Permit r
.<
CITY
O F TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
�,� 1 DEVELOPMENT SERVICES PERMIT #: ELR2005 - 00264
' DATE ISSUED: 9/7/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600-00300
SITE ADDRESS: 09329 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 VERSATILE CABLING, INC.
BY THE MACERICH COMPANY 12606 NE 95TH ST #C -130
9585 SW WASHINGTON SQUARE RD VANCOUVER, WA 98682
TIGARD, OR 97223
Phone: 503- 639 -8865 Phone: 360 = 816 -1021
Reg #: LIC 161614
ELE 37- 1048CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 9/7/2005 $75.00
[TAX] 8% State Surcha 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 questions to OUNC at 503 - 246 -6699.
Issued By: :: oIZz Permittee Signature: � t—e
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.
Ele'trical Permit Application FOR OFFICE USE ONLY
City of Tigard ', Received P ermit No.:
Tigard, OR 97223
RECEIVE y D� -p.."-.X. � � G O o
13125 SW Hall Blvd., Ti
g Plan Review
Phone: 503.639.4171 Fax: 503 598.1960 /`� i t� Date /By Other Permit
Inspection Line: 503.639 4175 ,,'' 0 ` " I Date Ready /By: Juris El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method 5 Supplemental Information
TYPE OF ti(Clf. I IGARl` PLAN REVIEW
New construction ❑ Additio galio eprac l ' i " ' Please check all that apply.
❑ Demolition ❑Other: ❑Service over 225 amps, comm'l ❑Hazardous location
['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑Building over three stories OFeeders, 400 amps or more
❑ Multi- family ❑Master builder ❑Other:
❑Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
�`'' ll AA ll ❑Health - care facility DOther
Job no.: Job site address: ��(� l JW Il � 5� 111 G � (5[h Submit 2 sets of plans with any of the above.
City/ State/ZIP: ,� Q f� V U The above are not applicable to temporary construction service
Suite/bldg. /apt. no.: Project nam FEE* SCHEDULE
e6 ,2, P 1 {n •bra Description I Q. I Fee. I Total I +`
Cross street/directions to job site: 1 New residential single- or multi - family dwelling unit.
Includes attached garage.
1" ' a I 1 1,000 sq ft or less 145.15 4
Subdivision: t Lot no.: Ea. add'! 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
AO D ' ] dwelling, service and/or feeder 90.90 2
(J LiS F^ 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
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 I ❑ CONTACT PERSON A. Fee for branch circuits with
/ J service or feeder fee, each 6.65 2
Business name: , g . 6 branch circuit
B Fee for branch circuits
Contact name: \/
tS ) L without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'l branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phot o D) -11. . j � )-1 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
n r� 1.1 extension. Describe: I Page 2 2
Business name: C � a 11') 1 i n y
Address: / 10 61 /' ] C q 5 L a -5 C - / 6 Each additional inspection over allowable in any of the above
I V Per inspection 62.50
City/State/ZIP: / , t n c n tL �� q ( Li 4 Id Y2 Investigation per hour (1 hr min) 62.50
Phone: V C j 1L, - L o x_ I Fax: V) Q) /J / (, - 03(02_ Industrial plant per hour 73.75
�n IL, ELECTRICAL PERMIT FEES*
' CCB Lic.: l.� 1 W / ll Electrical Lic.• j . ,! <te: Subtotal Suprv. Electrician signature, required: Plan review (25% of permit fee)
, State surcharge (8 /a of permit fee) Print name: 1_ . c "1,41_„/7 ' TOTAL PERMIT FEE t
Authorized signature: This permit application expires If a permit is not obtained within 18
days after it has been accepted as complete
Print name: Date: y 15T 0 * Fee methodology set by Tn -County Building Industry Service Board
** Number of inspections per permit allowed.
i \Building \ Permits \ELC - PermitApp doe 12/03 440-4 (10 2 /COM/WEB
_ t
CITY. OF TIGARD
BUILDING DIVISION • PERMIT #: ELR2005"00264
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/7/2005
Phone: (503) 639-4171
(24 Hrs.): (503) 639 -4175 .1,1 Wm IL.
INSPECTION WORKSHEET FOR , DATE: 11/4/2005 TIME: 7:08AM PAGE: 18
N
SITE ADDRESS: 09329 SW WASHING ON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARL LOT #: TYPE OF USE:
PROJECT NAME: SEPHORA
DESCRIPTION: Audio
OWNER: WASHINGTON SQUARE LLC, PHONE #: 603 -639 -8865
CONTRACTOR: VERSATILE CABLING, INC. PHONE #: 360- 816 -1021
Inspection Request Scheduled For: Oat -: 11/4/2005 Pour Time:
Code # Inspection Description • Confi # Contact # , Message
135 ow oltage 02039: 01 503-449-1013 Y
Correct ons/ +menus /IInsstruction .
•
I
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I' FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: r 1 V 66 L' Date: ` 1 • 4 -ck5 Phone #: (503).718- 140
CITY ®F TIGARD
BUILDING DIVISION PERMIT #: ELR2005 -00264
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/7/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 — e - ..
INSPECTION WORKSHEET FOR DATE: 9/13/2005 TIME: 7:05AM PAGE: 69
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SEPHORA
DESCRIPTION: Audio
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639 -8865
CONTRACTOR: VERSATILE CABLING, INC.' PHONE #: 360 - 816.1021
Inspection Request Scheduled For: Date: 9/13/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
13.1 Low voltage 015493 -01 503 - 449-1013 Y
Corrections /Comments /Instructions:
•
74 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 9.- /3 Phone #: (503) 718 -