Permit •
CITY F TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2009 - 00061
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/24/2009
PARCEL: 1512600 -00300
SITE ADDRESS: 09508 SW WASHINGTON SQUARE RD J01 ZONING: MUC
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: CLEARWIRE
Project Description: Limited energy for HVAC.
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: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC FIVE STAR ELECTRIC, INC.
BY THE MACERICH COMPANY PO BOX 555
9585 SW WASHINGTON SQUARE RD BANKS, OR 97106
TIGARD, OR 97223
Phone: Contact #: PRI 503- 324 -0948
FAX 503- 324 -0973
Reg #: ELE 34 -665C
FEES LIC 158231
Description Date Amount SUP 4622S
[ELPRMT] ELR Permit 2/24/2009 $75.00
[TAX] 12% State Surch 2/24/2009 $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 questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: 1 X/ iJ Permittee Signature: � r Ala I3i 1
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 REOEI Fax:503- 324 -0973 FOR OFFICE 2009
Js i o r i x P002 003
A
City of Tigard FEB 2 4 2009 E 'ePermt No t 2 po 4. 13125 SW Hall Blvd , Tigad, OR 97223 .,
t • ! Phone 503 639 4171 Fax. 503.598 196tITy OF TIGARD Date By Other Permit.
TT GAP.D Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/13y. +s 55 See Page 2 for
Internet' www tigard- or.gov Notified/Method: ! Supplemental Information
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Please check all that apply (submit sets of plans w /uems checked belay.)
❑ New construction ® Addition/alteration/replacement
El Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other: where the available fault current
Ca Marinas and boatyard;
Y71pij {',; '° i, fP l '' , e o it s,. �, ”„ '', r ,;''''''; , , 9 Y;: c:i:; exceeds 10,000 amps at 150 volts or ❑ Floating buildings
,
"'' less to ground, or exceeds 14,000 ❑ Commssc,al - usc agricultural
❑ 1 - and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations buildings
❑ Multi- family ❑ Master builder ❑ Other: 12 Fire pump. El Installation of 75 KVI' or
,, :1 „
• ;:,: , q "p � ❑Emerg sys tem larger separately denved system
`, 11 , • 's ",i )'1'di'"'" 1/4 ;ll1 ; J 0 i1i , �, ` ,' r :; , r ' ' I ,'• II II,a ." ' , • CI Addition of new motor load of i p
� ,�, N � E�'l�tr�� T!ir `' ... ❑ ..A„ "E","1-2”, „! _
Job no.: F51358 � Job site address: 9585 SW Washington Square Rd 1001-IF or more. occupancy.
❑ Six or more residential units ❑ Recreational vehicle parks
City /State /ZIP: Tigard, OR 97223 508 ❑ Health -care facilities, ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal.
Suite/bldg. /apt. no. • J1 Project name: C f v ❑ Senate or feeder 600 amps or more
�. ∎i
:. ,1 •.:* RI L t
E SCLE '
Cross street /directions to job site: Desertpeloo s l otv. I Fee. _7 : "- iot ce
New residential single- or multi- family dwelling unit_
Includes attached garage -
Subdivision: Lot no,: 1,000 sq. ft. or less 145.15 a
Tax map /parcel no.: Ea. add'! 500 sq ft. or portion 33.40 1
Limited energy, residential
' -'ri; t j ;, „/ i rr� �I: Ili;,l,� 75 2
,•�' "i,• :, 1 Oi (with above H)
Low Voltage for HVAC Limited energy, multi - family 75,00 2
residential (w■th above sq, f )
w
Services or feeders installation alteration, and/or relocation
200 amps or less 80.30 2
�}
, ; . .. ct', ' , 5 " E :.,,,, t. y'''. a „.i I. ' •❑3 . '0 •4';i ,l; "•! i, ' CI, �'i i; ;,;; 2
201 amps to 400 amps 106 85
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 454,65 2
City /State /ZIP. - Temporary services or feeders installation, alteration, and /or
relocation _
Phone: ( ) I 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
intended for sale, lease: gent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 1 2
Branch circuits - new, alteration_ or extension, per panel
Owner signature: �� mate. A. Fee for branch circuits With
. ,, •.a„ f1hE.ti' ; - a • rti , .Iii , ■ •; n ,t' . ir •�, 1 t' 1, ,rl',, , ;(1 ., . • - '„ T 4 C T P E:� !1T ', % above service o r feeder fee, 6 65 2
Business name: each branch circuit
B . Fee for branch circuits
wtrhout service or feeder fee,
Contact name: 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
.,' 'Gdi�ivii' , ∎•ill' ,.„ „L.' .);,, ∎,•' ,.,cONTR,,GTOR ,,, Sign or outline lighting 53.40 2 •
Business name: Five Star Electric, Inc. Signal circuit(s) or limited
energy panel. alteration, or
Address: PO Box 555 extension Describe I Page 2 75 00 2
HVAC _
City /State /ZIP: Banks, OR 97106 Each additional inspection over allowable in any of the above
Per inspection 62.50 J
Phone: (503) 324 -0948 Fax: (503) 324 -0973 Investigation per hour (1 hr mm) 62.50
CCB Lie.: 158231 ;71 Electrical Lie.: 34 - 665C Suprv. Lie.: 4622S Industrial plant per hour 73 75
,•r '� ''';',' ELEC RIC,4 ., ,FER?►g17? ,it EES
Suprv. Electrician sigiature, required: , Subtotal. 75.00
Print name: Royal Stearns Date: 2/24/2009 Plan review (25% of permit fee)
, State surcharge (12% of permit fee) 9,00
Authorized signature: TOTAL PERMIT FEE: 84,00
I
This permit application expires if a permit 15 not obtained within 150
Print name: Date: days after it has been accepted as complete.
° Number of inspections allowed per permit
I \Suildmg\Permits'ELC- PcrmitApp des 05/2 ?'06 440- 4 513T(i l /03 /C0Jcvs Es
CITY OF ��wn m n�'w� nm��������
BUILDING DIVISION PERMIT #: ElR2009.000t'i1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/74/2009
Phone: (503) 639-4171
Inspection Requests (24Hmj:(5U3)G3Q'4175 ~�V- a
INSPECTION WORKSHEET FOR DATE: 2/25/2009 TIME: 7:0OAk4 PAGE: 11
SITE ADDRESS: 09508 SW WASHINGTON SQUARE RD JOl CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: CU
DESCRIPTION: Liroited energy
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: FIVE STAR ELECTRIC, INC. PHONE #: 503-324'0940
/
Inspection Request Scheduled For: Pour Time:
Code # Inspection Description C # Contact #. Message
156 Low voltage 503-3240E48 N
ICA
Cornontiona/CorhnngntdY|na1rucdono:
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111 PAS PARTIAL APPROVAL [1] CANCEL NO ACCESS
ri CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
�J��� LE-a' � -�r
Inspector: ��� ^ "���*� Date: �~~�m ~ � Phons"#: (503) 718- 1,114