ' Per hour $62.50 In Plant $73.75 ❑ Outdoor Landscape Lighting Fees: ❑ Protective Signaling Enter total of above fees $ 53,40- ❑ Other 8% State Surcharge $ 1 r di Number of Systems 25% Plan Review Fee See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations front of application. _ / �/ Fees: 5 Total Balance Due , $ 7 (0 / Enter total of above fees $ ❑ Trust Account # ' '8% State Surcharge - $ Total Balance Due $ i:\dsts\forms\elc- fees.doc 10/09/00 CITY OF TIGARD 24 -Hour - f �' BUILDING '� - Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 - MST -- BUP , Received Date Requested 5 / ( AM PM BUP Location q 5 99 / Se-a /z-d 5,r.dsrue MEC _ Contact Person / ✓�� Ph ( ) 23'( 4 S4 c( PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC t1O 2% Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation 1` 0 r L p Drywall Nailing 1 Firewall 1 ` J Fire Sprinkler Fire Alarm 4 Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL 4e LECTRI rvice Rough -In UG /S ire arm Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall etASS PART FAIL SITE Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ' • ADA D /P� 2 Mope � � �spe or � Other: Final DO NOT REMOVE this inspection record rom the j site. PASS PART FAIL