Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00237
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/8/2008
PARCEL: 1512600 - 00300
SITE ADDRESS: 09461 SW WASHINGTON SQUARE RD A13 ZONING: C -
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: SWEET FACTORY
Project Description: Installing (1) security camera system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: CAMERA X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC TRINITY ELECTRIC
BY THE MACERICH COMPANY 13422 SW 128TH PL
9585 SW WASHINGTON SQUARE RD TIGARD, OR 97223
TIGARD, OR 97223
Phone: Contact #: PRI 503- 235 -6481
FAX 503 -579 -3929
FEES Reg #: ELE 34 -653C
LIC 156637
Description Date Amount SUP 4282S
[ELPRMT] ELR Permit 8/8/2008 $75.00
[TAX] 12% State Surch 8/8/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questio s to OUNC - I - : 00.332.2344.
/
Issued By: // ✓ `�` Permittee Signature: I
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.
•
Electrical Permit Application (.. FOR OFFICE USE ONLY
• City of Tigard r Date/Bya Y ,
6 '/ ���
— Permit No . (�- -r/tUSj7
Ilq q 13125 SW Hall Blvd , Tigard, OR 97223 ®� Plan Review
L' Phone: 503 639 4171 Fax 503.59 ti :1 1 D ateBy Other Permit
T 1 G A R I) Ins Line 503 639 , a rtQQ?J Date Ready/By orris 121 See Page 2 for
Internet. www tigard -or gov W .. U !.• , Notified/Method j Supplemental Information
TYPE OF WORK 0 �� �W " PLAN REVIEW
❑ New construction ig Add ition/alteration /r tit8Ri ON Please check all that apply (submit 2 sets of plans w /items checked below)
G \ \ �∎ '.r. ❑ Service or feeder 400 amps or more ❑ Building over three stones.
❑ Demolition ❑ Other: ` N . where the available fault current ❑ Marinas and boatyards
CATEGORY OF CONS1 tON 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 ), CommerciaUindustrial ❑ 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 ❑ Emergency system larger separately denved system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "1 - ",
Job no.: Job site address: 1 J4/ SIN W(A.Sb ht 5� Six or more or more occupancy
Rd. ❑ Six or more residential units ❑ Recreational vehicle parks
City /State /ZIP: • Ot d 6 R /) Z 2 3 ❑ ❑ Health -care facilities ❑ Supply voltage for more than
T I Ar _ Hazardous locations 600 volts nominal.
Suite/bldg. /apt. no.: A / 3 Project name: ,e-i r e- ifj ❑ Service or feeder 600 amps or more
��'''� �� FEE SCHEDULE
Cross street/directions to job site: Wo jl .p.(dp.N C VA "l ( Description I Qty. I Fee. I Total I •
G� `' New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft or less 145.15 4
Ea add'I 500 sq ft or portion 33 40 1
Tax map /parcel no.: Limited energy, residential
75 00 2
DESCRIPTION OF WORK (with above sq ft )
Limited energy, multi - family 75 00 2
Seca ri /y rpra residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80 30 2
❑ PROPERTY OWNER ❑ 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 I 454.65 I 2
City/State /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) 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, eer panel
Owner signature: Date: ✓ A. Fee for branch circuits with
APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6 65 2
each branch circuit
Business name: B Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'l branch circuit 6 65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90 90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53 40 2
J , Signal circuit(s) or limited -
Business name:
� , i ,'"),/ / `fie iy; L energy panel, alteration, or
Address: `�i ( z � �_ / f!j R4 extension. Describe. I Page 2 ��`� - 2
5h/ /.
City/State /ZIP: 77ga / r; ( oR 9!i__3 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (9'/) 3 6 4 c P / Fax: ( . . - - 0 3 ) ' 7 "- 3 5.1 Investigation per hour (1 hr min) 62 50
CCB Lic.: Elec i l Lic.: Su rv. Lic.: / Industnal p lant per hour 73.75
/� ^] ( �/ f ��' �� e p E LECTRICAL PERMIT • FEES
Suprv. Elec i l r Tature, regtSirbd: !V /to Subtotal s pv
Subtotal -
•
Print name: I S , //� �� Date: O D Plan review (25% of permit fee):
/$/ o State surcharge (12% of permit fee): .9c (,('
Authorized signature: TOTAL PERMIT FEE: eS
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit
1 \Budding'Permns\ELC•PermitApp doc 05/23/06 440- 4615T(I 1/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES: •
RESIDENTIALWORK.ONLY: �.
Fee for all residential systems combined $75.00 1 ,
Check Type of Work Involved:
❑, Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑: Other:
,COMMERCIALWORK'ONLY:.
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
0 . Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
• HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑, Protective Signaling
4, Other $ C fho) Cmeora
Total-number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I \Bwldmg\Permds\ELC- PermitApp doc 03/23/06
CITY OF TIGARD , • '�
A
BUILDING DIVISION PERMIT #:
ELR2008.00237
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/8/2008
Phone: (503) 639 -4171 j'11
Inspection Requests (24 Hrs.): (503) 639 -4175 `_
INSPECTION WORKSHEET FOR DATE: •f 1/1312008 TIME: 7:00AM PAGE: 8
SITE ADDRESS: 09461 SW WASHINGTON SQUARE RD M3 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SWEET FACTORY
DESCRIPTION: Installing (1) security camera system.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR. TRINITY ELECTRIC . PHONE #: 603..235.6481
Inspection Request Scheduled For: Date: 11/13/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electiical final 078043 -01 503.620 -8246 N
Corrections /Comments/ Instructions:
14 01 �'. '- i kavi01 til:tia Ott`• Raj c%6 litE
s - C
•
PASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G N66a L Date: VIII 3103 Phone #: (503) 718 -114
CITY OF TIGARD
BUILDING DIVISION PERMIT #: E 6 2008 00237
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/812008
Phone: (503) 639 -4171 4I • Inspection Requests (24 Hrs.): (503) 639 -4175 ......
INSPECTION WORKSHEET FOR DATE 10/23/2008 TIME: 7 :00AM PAGE: 6
SITE ADDRESS: 09461 SW WASHINGTON SQUARE RD A13 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: i : : -- F AcToRY
DESCRIPTION: Installing (1) security camera system,
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: TRINITY ELECTRIC PHONE #: 503- 235.6481
Inspection Request Scheduled For: Date: 10/23/2008 Pour Time:
Code # Inspection Description Co ' Contact # Message
19B Electrical final 1 077110 -01 503 - 620.8246 N
Corrections /Comments /Instructions:
Cj AU.- GA6 LE i N 6 I a El] AZovir @,t l.ao
' Y 'J61 66 1-1 51 P ' o vl'^ WE
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vii(, r.5 6vfg
" P L u,N� (Z�` p 4 , C
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63 S L W pL1.1\vvN RA760 cAPLE IN)
A mv`4 rk^q∎l ek, W- AO 300 . NBC.
The electrical installation defects noted
on this report shall be corrected and
an inspection request made within 20
calendar days per OAR 918- 271 -0030
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
/ 751NAIL y CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • 10 4G Date: 23101S Phone #: (503) 718- Viii)