Permit a CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2009 -00121
T I G ARD 13125 SW Hall Blvd , Tigard OR 97223 503.639 4171 Date Issued: 04/28/2009
Parcel: 1S 126CB00500
Jurisdiction: TIGARD
Site address: 9300 SW WASHINGTON SQUARE RD
Subdivision: Lot: 0
Project: Macys
Project Description: Install restricted energy for voice /data.
Owner: FEES
MACY'S DEPARTMENT STORES INC Description Date Amount
ATTN TAX DEPT, 7 WEST SEVENTH ST Restricted Energy Permit 04/28/2009 $75.00
CINCINNATI, OH 45202 12% State Surcharge - Restricted Energy 04/28/2009 $9 00
PHONE:
Contractor:
PROCOM COMMUNICATIONS INC
2316 SE CLATSOP
PORTLAND, OR 97202
PHONE 503 - 233 -8037
FAX: 503 - 233 -8052
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo. Boiler Controls:
CCTV: Clock Systems'
Data & Telecommunications Y Fire Alarm:
HVAC• Instrumentation. Total $84.00
Intercom /Paging: Landscape /Irrigation
Landscape Lighting. Medical:
Required Items and Reports (Conditions)
Nurse Calls. Protective Signal:
Security Alarm: Other:
Other Desc
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 rf work is not started within 180 days of issuance, or if work is suspended for more
the 180 days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952 - 001 -0010 through s • R 952-001-p.100 You may o am - I c..pyof the rules or direct questions to OUNC by calling 503 ( 99 or 1 800 332 2344,
Issued By: !L.L& tiC
. � ' 1 Permittee Signature: Q 1k
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.
Tue, April 28, 2009 07 am Shawn Giles 503- 727 -3397 74 0 -70-7 p 02
r.
t r - I
Electrical Permit AppLCa s FOR C)FFft L J:.ti l:: i) "N 1.1
City of Tigard � Permed I'umd No /
III
■ 13125 SIN ltani tIVd., Tikud. or. ^.72'L R 2 2009 Date /1)y �( 0 C C F GQ_ •001 (
I4aal'tcvicw Oren Pam
Phone. 503.639.4171 Fax: 503 - 5981960 Datc/fi
TIGARS Inspection line: 503.639.4175 CITY OF TIGARD Date Ready/By Jima. Pi See rage fur
Interne/ wwwtigtrd -O(. OV N atliei/MCthOd ' Supplemental'Information
BUILDING DIVISION
TYPE OF WORK PLAN REVIEW
El New construction N Addition/alteration/replacement
Please check all that apply (submit 2 to of plane wlll�>r�a :h x kid Ixlow)
❑ Service or f,arkr 400 am1r5 1/1 IIKK; ID Buildille, over three swlica.
❑ llemolil inn - ❑ Other: wham, the available fault 'am ) ❑ Monona and Iv ary4 d,
CATEGORY OF CONSTRUCTION exceeds I(i.0X10 amps at 1 511 vans or r ❑ y Iilo:umg hu,ld,nes
l to y t uua, us exceeds 14.000 COMIllertial -use agnriln,ral
❑ 1- and 2- family dwelling N Commi. rcial/itlilttatriai ❑ Accessory building amp- Iry all other mstallati,ms builrhal;s.
❑ Multi- family ❑ Martel builder ❑ Other ❑ FCC pump ❑ inaallat,nn of 75 F:VA nr
❑ Eauxgelley system larger separately rlenvrd ayslrm
JOB SITE INFORMATION AND LOCATION ❑ Adrirnon nf nrw motor load if ❑ °A" G" °I -2" °I -3e
Job TO). Job site address: 09300 SW Washington Square Rd
NOHOW woo occupancy
_ - ❑ Six or more residential umle ❑ Itocrwln,nal w,h,cle pal l'+
-
❑ I Iralth -care faolllrt.s. ❑ Sl apply vnil li,r mnrr thin
City/Stale/7.1P: Tigard/OR/
._ ❑ i larudous locations fiIN) volt•. nominal
Suite/bldg. /apt. no." Project name: Macy's Washington Sq. a s ervice or leerier bill) amrac or mule
WE SCHEDULE.
Cross street/directions to job site: onviplicm 15Ie_ re I Iasi I "
New rnridelttiul single- or multi family dwelling unit.
7 Includes attached garage.
Subdivision: I Lot no.: 1,000 aq. 11_ or loss 145.15 4
Ea. add'1 500 ay. II. or portion 33 40 I
Tax map/ptlrecl nu.. i.ialited energy. residential
DESURIPTION OF WORK (with above sq fI ) 77 -00 2
Voice and Data limited energy, multi - family
residential (with above sq 11) 75.110 2
-
Services or feeders Installation, alteration, and /or relonatiop
200 amps or lase 8030 2
❑ PROPER'T'Y OWNER ❑ TENANT 201 amps to 400 atnps 106.85 2
Name: Macy's Department Stores Inc 401 amps to GUU amps 160.60 2
- - -- 601 amps to 1))00 :maps 240.60 2
Address: 7 West Seventh St. Over L000 amps or volts 454.65 2
City /StaleJ7.11'. Cioclnnati /OH/45202 1'emponiry aervici s or feed•re inarallation, alteration, and /or
relocation
Phone: (313)379 -7667 l'ax. ( ) 2UU amps or lcaa . _ - - -- _ 06.85 1
Owner installation; This installation is Mug made on property that I own which is not 201 „rips 10 400 :minim 100 30 2
amended for sale, tease, rent, or exchange, acc.ording, to ORS 447, 449, 670, and701. 401 amps to 599 amps 133 75 2
Braise h eucuits new. ulteratiuu. ur extension. per panel
Owner signal MC' Dale. A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above Set vice vu feeder fee,
each branch circuit 6.65 2
Business name: ProCom Communications, Inc. B. Fes for &much circuits
Contact name: Shawn Giles
without service or lender fee, 46.85 2
first branch circuit
Address 2316 SE Clatsop Each add'l branch circuit 6.65 ( 2
_Mlsce_ Uanenns (service or feeder not liu luded)
City/ State / /ll': Portland/OR/97202 Each manufactured or modular
-
dwelling, act-vice and /or fbcdcr 90'90 2
Phone: (503) 233 -8037 Fax: : (503) 233 - 11052 Reconnect only 66 85 2
I mall' c hawng (a)prneoutcornmunicatlons_com Pump or irrigation circle 53 40 2
CON'l'RA(I l'OR Sign or outline li jiting 53.40 2
Business name: ProCom Communications, Inc_ Si i circuit(s) or limited
------ - - _ queasy panel. ahcxntion. or
1
Andress: 2316 SE Clatsop extension. Describe: Page 2 75 00 2
City/Staie/7JP: Portland/OR /97202 I Each additional inspection over allowable w any °Pelee above
Phone: (593) 233 -8037 — —__ - l l as (503) 233-8052 - Per inspection 62 50
` Imrestigption per bout (I hr min) 62.50
CCB Lie.: 109929 F.lectrical Lie.: 3 - 397CI .I.. f Suprv. I .ic.: 11721.EA Industrial plant per hour 73.75
Supry Electrician signature, required. _ Fa _ rx•rnrc•n1, TEIWSPP FEES -
—
.... __ Subtotal: 7500
Print name Shawn Cues Date 4/28/09 Pi m rev (25% of permit fcc):
slide eur:harge (12% of permit I o): 9 00
Auillorire J signature.
�.— S TOTAL PERMIT PEE: x4 1111
Print name: Shawn Gila; Daic 420/09 ���ccC�rNff , ` y �[� This permit application expires Ir permit is not obtained within 1511
f day+ alter it has hen accepted as Complete.
Number of I pectiralc allowed per peraut
Itti ,nlduitatroublELC•Penminppdoc 0 1/1 VIN, 440461510INNCOM/wFii