Permit 1
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CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
a DEVELOPMENT SERVICES PERMIT #: ELR2005 -00304
., 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/26/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09312 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Low voltage cabling.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: 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: CABLING X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC CHRISTENSON VELAGIO, INC.
BY THE MACERICH COMPANY 1631 NW THURMAN ST. STE 200
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97209
TIGARD, OR 97223
Phone: 503- 639 -8865 Phone: 503- 419 -3600
Reg #: LTC 64137
ELE 26 -1174C
FEES SUP 1994S
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 9/26/2005 $75.00
[TAX] 8% State Surchari 9/26/2005 $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- 1 -0 0. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: // ilL„) Permittee Signature: 0 r I- c.�■.
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.
r
SEP -22 -2005 THU 02:21 PM CHRISTENSON VELAGIO FAX NO, 95034193695 P. 01/02
P. 40.tirical Permit A Il elitnil V F
City of Tigard n �., G� 1/15 Permit No. 0 i•030
13125 SW Hull Blvd., Tigard, OR 97223 ', - wink. Plan Re
Phone: 503. 639,4171 Fax: 503.598.1966' itid1 " " OdterPetmit:
•
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inspection Line: 503. 639.4175 .. i ' � �' Date/Br Gate Rady/By: El See Page 2 for
Noti6cd/Methad: v '. Supplemental information
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intect: www.ci.tigard.or.0 �
s ( O)= T1ZiARD -
IvY„:.a at j r•.;r t ,fe, .r ..; . T 1 " iS i V . ! } 4"rt - 1e +w.cSti T.. i,}',1 Y;
❑ New construction ® Addition /alteration/replacement Please check all that apply:
❑Service over 225 amps, comm ['Hazardous location
❑ Demolition [] Other y r �, o � - k tl ❑Service over 320 amps - rating ❑ mare over 10,000 sq. ft., MA
•44-).T •44-).T , ,. a r .. -,•mil : I �_._ _ t , ; . r ;'''' of I- and 2 - family dwellings 4 or mre new �idential
❑ I- and 2- family dwelling ® Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
OBuilding over three stories ❑Feeders, 400 amps or more
❑ Multi - family ❑Master builder ❑ Other:
tr � t -• r c,. .. , ['Occupant load over 99 persons ['Manufactured structures or
ti,..--704' aw'�.+s ; .•tin ' a 4' jO 4 :�. • � 7' - 1 '." : i . • c � .1114: ,,") - el " t r , ❑ Egress/lighting plan RN park
Job no.: W0102855 I Job site address: 9312 Washington Square Road- ❑EIealth -care facility ❑other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: Portland, OR 97223 The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: 'Q tt Wl Pro ect name' ti1111StAi~ oA¢nun3Cat lOriS t , i, 1 , , { ?' ' 1 , t . .'. u:y k Ab . t t + "jff;;eA
6t 3 J 1C8 3 ew Ala bn s tor . Desniptton Qrf• Pm Tot,l ..
ca le 3
Cross street/direction5 to job site: Questions : Chris Gorman New residential single -or multi- family dwelling unit.
Includes attached garage.
503 -419 -3352 1,000 sq. R. or less 145.15 4
Subdivision: Lot no.: ,_Ea. add'l 500 sq. it or portion 33.40 1
- Limited energy, residential 75.00 2
Tax map/parccl no.: Limited energy, non - residential 75.00 2
i ' r �` �� r , k': o Ea r *yt ," i{tr a. �-r' } *�,ii ►�•e; s 'v�t�,� ,, :
s,6 't
1�i'.r,�;;�f,z �: +7•�`«�^ �. -. ! � ; . 1 .��t�!T'�p�v, �':,4CQ��si'..�'.�I`+r :- �z''4��` s:.,� , .,_t.i,}•,5�,��5 �; F Each RIDnufaCNted or modular
Low Voltage Data / Telecommunication dwelling, scrviccand/or feeder. 90.90 2
Services or feeders Installation, alteration, and/or relocation
200 amps or less 80.30 2
,} r g."i' i i/ , .,, -5.tg :�etiiti g.:1V 4,103 iiir N ',0 . +,4''!; 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
Phone: ( ) I F ax: ( ) relocation
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
,,i +,;a eSSr' "Iay,�-` pJy, }'c ;y • ti •'„ r:, ��u, /Y '[ [ app ,y> , c s; '`
A. Fee for brunch circuits with
. : , - 4. : RtI r7V #1 Yl :4 ,[}�.: :. �'r' i k :CIVO .O. ^1 ifl: li§Ol'1'i'ix •.M1 J'-,
service or feeder fee. each 6.65 2
Business name: brunch circuit _
B. Fee for branch circuits
Contact name: without service or feeder fee,
Address:
each branch circuit
46.85 2
Each add'1 branch circuit 6.65_ 2 -
City/ State/ZIP: miscellaneous (service or feeder not included)
Phone: ( ) Pump or irrigation circle 53.40 2
Fax:: ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
_ -Y trK...•'M .Og,'�e'' "'' '•S y , I Y'.''` w•4'r' ti rs • s '. -c,' energy 75.0C
���'.:�.71:J.5;- a; �..v,w•�tr:3..!?�x�+�� � l l�w ;•+[�rp.l� ! ,»•`' k Y ' , � T � 4�,5'.'�' iw e� � nel, alteration, or 75.00
. S ^"•! ,., '��.a� fi + "'•:�•.LniltlNd. _.'�ily +..iif:'d •.! ,
extension. Describe: Page 2 2
Business name: CHRISTENSON VELAGIO, INC.
Address: 1631 NW THURMAN ST 2ND FL Each additional Inspection over allowable in any of the above
. Per inspection 62.50
City / State/ZIP: PORTLAND, OR 97209 - 2558 Investigation per hour (I hr min) 62.50
Phone: (503) 419 -3300 I Fax: (503 ) 419 -3333 ' industrial plant per hour 73.75 _
CCB Lie.: 64137 I Electrical Lic.: - 174C I Suprv. Lie 1994S Subtotal 75.00
Suprv. Electrician signature, required: Plan review (25% of permit fee)
I
State surcharge (8% of permit fee) 6.00
Print name: ROBERT AXT + Date: 9/22/05
TOTAL PERMIT FEE 81.00
Authorized signature: This permit appltcatiuui expires if a permit It out of talned within ISO
days after It has been accepted a complete
Print name: I Date: • Fee methodology set by Tri- County Building Industry Service Doan'
'• Number of inspections per permit allowed.
i. \auildeg \rnnus\ELC•PcrmnApp•doc 12/03 410.46t5Tt10u02/COM/WEB
CITY OF TIGARD
•
BUILDING DIVISION PERMIT #: ELR200300304
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/26/2005
Phone: (503) 639 -4171 �ama a�
Inspection Requests (24 Hrs.): (503) 639-4175
WORKSHEET FOR DATE: 11/9/2005 TIME: 7:09AM PAGE: 20
SITE ADDRESS: 09312 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: •
PROJECT NAME: KAY JEWELERS
DESCRIPTION: Low voltage cabling.
OWNER: WASHINGTON SQUARE LLC, • PHONE #: 503 - 639-8865
CONTRACTOR: CHRISTENSON VELAGIO, INC. PHONE #: 503- 419-3600
Inspection Request Scheduled For: Date: 11/9/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
19N Electrical final �� /1 020842 -01 360-907-0718 N
Corrections /Comments /Instructions: 6
'PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑' ADDITIONAL FEES ASSESSED
Inspector: Date: // Q Phone #: (503) 718 -
l
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