Permit 1 q CITY OF TIGARD ELECTRICAL PERMIT
1:: COMMUNITY DEVELOPMENT Permit #: ELC2013 00354
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/26/2013
Parcel: 1 S 126CC00100
Jurisdiction: Tigard
Site address: 9700 SW WASHINGTON SQUARE RD
Project: Nordstroms Subdivision: FAIRVIEW PLACE CONDO Lot: 20
Project Description: Install (4) branch circuits for plugmold in cart charging room.
Contractor: COCHRAN INC Owner: PPR WASHINGTON SQUARE, LLC
7550 SW TECH CENTER DR #220 C/O NORDSTROM
TIGARD, OR 97223 ATTN. TAX DEPT
PO BOX 2229
SEATTLE, WA 98111
PHONE: 503 - 234 -6564 PHONE
FAX. 503 - 238 -2098
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 06/26/2013 $78 44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 06/26/2013 $9 41
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
Required Items and Reports (Conditions)
This perms - . -. bject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law, All work will
be dor - in accordance wi - pproved plans This permit will expire if work is not started within 180 days of issua ice, or if work is suspended for more the 180
day ATTENTION Oregon la. - -'res you to follow the rules adopted by the Oregon Utility No ' -= ion enter Those rules are set forth in OAR
95 001 -0010 th ugh OAR 95 r i 00 . may obtain a copy of the rules or direct questions to O • • line 503 .L1987 or 1 800,332. g 4.
Is ued By: Perm S�• !�- = - • � ��
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 INSTA LATION ONLY
SIGNATURE OF SUPR. ELEC' ') _ /�' / _ Date:
■ i
LICENSE NO.
Call 603.639.4175 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 Applicatioi E EI V ED r
POR OFFICE USE ONLY ,�/ ,, u
City of Tigard JUN 2 6 r • Date /B , A ,ir� PennitNo Ezed, ., 3-av 35 A
7 C ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Date /B Other Permit:
Phone: 503.718.2439 Fax 503.598.
TIGARD Inspection Line: 503.639 4175 � Y OFTIGARD Date Ready /By: June. RI Se
Internet: www.tigard-or gov BUILDING DIVISION Notified /Method Supplemental Information
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below)
El New construction ) Addition/alteration /replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other: 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 agncultural
❑ 1 - and 2- family dwelling [Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system
P ��
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2", "l -3",
100HP or more occupancy.
Job no.: ' O 70 Job site address: 9700 Sw 0/1/0 ❑ Six or more residential units. ❑Recreational vehicle parks
City/State/ZIP: D �J 9 ❑ Health-care facilities Supply voltage for more than
ty ' r ��A �� //�� / 7 ❑ Hazardous locations 600 volts nominal.
Suite/bldg. /apt. no.: P roject name: be . 0 Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site:�06�60iu� A °f Description I Qiv. I Fee. I Total I •
�� �/ New residential single - or multi - family dwelling unit.
p Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK
(with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
- s z dayme1.1) « N� �en�4 /y/ residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
.uf 200 amps or less 100.70 2
❑ PROPERTY OWNER I ❑ TENANT 201 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
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 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
❑ AP LICANT I CONTACT PERSON above service or feeder fee, 7.42 2
each branch circuit
Business name: el/
c.__.... B. Fee for branch circuits without
Am Nt�i service or feeder fee, first / 56.18 �j � / 2
Contact name: �A �.r) branch circuit r�tv
Each add'I branch circuit 7.42 z 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular 67 84 2
City/ State/ZiP: dwelling, service and/or feeder
Phone: 3) 1 79// I Fax: : ( 9 17 / ) Z°4 7 g Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: COCHRAN INC panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 7550 SW TECH CENTER DR. SUITE #220 Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City / State/ZIP: TIGARD OR 97223 Industnal plant (1 hr min) 78.18/ hr
Phone: (971) 205 - 4242 I Fax: (971) 205 - 4268 inspections for which no fee is 90.00 / hr
specifically listed ('/ hr min)
CCB Lie.: 72942 I Electrical Lie.: 37546C I ,uprv. Lic.: 3447S ELECTRICAL PERMIT FEES
rv. Electrician signature, required:
Subtotal. 7�, �{�
Su
P � eq \�� Plan review ( 25% o f permit fee):
Print name: KENNETH K' O .4411° I Date: --76 — `� State surcharge (12% of permit fee): y/
TOTAL PERMIT FEE: g > --
Authorized signature: i � / � i ,,, . This permit application expires if a permit is not obtained within i8„
days after it has been accepted as complete.
Print name: p thif.AM. N Date: —
Ai - — _ • Number of inspections allowed per permit
1. \ Building \Permits \ELC -P fp doc 07/01/10 440- 4615T( /COM/WEB