Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
4 11 1 4, DEVELOPMENT SERVICES PERMIT #: ELR2005 -00266
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/7/2005
PARCEL: 1512600 -00300
SITE ADDRESS: 09309 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Audio.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X 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:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC MERLIN POINTE TECHNOLOGIES
BY THE MACERICH COMPANY 11800 NE 95TH ST STE #230
9585 SW WASHINGTON SQUARE RD VANCOUVER, WA 98682
TIGARD, OR 97223
Phone: 503- 639 -8865 Phone: 360 - 892 -0065
Reg #: LIC 155924
ELE 37- 100CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 9/7/2005 $75.00
[TAX] 8% State Surchari 9/7/2005 $6.00
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, 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 • .stions to OUNC o - 246 -6699.
Issued By: Permittee Signature: - _
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 Appli a I roil A � 11VE roll 01 rlcr. llSE O L
City of Tigard EP 0 r1 200 pat Permit No.: c , z...05 �j ( .,
/B 13125 SW Hall Blvd., Tigard, OR 97223 d Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 //4 J pp ( - ji , Date/B Other Permit:
Inspection Line: 503.639.4175 CITY OF TIGAr-1-: Date Ready/By EMI 65 See Page 2 for
Internet: www.ci.tigard.or.us BUILDING DIVISION Nou fied/Method: . Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply
❑ Demolition ❑Other: ❑Service over 225 amps, comm'I 0 Hazardous location
OService over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1 and 2 family dwellings 4 or more new residential
❑ 1 - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building OSystem over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder ❑Other: ❑Building over three stories ❑Feeders, 400 amps or more
DOccupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: Job site address: CI 3 ®c/ torts N-1 U To►v s p� 01-care facility ❑Other:
'�1 • Submit 2 sets of plans with any of the above.
City/ State/ZIP: - - ct\_Vi., OXi_ q "7 3 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: 6,/f- FEE* SCHEDULE .
/L� % Description I Qty. I Fee. I Toial
Cross street/directions to job site: / New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
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Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
, DESCRIPTION. OF WORK Each manufactured or modular
dwelling, service and/or feeder 90.90 2
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
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
. ❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax::( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration, or
extension Describe: I Page 2 2
Business name: //j/e571 i I
Each additional inspection over allowable in any of the above
Address: J /ed 0 4/t3 93 /// S " s / 7 - tea 3 d
Per inspection 62.50
City /State/ZIP: v/�WcO t✓lJ�n vv/'- , / 86 Z Investigation per hour (I hr min) 62.50
Phone (3 pc) 8 cj 0 p,�� Fax: ( ) Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: ) 2 Electrical Lic.: 3 /0070 St4rv. Lic.: 3 6, 9 9teZ Subtotal
Suprv. Electrician signature, required: t Plan review (25% of permit fee)
1„ Print name: Date: State surcharge (8% of permit fee) igi`C______ �l2r; �a ' 9 7 0 TOTAL PERMIT FEE
v r f ��'7LJ
Authorized signatu : c ' This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete - Print name: s It.......' ' — -•—••"). , i ` Date: 9 —7 ' • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed
i \Budding\Perrnits\ELC- Pmn,Wpp doc 12/03 440-4615T(10/021COM/WEB
•
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
i 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:
I COMMERCIAL
Fee for each system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ 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\Perrnits\EL.C- PertnitApp doc 04/03
CITY OF TIGARD ,,',. .. -
BUILDING DIVISION P ERMIT #: E LR2005 -00266
13125 'SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9 /2005
Phone: (503) 639 -4171 ! I�I°
Inspection Requests (24 Hrs.): (503) 639 -4175 ...' "__..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 76
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SITE ADDRESS: 09309 SW WASHIN ' ON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUA LOT #: TYPE OF USE: '
PROJECT NAME: CHEESECAKE FACT
DESCRIPTION: Audio.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639 -8865
CONTRACTOR: MERLIN POINTE TECHNOLOG S PHONE #: 360- 692 -0065
Inspection Request Scheduled For: Dat • 10/31/2005 Pour Time:
Code # Inspection Description Confir # Contact # Message
199 Electrical final 019762 -0 603 312 -7794 N
Corrections /Comments / Instructions:
4
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1
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION . ❑ ADDITIONAL FEES ASSESSED
Inspector: G BAR No8 L Date: i0 105' Phone #: (503) 718 - vitik,