Permit 71 q " CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00391
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/16/2007
PARCEL: 1 S126CB -00500
SITE ADDRESS: 09300 SW WASHINGTON SQUARE RD ZONING:
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: MACY'S
Project Description: Limited energy for data, Christmas Shop area.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: . HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC PROCOM COMMUNICATIONS INC
BY THE MACERICH COMPANY 8326 SE 17TH AVE
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97202
TIGARD, OR 97223
Phone: Contact #: PRI 503- 233 -8037
FAX 503- 233 -8052
Reg #: ELE 3- 397CLE
FEES LIC 109929
Description Date Amount
[ELPRMT] ELR Permit 10/16/2007 $75.00
[TAX] 8% State Surcha 10/16/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
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 • ' work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow ru -s adopted by the Oregon
Utili otification - ■ ter. T - ules are set forth in OAR 952 - 001 -0010 through OAR 95 - 001 -0100. You j ay obtain copies of these
rules or direct question • • UNC - •3 246.6699 or 1.800.332.2344. /, /
Iss. ed By: 0 4, �' Permittee Signature: �( LAI, L ",'j'r
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 Date/By / / /5 ,or 7 Permit No 7039/
V 13125 SW Hall Blvd , Tigard, OR 97223 Plan Review
8 Phone. 503 639.4171 Fax. 503 598 1960 Date/By Other Permit
T I G A R D Inspection Line 503.639 4175 Date Ready/By i See Page 2 for
Internet www.tigard - gov Notified/Method suns ((q Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings
' less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1 - and 2- family dwelling ig Commercial /industrial ❑ 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 derived system
El Addition of new motor load of ❑ "A ", "E ", "I - ", "I - ",
Job no.: Job site address: Q2� I �(� d(� 1001 -IP or more occupancy.
�W ❑Six or more residential units. ❑ Recreational vehicle parks
City/State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than
( ❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: Project name: maw ‘A S � ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I • '
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 I
Tax map /parcel no.: Limited energy, residential 75 00 2
DESCRIPTION OF WORK (with above sq ft )
Limited energy, multi - family
----:- 75.00 2
D -� residential (with above sq ft )
Services or feeders installation, alteration, and/or relocation
200 amps or less 80 30 2
❑ PROPERTY OWNER I ❑ , TENANT 201 amps to 400 amps 106 85 2
Name: 1A),9- . 1-0, 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: ( ) 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, per panel
Owner signature: Date: A Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6 65 2
VI `
� � e p � Fee branch
each
Business name: � I B. Fee for branch ci rcc
uits
without service or feeder fee,
Contact name:
w. �� first branch circuit 46 85 2
Address: ?,S t( \\ 6s 04444 Each add'I branch circuit 6 65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: b Pi 30 a Each manufactured or modular 90 90 2
dwelling, service and/or feeder
Phone: (6 o3) a - SS _ F2O3 � Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53 40 2
CONTRACTOR Sign or outline lighting 53 40 2
I Signal circuit(s) or limited -
Business name:
PfLo ' t i extension e g el, alteration, a or I Page 2 1 2
Address: c.3 s li
City/State /ZIP: f Gtr t Olt e7 , - o a. Each additional inspection over allowable in any of the above
Per inspection 62 50
Phone: (503 ),D3 3 -e 03 7 Fax: ( ) Investigation per hour (1 hr min) 62 50
f � Indust plant per hour 73 75
CCB Lic.: ( D 1 "12 7 1 Electrical Lic.: 3 -39 i Suprv. Lic.: fiL p p
ELECTRICAL PERMIT FEES
Sum/. Electrician signature, required: / 7 1 Subtotal TS 0O
1
Print name: 1 Ar Date: / V -ta Plan review (25 %of permit fee) O (7
/ State surcharge (8% of permit fee) U
Authorized signature:] r . -,i+ �O ' j - TOTAL PERMIT FEE fl )
Print name: �t/rl / I Date: This permit application expires if a permit is not obtained wi 180
r " 7 � days after it has been accepted as comp
��•cccJJJ"' • Number of inspections allowed per permit
1 \Bmidmg\Permits\ELC- PermnApp doe 05/23/06 440- 4615T(l I/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information ° ° `•
LIMITED ENERGY PERMIT FEES:
F RESIDENTIAL'WORK ONLY: - .
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
CQMMERCIAL'WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
n 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
❑
Other
_ .
Total number of commercial systems:
*No 'Licenses are required. Licenses are required
for all other installations
I \Buddmg\Permns\ELC- PermiApp doc 03/23/06