Permit CITY OF TI GAR® F, ELECTRICAL PERMIT
PERMIT #: ELC2005 -00627
6i�il. DEVELOPMENT SERVICES DATE ISSUED: 8/25/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09345 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: Sign. EXP11,* ED
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: 1
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 MULTI -LIGHT SIGN CO.
BY THE MACERICH COMPANY 809 NE LOMBARD ST
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97211
TIGARD, OR 97223 EXPO +; to
,Phone: 503 -639 -8865 Phone: 503 - 281 -3083 3 /a 3
FEES Reg #: LIC 64107 (�,
Description Date Amount SUP 343SIG
ELE 26 - 90CLS
[TAX] 8% State Surcharge 8/25/2005 $4.27 Q
[ELPRMT] ELC Permit 8/25/2005 $53.40 REQUIRED ITEMS AND REPORTS d e
Total $57.67
1
0
0
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 S
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 04
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: "7 e-4) Permittee Signature: C, ,1,
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.
1. 11
`Inspections Required for: ELC2OO5 -00627
✓ Code Inspection Description PASS Date I By ✓ Code Inspection Description PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground/slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service /reconnect
205 Footing 120 Electrical rough -in
805 MFG - Structure grading/footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab X 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post/beam structural 150 Hot tub /spa/pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors X 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG Structure set-up MEC - Mechanical Permit
280 Insulation 605 Post/beam mechanical
285 Drywall nailing 610 Gas line
• 287 Suspended ceiling 615 Mechanical rough -in _
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
9 • 299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in 305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test 315 Post/beam plumbing
995 Misc. inspection: 320 Plumbing rough -in
998 Alarm final 325 RP/backflow preventer
999 Sprinkler final 330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert/catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 _Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I. \Building \IVR \InspCard- AOP.doc 02/02/2005
C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00627
s�lli DEVELOPMENT SERVICES DATE ISSUED: 8/25/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600 - 00300
SITE ADDRESS: 09345 SW WASHINGTON SQUARE RD ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: Sign.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: 1
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 MULTI -LIGHT SIGN CO.
BY THE MACERICH COMPANY 809 NE LOMBARD ST
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97211
TIGARD, OR 97223
Phone: 503 - 639 -8865 Phone: 503 - 281 -3083
FEES Reg #: LIC 64107
Description Date Amount SUP 26-90C
LS
26 -90CLS
[TAX] 8% State Surcharge 8/25/2005 $4.27
[ELPRMT] ELC Permit 8/25/2005 $53.40 REQUIRED ITEMS AND REPORTS
Total $57.67
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: '7:20 11,4,7 ;& Permittee Signature:
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.
ilectrical Permit Application -_ _.__ _.
_ ____ c)R DEICE tASI:NI l'
.- ..
_._,,
j , ..
City RECEI E _ Other Permit-
of Tigard /) nags �1 - � �� -
Permit No. 0 .'--/O t - 'J
13125 SW Hall Blvd., Tigard, OR 97223 Plan /,.,& R eview • '
Phone: 503.639.4171 Fax: 503.598.1960 P �'i Date/
Inspection Line: 503.639.4175 AUG 2 5 20!:-.,.0.4- x' I ` � ; L Date Ready/By. ILVE ®. See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method Supplemental Information
TYP6:OF(RGARIJ PLAN REVIEW Xt construction ❑ Addkii 4 iggo / 'agWient 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 oft, and 2 family dwellings 4 or more new residential
11 1- and 2- family dwelling ) ommercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family //❑ Master builder ❑Other: ❑Building over three stories 0 Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
❑Health -care facility ❑tee'.
Job no.: Job site address: ta� .
��t/ �s � �1 ,r � i, Submit 2 sets of plans with any ofthe above.
City/ State/ZIP: , �� The above are not applicable to temporary construction service.
/ FEE* SCHEDULE Suite/bldg. /apt. no.:�/ 2 roject name: „/ f (� Descr i ption I Qty. I Fee. I Total .•
v
Cross street/directions to job site: j 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
/) 4 �/ e -� /- dwelling, service and/or feeder 90 90 2
v ,,C �Z7/j ( Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
PROPERTY OWNER I XTENANT 201 amps to 400 amps 106.85 2
` 401 amps to 600 amps 160.60 2
N a I / ` C /g,/�4 '') 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: (_ _ �d7 /- �Q Fax: ( )
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 ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits •
Contact name: without service or feeder fee, 46.85 2
Address: each branch circuit _ .
• Each add'I branch circuit • 6.65 2
City / State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting ( 53.40 2
E -mail: Signal circuit(s) or limited- 1
' .CO RACTOR energy panel, alteration, or
/ / / = ' extension. Describe: Page 2 2
Business name: /
Each additional inspection over allowable in any of the above
Address: / / / % : Per inspection 62.50
- j
City / State/ZIP: �x�
9-77a°2 / Investigation per hour (I hr min) 62.50
Phone: ( / , 1 #' Industrial plant per hour 73.75
Fax: (� )
d' ELECTRICAL PERMIT FEES*
CCB Lic.:1 V / ,97 Electrical Lice..2h ....9 Suprv. Lic.: 3'97 .... 53 y o _
Suprv. Electrician signature, require�' � is _A/A te, Subtota Planreview(25 %ofpermit fee)
Print nam- . / (� D, fir , State surcharge (8% of permit fee)
:,/ `.�L w Di
fir TOTAL PERMIT FEE 5 �
Authorized signature: y � i / This permit application expires if a permit is not obtained 180
/ ' � days after it has been accepted as complete
Print name: Date: Fee methodology set by Tri -County Building Industry Service Board ,iff i •• Number of inspections per permit allowed.
i \Budding\Pennns\ELC- PennuApp doc 12/03 4404615 (10/0 OM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
El Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
\Budding\Penntts\ELC- PemtitApp doc 04/03
,
CITY OF TIGARD cL-c-
BUILDING DIVISION PERMIT #: p? 9 65 - I,O < o Z 7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 a
Inspection Requests (24 Hrs.): (503) 639 -4175 ,_•1,)! "'IL
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: ? 3 C I5 j) /. SO , 2 _Li CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
A211 k- 2' 1 1 ) EXPIRE®
'"�
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: / 1 / 7 - — Pour Time:
Code # Inspection Description Confirm # Contact # Message
! V7 — � 9 -- 16/S?
•
Corrections /Comments /Instructions:
NFiU■) . i P NOLL N 1.it .
• c c..Pa 10(v Ell(L i N A �� ti owl KO
I i C.4 Nj 0.. i fzrza., cs .
•
The electrical installation defects noted
on this report shall be corrected and
an inspection request made within 20
calendar days per OAR 918 - 271 -0090
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
i ■ ∎ FAIL rS CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
k t Inspector: r V Va Date: A I -I C -- Phone #: (503) 718- 2- •