Permit A: '%CITY OF TIGARD ELECTRICAL PERMIT
,++ PERMIT #: ELC2004 -00133
DEVELOPMENT SERVICES DATE ISSUED: 3/19/04
...MP. " .,�I 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09350 SW WASHINGTON SQUARE RD
SUBDIVISION: 1tCARglIANGTON SQUARE ZONING. C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Adding (2) branch circuits to kiosk located in front of Mervyn's.
Job No. 104077 -1 -4813
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: 1 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:
PPR WASHINGTON SQUARE LLC DYNALECTRIC
BY THE MACERICH COMPANY 2904 SW FIRST AVE.
9585 SW WASHINGTON SQ. RD. PORTLAND, OR 97201
PORTLAND, OR 97223
Phone: Phone: 503 - 226 - 6771
Reg #: LIC 066793
SUP 4817S
FEES ELE 26 -59C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 3/19/04 $53.50
[TAX] 8% State Surcharge 3/19/04 $4 Rough -in
Elect'l Final
Total $57.78
This Permit s 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 -3 - .
Is- ed By: k /t / ' Permit 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: 0 e--
Call 639 -4175 by 7:00pm for an inspection the next business day
MF1R 18 2004 12:51PM DYNRLECTRIC 503 226 7720 p. 1
Electrical Permit Application
RECEIVED • . �: Permit Datereceived j ! r� _ gig II
a
A �� City of Tigard Project/appl.no.: Expiredate:
t
it y of Address: 13125 SW Hall Blvd,
� R 4 Date S
'I'�g Q y. Receipt no.:
C of T igard h�II At( II
R897114 (503) 639 -4171 Case file no.: Payment type:
Fax: (503) 598 -1960 CITY OF TIGARD r
Land usl; approval: BUILDING DIVISION 1 4,4yi t- , / fl l/ )
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory - • • • ercial/industrial U Multi - family 0 Tenant improvement
0 New construction i . - Addition/alteration/replacement ❑ Other. CI Par
JOB SITE INFORMATION
Job address: ' _ �_ �..�� . : i t Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot Block: Subdivision:
Project narnejle j/ 3},' red- 516rel Description and location of work on premises: )9i , by t1./Y !1/ i
Estimated date of completion/inspection: D -
CONTRACTOR APPLICATION FEE SCIIEDME Fee Vial
Job no: /a 77 - /^ :: D eser t ' ton Qty. ea. Total no
Business name: l A ri / _ Aim mon Netrretideatiai -aiogleormo3ti-fatnilYper
i� daelEingmdt.Includes' adred garage.
Address: ._.. . / Sentcelncluded:
�! I I �� State, A =ft ��M� 4
1000 • • ft. or less
Phone:� f Fax' - : ! - mail: Each additional 500 sq. ft or portion th creel f
Elec bu s. lie. n, ,: . • — �� _ Limited energy, residential 2 2
CCB no.:
City /metro lic. no.: Limited energy, non- residential
` e?). � t O Each manufactured borne or modular dwelling 2
.� Date Service and/or feeder
Heave of se.. ising el - - • • required) Services or feeders- installation, .
Sup. elect. name (print): `' ) A , A ,r JA License no: �i
alteration orretoca8otr
PROPERTY OWNER 200 amps or less 2
201 amps to 400 amps 2
Name (print): 401 amps to 600 amps 2
Mailing address: • 601 amps to 1000 amps 2
City: I State: ZIP: Over 1000 amps or volts l
Re connect only 1
Phone: 'Fax: I E �
•
Owner installation: The installation is being made on property I own Temporary services or feeders - . instanalion ,altemtion,orreloadion:
which is not intended for sale, lease, rent, or exchange according to • zoo amps or less 2
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2
Owner's signature:
Date: 401 w 600 ... 2
ENGINEER Branch circuits - new, alteration,
or extension per panel
Name: A. Fee for branch circuits with purchase of 2
Address: service or feeler fog, each branch circuit
State: • ZIP: B. Pee for branch circuits without purchase �/� %+ 2
City: of service or feeder fee, first branch circuit: % ,
Phone: Fax: E Each additional branch circuit
a t
P1Ai` RI1'1li�Y(Please check alC_llrat tipJll {'�`: .' Kist (Service orfeedernotineinded): umporirigationrlrcle 2 -
0 Service over225 amps-commercial • O health- carefacility Each p 2
of ❑ Hazardouslocatlom Each sign or outline lighting •
❑ family w llings amps-rating S' el circuit(s) or a limited energy pane.
family dwellings ❑ Building ovr1 000 square feet four or � 2
❑ Systems over 600 volts nominal more residential units in constructors alteration, or extension*
❑ Building over three stories ❑ Feeders, 400 apps or more *Desaiption:
❑ Occupant load over 99 persons ❑ Maom:repaired structures or RV Pork Each additional Inspection over the allowable In any of the above:
0 Egress/lightingplan 0 Other. Perinspeodon I I I 1
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $ ✓r 3 • .50
"Not all jairdulloce accept credit cads, please all jurisdiction for more lmformegoo, Notice: This permit application plan review (at — 46) $
AViaa ❑? 55 c , ,�, expires if permitis no obtained State surcharge (8%) .... $
Gedlt card num • " 1 . ;. L • within 180 days after it has been r 7 8
L ✓.- 2 ir %± . 1e: accepted as complete. TOTAL $
�• <_ _ .....b ._ $ 57.7g aao d61s (6+oo�coM1
Cerdbol• rignature • Amount
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: _(503) 639 -4171 MST
BUP
Received p .2 / ' ate Requested 3 J 3 I /) 4/ AM PM BUP
Location G - Mali Suite MEC
Contact Person / Ph (3 3) 2-241 _ 7 2 / PLM
Contractor ��G' : Ph (�2 2 ) S 4 7 SWR
BUILDING Tenant/Owner 7 l./�I. •v�-r ��J%t u�-, 4Cp / 0 1 33
Footing ,400Les. ELC
Foundation Access:
Ftg Drain , ELR
• Crawl Drain - - - z -
Slab r--+ •ection Note•
s
1
Post & Beam � ppGGf) % < %/4
Shear Anchors ZAR.C1AA <v l / 04 ta.
Ext Sheath/Shear
Int Sheath/Shear �_ ---
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
\\AI
Rough -In
•
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS FAIL
(LECTRICA
- 5"g race
Rough -In
UG/Slab
Low Voltage
PASS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SI 0 Please call for reinspection RE: le Unable to inspect - no access
Fire ADASupply Line ,
Approach/Sidewalk Date — 3/ - Inspe r 0% IExt
Other:
Final • DO NOT REMOVE this Inspection record fr . , the job = ite:
PASS PART FAIL