Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
i� DEVELOPMENT SERVICES PERMIT #: ELR2005 -00322
1L ,_�JI 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/5/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09339 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Limited energy for fire alarm. Job No. 13312
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 OREGON ELECTRIC CONST /GROUP
BY THE MACERICH COMPANY 1010 SE 11TH AVE
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97214
TIGARD, OR 97223
Phone: 503 639 - 8865 Phone: 503 234 - 9900
Reg #: LIC 203
SUP 4460S
FEES ELE 26 -95C
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 10/5/2005 $75.00
[TAX] 8% State Surchari s 10/5/2005 $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 - adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through • • R 952 -0I -I • ). ou may obtain copies of these rules or direct 2 gestl.ns to OUNC a 03 -246 .699.
Issued :y: ,A, .4( J / A !/ i / Permittee Signat 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 • s lie •-0 �EN tA) Foli OFFICE USE ONLY
w
City of Tigard 3 owi Date /B : !� =� Permit No : X1.2 , -' -00 39.....
13125 SW hall Blvd., Tigard, OR 97223 QC Plan Review
Prone: 503 639.4171 Fax: 503.598.1960 "^a " " ` ,• w°,;;?I � �'1' Date/B • : Other Permit:
Inspection Line: 503.639.4175 G` -C‘( O - °II I� Date Ready/By HI See Page 2 for
Internet: www.ci.tigard.or.us �,�Q� • Notified/Method: Supplemental Information
TYPE OF W ORK PLAN REVIEW :. .
❑ New construction ® Addition/alteration/replacement 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
❑ Multi - family ❑Master builder ❑Other: ❑Building over three stories ['Feeders, 400 amps or more
DOccupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION _ ❑Egress/lighting plan RV park
❑Health - care facility ❑Other:
Job no.: 13312 Job site address '333' gW Washington Square Rd
Submit 2 sets of plans with any of the above.
City / State/ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: TI1 Project name: Janeville FEE* SCHEDULE
Description I Qty. I Fee. I Total I *•
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'I 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
Install low voltage wiring and cabling for Fire Alarm dwelling, service and/or feeder 90.90 2
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: Washington Square LLC 601 amps to 1,000 amps 240.60 2
Address: 9585 SW Washington Square Rd Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/ State/ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( )
200 amps or less 66.85 I
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
service or feeder fee, each 6.65 2
Business name: Oregon Electric Group, Inc. branch circuit
B. Fee for branch circuits
Contact name: Loni Martin without service or feeder fee,
Address: 1010 SE 11 Ave each branch circuit 46.85 2
Each add'I branch circuit 6.65 2
City/State/ZIP: Portland, OR 97214 Miscellaneous (service or feeder not included)
Phone: (503) 234 -9900 Fax: : (503) 535 -2620 Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: loni @oregon - electric.com Signal circuit(s) or limited- ,'
CONTRACTOR energy panel, alteration, or
extension. Describe: l Page 2 75 2
Business name: Oregon Electric Group, Inc. l
Address: 1010 SE 11 Ave Each additional inspection over allowable in any of the above
Per inspection 62 50
City /State/ZIP: Portland, OR 97223 Investigation per hour (I hr nun) 62.50
Phone: (503) 234-9900 Fax: (503) 535 -2620 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES* ,
CCB Lic.: 203 Electrical Lic.: Suprv. Lie.: �{�(� Subtotal °jS 4,•-
Suprv. Electrician signature, required: / i( Plan review (25% of permit fee)
State surcharge (8% of permit fee) 6,.,(.....1, 6,.,(.....1, Pnnt name: /viv4ret c 1) • Date: f /05 _
TOTAL PERMIT FEE f i'-c-- c A uthorized signature: /!�`� rmit T his a e: Pe PP lication P ires it a tro permit is t obtai thin 180
days after It has been accepted as complete
Print name: Ipl ad ick 1, A/61/ :9/30/05 • Fee methodology set by Tn- County Building Industry Service Board
A/61/ •• Number of inspections per permit allowed
IABuildmg\Permns\ELC- Permii App doe 12/03 440-4615T( 10/02/COM/WEB
‘ +CA - ed .... .7--
CITY OF TIGARD
BUILDING DIVISION A PERMIT #: ELR2005 -00322
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/512005
Phone: (503) 639 -4171 • Inspection Requests (24 Hrs.): (503) 639 -4175 Vlit
INSPECTION WORKSHEET FOR DATE: 11/2/2005 TIME: 7:04AM PAGE: 64
SITE ADDRESS: 09339 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHING ON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: JANEVILLE
' DESCRIPTION: Limited energy r fire alarm. .Job No. 13312
OWNER: WASHINGTON SQ I RE LLC, PHONE #: 503-639-8865
CONTRACTOR: OREGON ELECTRIC .ONST /GROUP PHONE #: 503 - 2349900
Inspection Request Scheduled For: Date: 11/2/2005 Pour Time:
•
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 120098 -01 503-793-7177 N
Corrections /Comments /Instructions:
(4 G, lq-1 /ys-, ( �
IA 5
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N Date: 1 1 ' li 65 Phone #: (503) 718- ZA44
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005 -00322
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/5/2005
Phone: (503) 639 -4171 4
Inspection Requests (24 Hrs.): (503) 639 -4175 `'I I..
INSPECTION WORKSHEET FOR DATE: 10/7/2005 TIME: 7:05AM PAGE: 68
SITE ADDRESS: 09339 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: JANEVILLE
DESCRIPTION: Limited energy for fire alarm. Job No. 13312
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639-8865
CONTRACTOR: OREGON ELECTRIC CONST /GROUP PHONE #: 503.234 - 9900
Inspection Request Scheduled For: Date: 10/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 017714 -02 503-793 -7177 N
Corrections /Comments /Instructions:
•
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v i 1\1
Date: IOf Phone #: (503) 718- L?%
•