Permit � (f ' 4
C ITY O® TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00502
r �n DEVELOPMENT SERVICES DATE ISSUED: 7/14/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
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SITE ADDRESS: 09309 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: Temporary service.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
WASHINGTON SQUARE LLC OREGON ELECTRIC CONST /GROUP
BY THE MACERICH COMPANY 1010 SE 11TH AVE
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97214
TIGARD, OR 97223
Phone: Phone: 503 - 234 - 9900
FEES Reg #: LIC 203
4460S
Description Date Amount SUP 26-95
ELE 26 -95C
[ELPRMT] ELC Permit 7/14/2005 $66.85
[TAX] 8% State Surcharge 7/14/2005 $5.35 REQUIRED ITEMS AND REPORTS
Total $72.20
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 questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: r Permittee Signature: p
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.
s. if ,OT- lid -05 04:08AM FROM-Oregon Electric Estimating 5032313587 T -652 P.002/002 F -784
Electrical Permit Application FOR OFF! ' . . a .. '
0 � Received _; t7' Ferm,iNo..t�L e„ -0.0-42. City of Tigard Date/rb — , C
13125 SW Hall Blvd., Tigard, OR 97 x23 Plan Review Other Permit
Phone: 503. 639.4171 Fax: 503.598.1960 & �1 A " 4 { i t Daudliy:
Inspection Line: 503. 639.4175 j 1 a-} 2.10.-1 4 "�� `W Date /
a,d;. cage 2 for
'U Notdied/Mahod, Supp eft information
interne[: www.citigard.or -ua T a r AF�D
Calk oir,,wti g101 rLAN REVIEW _
dkli1i r' Wait-ton/replacement Please Clicck all that apply:
® New construction ❑> /leenl 0S over 225 amps. comm'1 ❑Hazardous location
❑ Demolition ❑ Other DServicc over 320 amps - rating ❑Bulldog over 10,000 sq. ft..
CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential
QS over 600 volts nominal units in one stnaCntrc
El 1 - and 2-family dwelling ® Commzrcial/mciustlial ❑ Accessory building
❑Building over three atones ❑F eeders. 400 amps or more
❑ Multi family ❑ Master builder ❑ Other ❑Occupant load over 99 persons ❑Manufactured structures or
30E SITE INFORMATION AND LOCATION ❑figress/lighimg plan RV park
❑ Rea hozarc facility Dottier .—
Job no.: 18572 1 Job site address: 9050 sw Washimmnuton Square Rd submit z sets of plans with any of the above.
City/State/ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service.
FEE* SCHEDULE
Suite/bldg./apt. no.: I Project name: C heese Cake Factory Temporary o.crip eon I o,,,, i aK I fact -
Cross strtx.-t/directions to job site; New residential single- or multi - family dwelling emit.
_ Includes attached garage.
1,000 sq. tt or less 145.15 4
Subdivision: I Lot no.: Ea a dd'1500 s it or portion 33.40 1
-
' Limited energy. residential 75 2
w
Dix map /parcel no.: Limited energy, nog residential 75.00 2
DESCRIPTION OF WORK Each rnamrf scarred or modular 1
- dwelling, service and/or feeder 90.90 2
Temp Sevice Services or feeders installation. alteration, and /or relocation -
200 amps or less 80.30 2
201 amps to 400 a 106.85 _ 2
❑ PROPERTY OWNER I ❑ TENANT 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 2 40.60 2 .
Over 1,000 amps or volts 454.65 2
Address: Reconnect only 66.85 2
City/Stat IZlP: Temporary ser riccs or feeders installation, alteration, and /or
relocation Phone: ( ) I Fax: ( ) 200 amps or less ! I 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 138 -75 _ 2
Owner signature: Date: _ Branch circuits — new, alteration, or extension. per panel
❑ APPLICANT ❑ coNTA.cr PERSON A- Fee for branch circuit: with
service or feeder ice, each 6.65 2
Business name: branch circuit .
B. fee for branch circuits
Contact name. wrthour service or feeder fec, 46.85 2
' each branch circuit
Address: Each :41'1 branch circuit 6.65 2
City/State/ZIP: - Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 , 2
Phone; ( ) Fax ( ) Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: Oregon Electric Group _ -
Each additional inspection over allowable in any of the above
Address: 101 O SE 11th Ave — - Per inspeu,ion 62.50
City/State/LIP: Portland, OR 97214 Invastigation per hour (1 hr mat) 62.50
Industrial plant per hour 73.75
Phone: (503) 234 -9900 I Fax: (503) 535 - 2763 ELECTRICAL PERMIT FEES*
CCB Lie.: 203 I Electrical Lie.: 26-95C Suprv. Lie.: 4460S Subtotal L 85
Suprv. Electrician signature, required !/ Plan review (25% of permit fee)
�- State surcharge (8% of permit fec) 3 )
Pratt 112211C: AA j � . t� 1 Datc: Z a f0 TOTAL PERMEr FEE `1 -- �(1)
Authorized sip =re: Thb pownitapplieosion esp4re. Ira permit is not obtained within t80
O days alter it has been accepted as complete
Print name: •/ /� 1-1 Date: 71/5/ - F c me hodology set by Tri -Coemry Bwldang fndi=try a-rvot Picard
r OF TIGARD
BUILDING DIVISION PERMIT #: ELC200& -00502
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/14/2005
Phone: (503) 639 -4171 ° 7a1 "'l�1i .F. �1/
Inspection Requests (24 Hrs.): (503) 639 -4175 �
INSP ION WORKSHEET FOR DATE: 7/21/2005 TIME: 7:09AM PAGE: 70
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SITE ADDRESS: 19309 SW WASHINGTON SQUARE RD CLASS OF. WORK:
SUBDIVISION: HINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: CHE CAKE FACTORY
DESCRIPTION: Tempora ervice.
OWNER: WASHINGTON 0UARE LLC, PHONE #:
CONTRACTOR: OREGON ELECTR : CONST /GROUP PHONE #: 503-234-9900
Inspection Request Scheduled For: Date: 7/21/2005 Pour Time:
Code # 1" 11- .. •nfirrn # Contact # Message
'110 Temporary ical service 011B -01 503- 849.21B5 Y
- -�' d1t951 t
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Corrections /Comments /Instructio► : - A F4) ("z-
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$PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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Inspector: 6156 � Date: 1 2_ atl Phone #: (503) 718 -2kib
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