Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
� ;� DEVELOPMENT SERVICES PERMIT #: ELR2005 -00300
'�J I-' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/22/2005
PARCEL: 1512600 -00300
SITE ADDRESS: 09309 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Limited energy for voice /data and CATV. Job No. 10258
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: CATV X
TOTAL # OF SYSTEMS:
Owner: Contractor:
WASHINGTON SQUARE LLC PTSC
BY THE MACERICH COMPANY 710 NE CLEVELAND
9585 SW WASHINGTON SQUARE RD GRESHAM, OR 97030
TIGARD, OR 97223
Phone: 503- 639 -8865 Phone: 503- 665 -4900
Reg #: LIC 150175
ELE 26- 1117CLE
. FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 9/22/2005 $150.00
[TAX] 8% State Surchari 9/22/2005 $12.00
Total $162.00
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 within180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you ollow rules :so. - b the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
thr ugh OAR 952 -00 ' -0110. •u may obtain copies of these rules or direct questions to • NC at 503 - 246 -6699.
Is ued By: /1 � I Permittee Signature: At "
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.
Electrici~l Permit Application FOR OFFICE USE ONLY
City of Tigard Receewed Permit No / // I '�
13125 SW Hall Blvd , Tigard, OR 97223 Plan Review
Phone: 503.639 4171 ' Fax 503 598 1960 -. lit (+ 1 Datdgy Other Permit
Inspection Line 503.639 4175 c . � Date Ready/By ions ® See Page 2 for
Internet: www ci tigard.or us Notified/Method Supplemental Information
„ _ _ -�:,:� _ - •:.. " ^• . - - PLAht-REVIEVv
X New construction ❑ Addition/alteration/replacement Please check all that apply.
E] Demolition ❑Other: ['Service over 225 amps, comm'l Hazardous location
❑Service over 320 amps — rating ❑ Buildng over 10,000 sq ft ,
. , : i • „ CAT - ,QF CONSTRUCTION - „. of 1- and 2- family dwellings 4 or more new residential
❑ 1 and 2 family dwelling igii Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi ❑ Master builder ❑Other: ❑Building over three stones ❑Feeders, 400 amps or more
DOccupant load over 99 persons ❑Manufactured structures or
• s--. ; r .: • ,. ' :JOB SITE INFORMATION AND LOCATION , }, ,_ . ' ❑E plan RV park
Job no. /� 6 n Q Job site address. '. �_ -( 64 ��• ❑Health -care facility ❑Other
1 � �� 7 9 �- p �q �a� Submit 2 sets of plans vnth any of the above
City/State /ZIP: T dl o (� - 9 7 ,p33 Q The above are not applicable to temporary construction service
Suite/bldg. /apt. no.: P roject name: t • : `. , ... . F *,SCI EDULE•.: ..
A
t‘, t!_ � t�..1.LT[ JI- l� D I Q I Fee
Total
Cross street/directions to job site: to UL
U( MAI 1 J New resident s -or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145 15 4
Subdivision: Lot no.: Ea. add'l 500 sq ft or portion 33 40 l
Tax map /parcel no.: Limited energy, residential 75.00 2
v r Limited energy, non - residential 75 00 2
s ^y -' "DESCRIPON TI OF,'VORK ' • s : + , _ s » Each manufactured or modular
dwelling, service and /or feeder 90 90 2
VQ \ C__2._ o - bo._ \cam ` Os.Y'..CJ� T \i Services or feeders installation, alteration, and/or relocation
1 200 amps or less 80 30 2
, ,_" t , 201 amps to 400 amps 106 85 2
` :rPRQPERTY "OWNER ; : _.- :.' , ' , TENANT.:.: 3.: r - :
� �" hi •
401 amps to 600 amps 160 60 2
Name: OA_ , mo - O f� 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
Phone: 023) 6 3p _ ,g Fax: ( ) relocation
200 amps or less 66.85 1
Owner installation: This installation is being ai d n property that I own which is not 201 amps to 400 amps 100 30 2
intended for sale, lease, rent, or exchange, according to 7, 449, 670, and 701 401 amps to 600 amps 133 75 2
Owner signature: Da . Branch circuits — new, alteration, or extension, per panel
y. ,, ' " ?: M ; APPLLC:Oi';' s . "" '� •',f fir }' .D CONTACT P44t50 A Fee for branch circuits with
- . ' u� x � r - t' "
service or feeder fee, each 6 65 2
Busines e: branch circuit
B Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 46 85 2
Address:
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 -
t��. ".:_` .,;::;_i.,';.:::.'.. ". ",- .':fi, " ;C�ONTRA(`I'�OR'. .i.,
a."::r::` . ,,` „
.- :.,- ,.'i••".• energy panel, alteration, or
'S ^ extension Describe Page 2 's� 2
(
Business name: l ___
Address: -7 t o A) E /t /Q t i P_'d . vI el S , i � Each additional inspection over allowable in any of the above
rr� -� a v Per inspection 62 50
City /State/ZIP: e1re5v�.w4. a o1 el 7030 Investigation per hour (1 hr nun) 6250
I ndustrial plant per hour 73 75
Phone: t3b3) b'G S- 4900 Fax. (503) 64 S 4A3c) -•
•` ";;t: -- ••,; -;`• :EL•ECTRICAL PERMIT 'FEES *'
CCB Lic.: 150 1 j 5 ` Electrical Lc • � t Suprv. Lic.:3ZgI� A Subtotal 45o
0. Suprv. Electrician e, required W °0 _A • Plan review (25% of permit fee)
. ....4..4..e.41.-- ....4..4..e.41.-- � State surcharge (8% of permit fee) �c
P
runt name: STE J EA) �6G ?CI uS Date: q I to ) O, s / � a
/ TOTAL PERMIT FEE
Authorized signature " / This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name SM-1/.7-A.) aE d.- irl d f Date" /� a � f • Fee methodology set by Tn- County Building Industry Service Board
/{ •• Number of inspections per perrrut allowed
i \Building\Pemuts\ELC•PemutApp dot 12/03 440"461 ST(10 /02/CObt/WEB
Electrical Permit Application - City of Tigard
Page 2, - Supplemental Information
LIMITED ENERGY PERMIT FEES:
_- �YOav�,. R sa- s srsc :�_ - °•r�.�,..sa .-.#, °.r..�w' "•:r Gir'T'._7 , . ,.
<RE�SIDE�TTIAI��WO�RK,01�7I:Y �� xra:�'a�.�:.�- .
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:
C,OmkER - . ;.._ t WwoWxWorrL � � qM
Fee for each commercial system $75.00
(SEE OAR 918 - 260 -260)
Check Type of Work Involved: ,
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
D ata Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls .
❑ Outdoor Landscape Lighting* ,
❑ Protective Signaling
Other t.rr'ek-S . '
Total number of commercial systems: .2 ,
*No licenses are required. Licenses are required
for all other installations
1 \Buildmg\Pemuu\ELC- PermApp doc 04/03
CITY OF TIGARD ►, ?.
BOIL G DIVISION PERMIT #: ELR200��00300
13125 SW Hall Blvd., Tigard, OR 97223', DATE ISSUED: 9/22/2005
Phone: (503) 639-4171 i� h l
Inspection Requests (24 Hrs.): (503) 639 -175 � °:
•
INSPECTION WORKSHEET FOR DA : 10/27/2005 TIME: 4: 11PM PAGE: 68
SITE ADDRESS: 09309 SW WASHINGTON .SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: CHEESECAKE FACTORY
DESCRIPTION: Limited energy for voice/data a • CATV. Job No. 10258
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503-639-8865
CONTRACTOR: PTSC PHONE #: 503- 665 -4900
Inspection Request Scheduled For: Date: 10/28/2005 Pour Time:
Code # Inspec •• lescription Confirm Contact # Message
199 Electrical final 019581 -0 503 4:89 -2707 N
Corrections/ - _ - • - - _ s:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Giv N 08 L Date: t 21I Phone #: (503) 718- 2.14
11
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: ELR2006 -00300
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/22/2005
Phone: (503) 639 -4171 At
Inspection Requests (24 Hrs.): (503) 639 -4175 ��'
INSPECTION WORKSHEET FOR DATE: 10/26/2005 • TIME: 7:07AM PAGE: 98
SITE ADDRESS: 09309 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: CHEESECAKE FACTORY
DESCRIPTION: Limited energy for voice/data and CATV. Job No. 10258
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503- 639 -8866
CONTRACTOR: PTSC PHONE #: 503 - 665 -4900
Inspection Request Scheduled For: Date: 10/2.6/2005 Pour Time:
Code # I • -. -. • • Description Con • Contact # Message
135 Low voltage 19328-01 503-489-2707 Y
Corrections /Comments /Instructions:
•
�• PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ ALL FOR INSPECTIO ❑ ADDITIONAL FEES ASSESSED
Inspector: .A.O / % Date: 10 2/6 Phone #: (503) 718- 2�