Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
*►'I'� DEVELOPMENT SERVICES PERMIT #: ELR2005 -00340
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'� II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/12/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09348 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: HVAC.
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: OUTDOOR LANDSC LITE:
OTHER: : HVAC: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC BEWLEY MECHANICAL SYSTEMS
BY THE MACERICH COMPANY 7911 NE 33RD DR #250
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97211
TIGARD, OR 97223
Phone: 503- 639 -8865 Phone: 503- 626 -8986
Reg #: LIC 63582
ELE 34- 339CLE
FEES SUP 145LEB
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 10/12/200f. $75.00
[TAX] 8% State Surchar€ 10/12/200f $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 re set forth in OAR 952 - 001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct ues ns to C
t
Issued By: L Permittee Signature: f
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 am required on the job site at the time of each inspection.
'1 .
ectrical Permit Application ruin orrice: ►, s ►; o N I . V
City of Tigard Received ) IL , / WM
13125 SW Hall Blvd, Tigard, OR 97223 pl Review
Phone: 503.639.4171 Fax 503.598.1960 ' e 4 'f' t3' I. ; ..... :: Other Permit:
Inspection Line: 503.639.4175 A'i I Date Ready/By: RI See Page 2 for
Internet www.ci.tigardor.us Notified/Method: WI Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other ['Service over 225 amps, comm'I ['Hazardous location
OService 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 ❑Buildin over three stories ['Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION DEgress/lighting plan RV park
Job no.: Job site address: ❑Health-care facility ❑Other.
Submit 2 sets of plans with any of the above.
City/State/ZIP: The above are not applicable to temporary construction service.
Suite/bldgJapt no.: I Project name: sL g n FEE* SCHEDULE
f'
L AMA P5 42- , peeeripuoo I Qty. I Fee I Total I ••
Cross street/directions to job site: `l 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 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
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: - 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
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 46.85 2
Address:
Each add'l branch circuit 6.65 2
City/ State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) 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
extension. Describe: Page 2 2
Business name: (3ew & M2G (y9A14 i Got ( 5 )1STewr. c
Address: 7Q NE 3 3 r� t DT SV t 7'-� 'j• 5 O Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: Pp rfil to to 4 O2 97 xi ( Investigation per hour (t hr min) 62.50
Phone: (S05) 6 C - sq o C I Fax: (5 - (D34 S Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES'
CCB Lic.: 63 Es 7._ Electrical Lic.: • 33gc1.E Suprv. ic.: 145LE!3 Subtotal
Suprv. Electrician signature, required: / Plan review (25% of pe emit fee)
State surcharge
Print name: 1 0 h Ai a (3 .e I C � I e w (8% of permit fee)
�� 1 Y ' 1 O— i l— O 5 TOT AL PERMIT FEE
Authorized signature: i &� _____ This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: 20 1 � 0 0 . e t /3 e.i (e. Y I Date: l 0 — l t -05 • Fee methodology set by Tri starry Building Industry Service Board
" Number of inspections per permit allowed.
i \Build ng\Pmaits LC- PermitApp.doe 12/03 440- 4615T(10/02/COM/WEB
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CITY . OF TIGARD
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BUILDING DIVISION PERMIT #: ELR200S-00340
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/12/2005
Phone: (503) 639 -4171 �w p AP
Inspection Requests (24 Hrs.): (503) 639 -4175 ' 'IL
INSPECTION WORKSHEET FOR DATE: 11/15/2005 TIME: 7:02AM 'PAGE: 46
SITE ADDRESS: 09348 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISI oN: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAM SHARPER IMAGE
DESCRIPTION: VAC.
OWNER:. W 'HINGTON SQUARE LLC, PHONE #: 503- 639 -88655
, CONTRACTOR: B EY MECHANICAL SYSTEMS PHONE #: 503-626-8986
Inspection Request Scheduler For: Date: 11/1612005 Pour Time:
Co• : . Inspection Des on Confirm # Contact # Message
199 Electrical final 021285 -01 360- 601 -7930 N
C or - '.. • .... - • - -- • '. s:
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1PLPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G.-sigZ- V Date:. t/ I 05 Phone #: (503) 718- 2k �p