Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00141
TIGARD DATE ISSUED: 6/5/2008
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S126CA - 00900
SITE ADDRESS: 09009 SW HALL BLVD 200 ZONING: C - G
SUBDIVISION: WASHINGTON CIRCLE PLAZA LOT: JURISDICTION: TIG
PROJECT: MACY'S FURNITURE GALLERY
Project Description: Installation of limited energy for fire alarm. Job No 66291
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: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
MACY'S NORTHWEST OREGON ELECTRIC GROUP
7W SEVENTH ST. 1010 SE 11TH AVE
C/O TOM HOWARD PORTLAND, OR 97214
CINCINNATI, OH 45202
Phone: (206)506 -7738 Contact #: FAX 503- 234 -1001
PRI 503- 234 -9900
FEES Reg #: ELE 26 -95C
LIC 203
Description Date Amount SUP 4460S
[ELPRMT] ELR Permit 6/5/2008 $75.00
[TAX] 12% State Surchar 6/5/2008 $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 . OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503.24:.6699 or 1.80.. . ".:344.
Issue. :y:
• i �. Permittee Signat ���jv .10 s
� 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'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.
. 4 i
! JUN -05 -08 - 10:01AM FROM- Oregon EI ec b,t :I CE WED 95032313587 T -131 P.002/004 F -570
City of Tigard RDarceceived /By: / �� /
U PI
G8 Perini No,; Eli /
S 13125 SW Hall Blvd., Tigard, OR 97223 II IN 0 5 2008 Plan Review
Phone: 503.639.4171 Fax: 503.598.19& Date/13y: Other Permit:
T t t; A R O Inspection Line: 503.639.4175 A�D —
Internet: wWw.tignrd -0r_gov rip oftedRvlhetoo Date Ready/By; 1 S Stn Page 2 rot
,,, DINGD�� Nti �C/+ Supplemental tnforrnation
TYPE OF � . PLAN REVIEW ------
❑ New construction ® Addition /alteration/replacement PP15ase check all that apply (submit 2 sets of plans w/itemr checked below):
❑ Demolition El Other: El Service or feeder 400 amps or moms El Building over three stories.
where the available fault current ❑ Marinas and boatyards.
. CATEGORY OF CONSTRUCTION • exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
111 ] - and 2-family dwelling ®Commercial /industrial less to ground, or exceeds 14000 ❑ Commercial -use agricultural
❑ A ccessory b uilding amps for all other installadoris, buildings,
❑ Multi- family ❑ Master builder ❑ Other ❑Fire pump. n Installation of '75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ 'A ", "E ' 1 _Z . 1 -3 ",
Job no.: 66291 Job site address: 9009 SW Hall Blvd 100HP or snore, occupancy.
❑ Six or more residential unils.` ❑ Recreational vehicle parks.
City / State/ZIP: Tigard, OR 97223 ❑ Heahh -cars facilities. ❑ Supply voltage for more Man
❑ Hazardous locations. : 600 volts nominal.
Suite/bldg/apt, no.: Project name: Macy's WA Sq Fire Alarm ❑ Service or feeder 600 amps of more.
Cross street/directions to job sire: 1114 SCHEDULE
— Dc n'lpiion Fie 'rota) +
New residential single- or multi- family dwelling unit.
— ..
� Includes attached garage.
Subdivision; l tof no,: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: 1 __ "" Ea add'I 500 sq. ft. or portion 33 -40 1
Limited energy, residential
DESCRIPTION OF WORK . (with above sq. ft.) 75.00 2
]Fire Alarm Installation Limited energy, multi- family
residential (with above sq. fr.) 75.00 2
Services or feeders lnstaillution, alteration, and/or relocation
200 amps or less _80.30 2
❑ PROPERTY OWNER D TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps ; 160.60 2
Address:
-- 601 amps to 1,000 amps 240.60 2
Over 1.000 amps or volts i 454.65 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 amp 100,30 2
intended for salt, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: D Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits wilt
❑ APPLICANT 0 CONTACT PERSON above service or feeder fe 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: • i without service or feeder fee,
First branch circuit 46.85 2
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feed
eeder not included)
City / State/ZIP: Each manufactured or modular
dwelling, service and/or feed 90.90 2
er
Phone: ( ) + Fax: : ( ) Reconnect only I 66.85 2
•
E-mail:
Pump or irrigation circle i 53.40 2
CONTRACTOR Sign or outline lighting 5340 2 i
Business name: Oregon Electric Group Signal circuit(s) or limited -
energy panel, altera, Address: 1010 SE li Ave extension. Describe or 1 Page 2 7500 2
City /State/ZIP: Portland, OR 97214 Each additional inspection ov allowable in any of the above
—
Phone: S03 2 349900 Per inspection 62.50
( ) Fax: (503) 234 - 1001 Investigation per hour (l hr min) 62.30
—
CCB Lie.: 203 Electrical Lie.; 26 -95 r ••rv. - ic.: 48,188 Industrial plant per hour 1 73.75
Suprv, Electrician signature, requ I A! ELECTRICAL PERMIT FEES I` + ,. r r t subtotal:
Print name: Mark Weinbcnder I/ ate: y 5/08 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 9.00
Authorized signature:
TOTAL PERMIT FEE: 84,00
Print name: Date: This permit application explres; if a permit is not obtained within 180
— days after it hna bQerl accepted uv complete.
iNiti ldiugwermiem_C- a'etmitApp.duc 05/13/06 • Number of inspections altuwed {xrpernut.
440-46151(1 ln)3/COM/WLI3
/ — •
CITY OF ��mm w n�`w mn���mna�� , ^.
A
BUILDING DIVISION PERMIT =°~°"~~~°"""~° ~�"""~°"~~"" � ELF�20O[�OU14i
13125SVV Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/5/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 m�0�- ^��
INSPECTION WORKSHEET FOR DATE: TIME: PAGE: � 8K20/2000 � 7:O2Ak4 � A
SITE ADDRESS: 09009 CLASS � SW HALL F3LVD �
SUBDIVISION: LOT TYPE � WASHINGTON QR(�LEPLAZA #: �
PROJECT NAME: MAcV'S FURNITURE GALLERY
DESCRIPTION: Irisiallation of limited energy for fire alarm. Job NV56281
OWNER: kAACYY9N[)RTM\NEEJT. PHONE #: C206l506'7738
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503-2349900
Inspection Request Scheduled For: Date: 8/30/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final • 074374-02 503-793-9535 N
_--_
Corrections/Comments/Instructions:
^
`
.
.
�� PASS -- PART|ALAPPROVAL �� CANCEL NO ACCESS
_ _
El FAIL El CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
�. .... ��"��.� ����
Inspector: »`�-~ �~���1�� � Oada� «» °~~ � Phone #: /5O3)718' ������