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Permit n CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2016-00140 r 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/29/2016 Parcel: 1S1260000300 Jurisdiction: Tigard Site address: 9610 SW WASHINGTON SQUARE RD G01 Project: The Walking Company Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S Project Description: TI-(1)electrical service,(20)branch circuits&low voltage for data. Contractor: ERIC OLSON ELECTRIC COMPANY Owner: PPR WASHINGTON SQUARE LLC 10013 NE HAZEL DELL AVE PMB 432 PO BOX 847 VANCOUVER,WA 98685 CARLSBAD, CA 92018 PHONE: 360-609-4901 PHONE: FAX: 360-693-2980 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 02/26/2016 $100.70 Specifics: amps or less 20 crt Branch Circuits w/Purchase 02/26/2016 $148.40 Type of Use: Service or Feeder Class of Work: 1 ea Signal circuit or Limited 02/26/2016 $75.00 Energy Panel Type of Const: 1 ea 12%State Surcharge- 02/26/2016 $38.89 Occupancy Grp: Electrical Total $362.99 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. ATT gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0(1010 through OA 5 01- 09 You may obtain a copy of the rules or direct questions to OUNC by calling 5 . 32.1987 or 1.800.332.2344. IssBy: Permittee Sign re: 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. T 6 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. Feb 25 16 12:09p ERIC OLSON ELECTRIC INC 3602581859 p.1 cc."O 11Alu l•t,v r,, Electrical Permit Application City of Tigard Receivedt Permit 0; r 13125 SW Hall Blvd.,Tigard.OR 97723 Plan Review Phony 503.718.2439 Fax: 503.598.1960 Date/B : Rated Permit#: Inspection Line: 503.639.4175 Ready Date/By: Juris: H See Page 2 for Intemet: www.tigard-or.gov NotifiedlMcthod: Supptemeoalla[ot,raeion TYPE OF WORK PLAN REVIEW ❑New construction Addition/alteration/replacernent Please check all that apply(submit 2 sets of plans w6tems checked): ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: uirere the available Laub current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or []Floating buildings. r7 l-and 2-family dwellingCommercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for an other installations. buildings. 13 Multi-family ❑Master builder ❑Other. ❑Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system, larger separately derived ❑Addition of new motor load of system. Job#: C)(,Q j lob site address: k U S1N Sbt�t ,yi V IOOHP or more. ❑"A `E'."I-z^ `L-3" f, ❑Six or more residential units. occupuney. City,State/ZIP: -V\ l/ly(A cg 01 ❑Health-care facilities. ❑Recreational vehicle parks. #: C)-I— Project name:-1-VI Q VQa I1kj y1 ❑Hazardous locations. ❑Supply voltage for more th n Suite/bldgJapt. C©' ❑stx,.ice or fader 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Oestri tanI 01y. I Faeh I Twat New residential single-or multi-family dwelling unit_ Subdivision: Lot#: Includes attached garage. 1,000 sq.ftor less 168.54 4 Tar map/parcel#: Ea.add'[500 sq.ft-or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 with above sq fZ l L. N e VV cc , Limited energy,multi-family residential(with above N.ft.) 75.00 _ fin r-t �� Renewable EnerIM ❑ PROPERTY OWNER TENANT Services or feeders installation,AtUrb li,'sind/or relocation Name: 200 amps or less 1 100.70 2 201 amps to 400 amps 133.56 2 Address: 401 amps to 600 amps 200.34 2 City/Statc./ZIP: 601 amps to 1,000 amps 301.04 2 Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on properly that I own which is not 200 amps or Iess 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 ❑ APPLICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or cxtensioa, panel A.Fee for branch circuits with above service or feeder fee, (� Qe�go 7 Business name: Z 7.42 r Iv each branch circuit y� - Contact name: B.Fee for branch circuits wuhovt service or feeder fee,first 56.18 2 Address: branch circuit CitylState/ZIP: Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included Phone:( ) Fax::( } Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnectonly 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 - 2 ✓ - t Sign or outline lighting 67.84 2 Business name: i� � � g g € Signal circuits)or limited-energy See Page 2 �� 12 Address: -6 )Etk3f)l')) panel,alteration,of extension. Each additional inspection over albwable in any of the above City!State/ZIP: CA , \(2Y' WA '1 Additional inspection(1 hr min) 66.25/hr Phone:(^ ,c) Investigation(I hr min) 90.00/hr f1 Industrial plant(I hr min) 78.18/hr Email: S�>� ,e -r•Y I 1, .�Vn Inspections for which no fee is 90,00/hr CCB LiC.: 1�- � Electrical Lic.: -`±�1�, Suprv.Lic.:'fin 1L Cj specifically listed(%hr min) ---- - ELECTRICAL PERMT FEES Suprv.Electrician signature,required: Subtotal: o't ,I Printname: ID—(qOl5 r Date: 2- [I permit fee): State surcharge(12%of permit fee): 3 Authorized signature: TOTAL PERMIT FEE: �'`� This permit application expires ifs permit is not attained within 180 Print name: 1 j i `(1 V\5 Ly) Date: Zl Z Gj �1{Q days after it bas been accepted as c•r■plete. -- • Number of inspections allowed per permit. t:\Building\Permits'.ELC_PermitApp_Ellt_ERE.dac Rev06117.2015 4404615Th 11051COWINEB Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 9610 SW WASHINGTON SQUARE RD G01, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical final PASS - No C of O ELC2016-00140 Jeff Grove Violation Summary: Inspector Contractor