Permit CITY OF TIGARD ELECTRICAL PERMIT
rt Permit#: ELC2015-00652
1 • COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/17/2015
TIGARD Parcel: 1S135BA00102
Jurisdiction: Tigard
Site address: 10108 SW WASHINGTON SQUARE RD
Project: Cost Plus Subdivision: OAKBURG Lot: 9
Project Description: (7)branch circuits for TI
Contractor: A C&E ELECTRIC CO Owner: PPR SQUARE TOO LLC
3535 DEL WEBB AVE NE#100 PO BOX 847
SALEM, OR 97303 CARLSBAD, CA 92018
PHONE: 503-363-2301 PHONE:
FAX: 503-363-2302
FEES
Quantity Description Date Amount
7 crt Branch Circuits wo/Purchase 08/17/2015 $100.70
Specifics: Service or Feeder
1 ea 12%State Surcharge- 08/17/2015 $12.08
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
Required Items and Reports(Conditions)
This pe • • issued subject • the regulations contained in the Tigard Municipal Code. State of OR. Specialty Codes and all other applicable law. All work will
be •• in accordance with appr• e• •an . This permit will expire if work is not started within_3.80 da •f •-nce, or if work is suspended for more the 180
d ,s. ATTENTION: Oregon law •wires ou to follow the rules adopted by the Oregon Utility N ificatio enter. Those rules are set forth in OAR
•52-001-0010 thr• gh OAR 952-•• r r=0. .y•btain a copy of the r les or direct questions to OUNC by calli • -r 232.1''7 or 1.800.332.234,.
ifr
Issued By: ' C Permittee Signature: /J
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' -` nrerr, V! Date: ,i
LICENSE NO. 5-5 9/ S
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.
08/17/2015 11:00 50348EECEjVED AC&E ELECTRIC PAGE 01/01
Electrical Permit Application FOR OFFICF 1 Sr oil
City of Tigard #')G 1 7 2015 p„i°`tiv ,, g l�rmitit: u'�/S---e°(tea
13125 SW Hall Blvd..Tigard,OR 97223 Plan eview Related Permit M' V c/'
74
A Phone; 503.718.2439 Fax: 5(1 1Sei1i, I ARrj DateB • cpC'/S—OO l7
' Inspection Line: 503.639A�� l!V U See P.ee 2 for
TI C.A R n Internee www.tigard-or,g IILDING DIVISION x� Supplemental Incantation
7'" i !., " cto �Ol -' ,, - "ice!r _ }-- itri. `'�t to s PLAIsI�1Eb11�iW'`w;';"��t " ,:!C" ��r,1L�: `
�G" xtik� -.�1 Al.;J� .i, fir=
❑New construction ®Addition/situation/replacement Please check all that apply(submit 2 acts of plans w/items checked)!
❑Demolition ❑Other ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current LI Marinas and bontyarda.
n a x r` '...- exccods 10,000 'tt 150 volts or ❑Floating buildings.
I-and 2-family Y� t� ..,r.4��+t'Y'1r;GO�'S! O1F' C�S�131'1�ttlC'I'lON �- ,.� ;. �� M ,� amps g
❑ dwelling ®Commercial/industrial ❑Accessory building loss to ground,or excoods 14,000 ❑Commercial-use agricultural
amps for all other insfnllMions. buildings,
❑Multi-family ❑Mastcr builder ❑Other: 13 Fix pump. ❑Installation of 150 KVA or
'" '1i?' . ,; r ,y�y"•J.P.Or$Il'TE INF L,,' TJON a "tOATtOi�.` p,„ r p8, ti` ❑Emergency syseemt larger separately derived
+'' ❑Adel i66n of new motor lead of system.
Job#: I Job site address:10108 SW Washington Square 10014P or mere. ❑"A".'� ."t-2 "1-3
City/State/,ZIP:Tigard Oregon,9722.3 ❑Six or more residential unite. occupancy
❑Health-care Facilities, ❑get reeuional vehicle parks.
Suite/bldg./apt#: Project name:world Market TI ❑Hanmlmw Inenhcma, 0 600 wlta no mfor more than
❑Service or feeder 600 amps or ism,
Cross strcct/directions to job site: ',••;-; t t, ' X' . -, ''f, t , "
Description Qtr. I- DO I 1'teral ) -
New residential single-nr multi-family dwelling unit.
Subdivision: I Lot#: included attached garage.
i,000 sq,ft,or Ica* 168.54 4
Tax map/parcel#: Be add'I 500 sq.it.or portion 33,92 1
'.,Vi`lli,I z ,, „ipw.sC1 1flON Of WORIZ, 3:�;*:: t'1 .t `.:*e`:I Limited energy,residential 75.00 2
Minor remodel of lighting and cash registers ( abov®sg,t1;)
Limited energy,multi-ihmily 75,00 2
residential(with above sq.ft.) ,
Rr ^mss a'r , ,- Renewable Energy ❑ See Page 2
'' ,,-0:"P1tOPtR1V O'WNE1t ..., . w.. .,+nw«i '' ❑i:T,".nGA1517' :'' ,r.= Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
201 amps to 400 amps 133,56 2
Address:
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) , Fax:( ) Over 1,000 amps or volts 552.26 L.?
Temporary services nr feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59,36
1.. 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps - 125,08 j 2,
Owner signature: Date: 401 amps to 599 amps 168.54 I 2
w Branch circuits—new,alteration,or extension,perfancl
Q
"�'P1.IIv/kN'I',' i '.>�: ,,,�.:. .� •,0 CO\"r'AC'�'PER90I�T'' is with I ",; A.Fcc for branch circuits
Business name: above service or fhedcr fcc, 7A2 2
each beinch circuit
Contact name: B.Pee for branch circuits without
- service or feeder fcc,first 1 56.18 56.18 2
Address: branch circuit
Each add'l branch circuit 6 7.42 44.52 2
City/State/ZIP! Miscellaneous(service or feeder not included)
Phone:( ) I Fax::( ) Each manufactured or modular
67.841 2
dwelling,service and/or feeder
Email: Reconnect only 67.84 2
e eypa. p-':;341.; 1.' .�. 4:q,;,, Cb i',a']'OR AM 4 � ,: ::�" m*-y Pump or irrigation circle 67.84
Business name:AC&E Electric Sign or outline lighting _ 67,84 2
' Signal circuit(s)or limited-encrgy ❑ SK Page 2 2
Address:3535 Del Webb Aye,NE,Ste 100 panel,alteration,or extension.
Each additional inspecdon over allowable in any of the above
City/State/ZIP:Salem Oregon,97301 Additional inspection(1 hr min) ' 66,25/hr
Phone:(503)363 2301 Fax:(503)363 2302 investigation(1 hr min) 90.00/hr
-
Industrial plant(1 hr min) 78,18/hr
Email;kenny(a@acandeelectric.com Inspections for which no fcc is
specifically listed('/�hr rain} 90.001 hr
CCB Lie.: 591 Electrical Lie,: 24-IC, Suprv,Lie.: 5391S n y,,,E1 V'VELyy' 4.44,1; .
Suprv.Electrician signature,required: `"t__ Subtotal: 100,70 W
Print name: Kenny Oates Date: 8-13-15 ❑Plan Review Requited(25%of permit fee):
State surcharge(12%of permit fee): 12.08
TOTAL PERMIT FEE: 112.78
Authorized signature: — 1 This permit application expires if a permit is not obtained within 180
—Print name: Date: • days after it has been accepted Si complete.
Number of inspections allowed per permit.
1'18ult4ing\Permit:\E,C_rcmikArp_ELR_ERE doe Rev 06/17/2015 440.16157(1Il05/COM/WEB