Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT
PERMIT D: ED: 10 /9/2 07-00695
11
DATE ISSUED: 10/9/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1512600 -00300
SITE ADDRESS: 09345 SW WASHINGTON SQUARE RD T13 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
PROJECT: POTTERY BARN KIDS
Project Description: (4) branch circuits for stock room TI.
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:
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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 3 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 RIVIERA ELECTRIC
BY THE MACERICH COMPANY 7312 NE PAR LN
9585 SW WASHINGTON SQUARE RD VANCOUVER, WA 98662
TIGARD, OR 97223
Phone: Contact #: PRI 503 - 740 -2291
FEES
Description Date Amount Reg #: ELE C9
[ELPRMTI ELC Permit 10/9/2007 $66.80 LIC 161787
[TAX] 8% State Surcharge 10/9/2007 $5.34 SUP 5294S
Total $72.14 REQUIRED ITEMS AND REPORTS
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 d • • . n- 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 tha :0 days ATTENTION' Or -- , law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 9 - 001 -0010 through OA 9 -001 -1 00. ou may obtain copies of these rules or direct questions to OUNC at 503 246 6699 or 1.800.332.2344
Iss ed By: - ` AA1/—LL • / 1 Permittee Signature:
OWNER INSTALLATION ONLY
The insta . - .eing made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CO TRACTOR IN TALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE: /4 1`A 7
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 Applic :,S,• -�, ev FOR OFFICE; USE. ONLY
_ __
Received
City of Tigard Date/By (6) 9 a 7 C Permit No.. E LC 7 _ '5'
,11 n 13125 SW Hall Blvd , Tigard, ORM7243 9 2001 Plan Review
Phone: 503 639 4171 Fax 503 1 Date/By Other Permit
TI G A R D Inspection Line 503 639 4175 CATY OF, `i D Date Ready /By 3ur , HI See Page 2 for
Internet: www tigard -or gov 8 ��91 IS10N Notified/Method Supplemental Information
TYPE OF WORK ' 'PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stones
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ I- and 2- family dwelling L Commercial /industrial ❑ Accessory building amps for all other installations buildings
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system
❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "1 - ",
Job no.: I Job site address: 9 3 I wa
/,t/ 100HP or more. occupancy
s t v ' I Z �Y � —"❑ Six or more residential units ❑ Recreational vehicle parks
City/State /ZIP: T ' `ia:0.rd 0 ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt. no.: 1 Project name: PoH ,. tf S ❑ Service or feeder 600 amps or more
Cross street/directions to job site: // FEE SCHEDULE
J Description I Qty. I Fee. I Total
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq ft. or less 145 15 4
Ea add'I 500 sq. ft or portion 33 40 1
Tax map /parcel no.: Limited energy, residential 75 00 2
DESCRIPTION OF WORK (with above sq ft )
ii ��ii /lid L I Limited energy, multi - family 75 00 2
C K- Lv i iM /te►G�Irf7bn ' S u- residential (with above sq B )
✓ Services or feeders installation, alteration, and/or relocation
200 amps or less 80 30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106 85 2
Name: 401 amps to 600 amps 160.60 2
• 601 amps to 1,000 amps 240 60 2
Address: Over 1,000 amps or volts 454 65 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 599 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6 65 2
Business name: B. Fee for branch circuits
without service or feeder fee, ` 46.85 . P" 2
Contact name: first branch circuit
Address: Each add'I branch circuit 3 6 65 /9, 95" , 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66 85 2
E -mail: Pump or irrigation circle 53 40 2
CONTRACTOR Sign or outline lighting 53 40 2
r Signal circuit(s) or limited -
Business name: .I vl '�,
' ro � 'IcpG-r-rf 'L energy panel, alteration, or
Address: 73 /Z pi 6_ erne_ L A" extension Describe Page 2 2
City/State /ZIP: 1/ / (/in 16 2 Each additional inspection over allowable in any of the above
Per inspection 62 50
Phone:
(9-0 >) 7If D 2 Z 9 / Fax: ( ) Investigation per hour (i hr mm) 62 50
CCB Lic.: /6 /7' 7 I Electrical Lic.: (7 7 d Suprv. Lic.: 52 s 4 5' Industrial plant per hour 73 75
/ {� ELECTRICAL PERMIT FEES
Suprv. Electr si a required: /2 �B�i� /o Subtotal 4 6, gv
Print name: 1 e C (- 'J . G� Date: Plan review (25% of permit fee) $ —
State surcharge (8% of permit fee) 5.3(11
Authorized signature: TOTAL PERMIT FEE �p�,
This permit application expires if a permit is not obtained withi 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit
1 \Building\Permns\ELC- PermitApp doc 05/23/06 440 -4615T(1 I /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
ti r E, 9 l; i -- in
LIMITED ENERGY PERMIT FEES:
' 1
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:
[t' COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(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
❑ Other .
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I \Buddmg\Permits\ELC- PermitApp doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: CI. C2007.00695
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/9/2007
Phone: (503) 639 -4171 !'
Inspection Requests (24 Hrs.): (503) 639 -4175 "'l l..
INSPECTION WORKSHEET FOR DATE: 10/15/2007 TIME: 7:01AM PAGE: 21
SITE ADDRESS: 09345 SW WASHINGTON SQUARE RD T13 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: POTTERY BARN KIDS
DESCRIPTION: (4) branch circuits for stock room TI.
OWNER: WASHINGTON SQUARE LLC, • PHONE #:
CONTRACTOR: RIVIERA ELICTRIC. PHONE #: 503.740 -2291
Inspection Request Scheduled For: , Date: - 40/15/2007 Pour Time:
Code # Inspection Description l Col nfirm # Contact # Message
199 Eloctiical final 057613-01 503.740 -2291 N
Corrections /Comments /Instructions:
•
•
/ v
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ,
Inspector: ` I " v FS Date: I O( 1b' Phone #: (503) 718 - ILO°
CITY OF TIGARD • . _
BUILDING DIVISION PERMIT #: EL.C2007 00696
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/9/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 .,.' Ii.
INSPECTION WORKSHEET FOR DATE: 10/13h007 TIME: 7:01AMN PAGE: 35
SITE ADDRESS: 09345 SW WASHINGTON SQUARE RD T13 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: POTTERY BARN KIDS
DESCRIPTION: ( branch circuits for stock room TI.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR. RIVIERA ELECTRIC PHONE #: 503740.2291
5 s) CL,3
Inspection Request Scheduled For: Date: 10/12/2007 Pour Time: ,j) o f) K
Code # Inspection Description Confirm #\ Contact # Message (j 1 E c,tc
120 Electiical rough -in 057527 -01 503 - 5166412 N
�, nNO
Corrections /Comments/ Instructions:
(. 0 t g Al N *I\) —.; F ) C1 . \ moq 86"
, AC. 414 . 2,b ( ..) _
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL )c CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Nu LT Date: 1011 401 Phone #: (503) 718- 1.-1111.■