Permit •,.. A CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
I4 DEVELOPMENT SERVICES PERMIT #: ELR2005 -00297
' �� I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/27/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09336 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Fire alarm low voltage.
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: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC
BY THE MACERICH COMPANY
9585 SW WASHINGTON SQUARE RD
TIGARD, OR 97223
Phone: 503 639 - 8865 Phone:
Reg #:
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 9/22/2005 $75.00
[TAX] 8% State Surchari 9/22/2005 $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: ) Permittee Signature: 4'f11-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.
electrical Permit A i ion 1.01:01:1- r 1 s c ()NI.)
• City'af Tigard 1 VE Date/B ed I /
Permit No: �, __� - Ov. .,, 7
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revs w
Phone: 503 639.4171 Fax: 503.598 1963ED iAer. j I ' Date/By Other Permit
Inspection Line: 503.639.4175 JV II 1 ?005 4 .1J'' Date Ready/By ® See Page 2 for
Internet: www.ci.tigard.or.us CITY O T 'n Notified/Method Supplemental Information
eCw t •
t iby a '_ PLAN REVIEW
❑ New construction Addition/alteratiodacement Please check all that apply:
El Demolition Other: ['Service over 225 amps, comm'l 0 Hazardous location
❑Service 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 14 Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
El Multi - family 11 Master builder ❑ Other ❑Building over three stories ❑ Feeders, 400 amps or more
❑Occupant load over 99 persons ❑ Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/ligiting plan RV park
Job no.: 113 2g I Job site address: tigJ au \M 4ls 4.01• § ❑He -care facility ❑Other:
"' alth
Subm 2 sets of plans with any of the above.
City /State/ZIP: ` 1 / r , , A , b 0_, C j 1 2 . � The above are not applicable to temporary construction service. -
Suite/bldg. /apt. no.: to 1 I Project name: katAkii VkcykS 161,4, Mit V44' FEE* SCHEDULE
Derma I Q7. l Fee. I Total ••
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
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
ct 1 �� (� ,, j. dwelling, service and/or feeder 90.90 2
v `''�' L v P S i ULta Services or feeders installation, alteration, and/or relocation
't r.kis0e1(1111114 200 amps or less 80.30 2
P ROPERTY OWNER I ❑ Tv,.....,---; 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
• Name: k • I ( 1, L V 1� L 601 amps to 1,000 amps 240.60 2
Address: CI S so) IA) , L t twin' 4,17}, &„ VIti Rec `, a , ied av onn er 1,000 oct amp only or volts 454.65 2
J 66.85 2
City /State/ZIP: ' 17 CL/I'd t (9 12- 2 - Z.'3 Temporary services or feeders installation, alteration, and/or
Phone: ( ) ) 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
APPLICANT I ❑ CONTACT PERSON k Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: C(� -
� ( Le . C )) ' ,,, branch circuit
B. Fee
Contact name: / ry 0.0.14-1, l/ '� withoo ut service branch circuits
C ce or feeder fee,
each branch circuit 46.85 2
Address: r 01 Q S r , pill /9y-e Each add'l branch circuit 6.65 2
City /State/ZIP: 1: (L - i u4 1,
r " /2_ - 7 c 4 Miscellaneous (service or feeder not included)
Pump or Phone: (SZ) ) 7 el t d d Fax: : (93) 5-35-, re Sign or outline L�ting 53.40 2
E -mail: j a h s P 1) J- r� 4 7 - ef,e d !+ • d -, Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
_ , extension. Describe: / Page 2 7 ( 2
Business name: CP126- �y� I S, 6 (( p,,,,,p
Address: (-Di 0 S 1_,_ ‘010,-- 1/�I V T I `D Each additional inspection over allowable in any of the above
Y` Per inspection 62.50
City /State/ZIP: i --- 0 0_,1 ( 1 O R q.13-3-73 Investigation per hour (I he mm) 62.50
I • ( / 5
-b 53 S
` -� „•� Industrial plant per hour 73.75
Phone:3) ` 9 1 Fax: (� U�) �' Ct% ty-(J ELECTRICAL PERMIT FEES* --- CCB Lic.: (� Electrical Lic.: Suprv. Lic.:2$ WS Subtotal 75 `'
Suprv. Electrician signature, required / � f, Plan review (25% of permit fee)
,�/ / / ' State surchar (8% of p ermit fee) b G
Print name: E/4/24._ 5 em 7 I Date 2./ ('
TOTAL PERMIT FEE b u
Authorized signature: This permit application expires if a permit Is not obtained within 180
days after it has been accepted as complete
Print name: Date. • Fee methodology set by Tn- County Building Industry Service Board
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005 -00297
13125 SW Hall Blvd., Tigard, O" 97223 DATE ISSUED: 9/27/2005
Phone: (503) 639 -4171 Arw i I
Inspection Requests (24 Hrs.): (503) 639 -4175 . ! " 'I —
INSPECTION WORKSHEET FOR DATE: 11/2/2005 TIME: 7:04AM PAGE: 63
SITE ADDRESS: 09336 SW WASHING' ON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SOUR''.- LOT #: TYPE OF USE:
PROJECT NAME: WHITEHOUSE BLACK RKET
DESCRIPTION: Fire alarm low voltage.
OWNER: WASHINGTON SQUARE LL• PHONE #: 503- 639 •8865 •
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: D -te: 11/2/200+5 Pour Time:
Code # Inspection Description Con 'rm # Contact # Message
199 Electrical final 02009 02 503-793-7177 N
Corrections /Commen s ' • . • s:
PIA "hi' bar s &i
•
mie `l�> T ( 6t)
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G* Date: 11 C6 Phone #: (503) 718- VAL1 6
CITY OF TIGARD _
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ELR2005
Phone: (503) 639 -4171 ' ie 9/27/2005
Inspection Requests (24 Hrs.): (503) 639 -4175 " ---
INSPECTION WORKSHEET FOR DATE: 9/29/2005 TIME: 7:08AM PAGE: 102
SITE ADDRESS: 09336 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT N WHIT ' ' u - CK MARKET
DESCRIPT ► k
ire alarm low voltage.
OWNER: WASHINGTON • • LC, PHONE #: 503.639 -8865
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 9/29 /2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltag 01694801 503-793-7177 N
Corrections /Comments /Instructions:
_ I
•
•
•
n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
Inspector: Date: Phone #: (503) 718-
,