Permit CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
fir^ DEVELOPMENT SERVICES
PERMIT #: ELR2005 -00345
„� I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/13/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09359 SW WASHINGTON SQUARE RD ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Security cabling. Job #C50454.
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: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC CAPITOL DATA & COMMUNICATIONS
BY THE MACERICH COMPANY 11401 NE MARX ST.
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97220
TIGARD, OR 97223
Phone: 503- 639 -8865 • Phone: 503- 255 -9488
Reg #: LIC 142457
ELE 26- 1054CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 10/13/200E $75.00
[TAX] 8% State Surcha 10/13/200E $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 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.
Issued By: 2zez 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.
r g ' FOR OFFICE USE ONLY
'Electrical Permit Application !ll���llf P Recetvyd i n / p i y Permit no •
Date /B ,(�� „ , �,j�
/ e 1 Z lr
City of Tigard ) Plan Review
OCT e t.� i Other Permit:
13125 SW HALL BLVD , TIGARD, OR 97223 ; r• I' Date /By.
Phone: (503) 639 -4171 Fax (503) 598 -1960 CITE OF V oL RO Date Ready /By • Jurist_ 1 � U See Page 2 for
Inspection Line: 503 - 639 -4175 Notified /Method. 1 l Supplemental Information
Internet. www ci tigard.or.us R� DING DIVISION
TYPE OF WORK DING DIVISION PLAN REVIEW
U New construction H Addition/alteration /replacement Please check all that apply:
❑ Demolition ❑ Other. ❑ Service over 225 amps, comm'l ❑ Hazardous location
CATEGORY OF CONSTRUCTION ❑ Service over 320 amps - rating ❑ Building over 10,000 sq.ft.
U I- and 2- family dwelling H Commercial /industrial U Accessory building of 1- and 2- family dwellings 4 or more new residential
❑ Multi- family ❑ Master Builder ❑ Other ❑ System over 600 volts nominal units in one structure
JOB SITE INFORMATION AND LOCATION ❑ Building over three stories ❑ Feeders, 400 amps or more
Job no • C50454 Job site address: 9359 SW Washington Square Rd III Occupant load over 99 persons ❑ Manufactured structures or
❑ Egress /lighting plan RV park
City /State /ZIP: Tigard Or 97223
CI Health-care facility III Other:
Submit 2 sets of plans with any of the above
Suite/bldg. /apt no.: T - 21 Project name: Starbucks The above are not applicable to temporary construction service.
FEE SCHEDULE
Cross Street/Directions to job site Description I Qty. I Fee. I Total I ”
New residential - single or multi - family dwelling unit.
Subdivision: Lot no. Includes attached garage.
1000 sq. ft. or less $ 145.15 4
Tax map /parcel no.: Ea. Add'I 500 sq ft or portion $ 33.40 1
DESCRIPTION OF WORK Limited energy residential $ 75.00 2
Security cabling Limited energy, non - residential $ 75.00 2
Each manufactured home or modular
Li PROPERTY OWNER I H TENANT dwelling, Service and/or feeder $ 90.90 _ 2
Name: Service or feeders installation, alteration, and/or relocation
Washington Square 200 amps or less 5 80 30 2
Address 201 amps to 400 amps $ 106.85 2
401 amps to 600 amps $ 160 60 2
City /State /ZIP 601 amps to 1000 amps 5 240 60 2
Over 1000 amps or volts $ 454.65 2
Phone. Reconnect only $ 66 85 2
Temporary services or feeders installation, alteration, and/or
Owner installation: This installation is being made on property that I own which is not relocation
intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701 200 amps or less $ 66 85 1
201 amps to 400 amps $ 100 30 2
Owner signature: 401 amps to 600 amps 5 133 75 _ 2
Li APPLICANT I U CONTACT PERSON Branch circuits - new, alteration, or extension, per panel
Business Name: A Fee for branch circuits with
service or feeder fee, each
Contact name: branch circuit $ 6.65 2
B. Fee for branch circuits
Address: without service or feeder fee,
each branch circuit $ 46 85 2
City /State/ZIP. Each additional branch circuit: _ $ 6 65 _ 2
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 circuits(s) or limited -
CONTRACTOR energy panel, alteration, or
Business Name: CAPITOL DATA & COMMUNICATIONS extension. Describe: 1 Page 2 2
Contact name RAY YOUNGER Each additional inspection over allowable in any of the above
Per inspection 5 62.50
Address 11401 1401 NE MARX ST. Investigation per hour (1 hr min) 5 62 50
Industnal plant per hour $ 73.75 _
City /State /ZIP PORTLAND, OR 97220 -1041 ELECTRICAL PERMIT FEES°
Subtotal
Phone: 503- 255 -9488 Fax: 503- 257 -7121 Plan review (25% of permit fee)
State surcharge ( 8% of permit fee)
CCB Lic.. 487 'Electrical Lic. 2 GC ISuprv Lic 2834 LEA TOTAL PERMIT FEE 81.00
Suprv. Electrician signature, required: `^ This permit application expires if a permit Is not obtained within 180
days after it has been accepted as complete
Print Name. Raymond C Younger 1 Dal ' 10/12/05 • Fee methodology set by Tn -County Building Industry Service Board
" "Number of inspections per permit allowed
Authorized signature:
Print Name. Raymond C Younger // —
T--
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR200S -00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/13/2005
Phone: (503) 639 -4171 ,. to
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: /1/1512005 TIME: 7:02AM' PAGE: 36
SITE ADDRESS: 09359 ASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHING N SQUARE LOT #: TYPE OF USE:
PROJECT NAME: STARBUCK'
DESCRIPTION: Security cabli q. Job #C50454.
OWNER: WASHINGTON • QUARE LLC, PHONE #: 503 - 639-8865
CONTRACTOR: CAPITOL DATA COMMUNICATIONS PHONE #: 503 - 255-9488
Inspection Request Scheduled For: Date: 11/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final ' 021297 -01 360 -601 -7930 N
Corrections /Comments /Instructions:
•
PASS .❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: NOD LE Date: I t • I3 Phone #: (503) 718 - 1.L{t'fib•
.
. CITY OF TIGARD
BUILDING DIVISION - A PERMIT #: ELR2005.00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/13/2005
Phone: (503) 639- 4171Q. �
Inspection Requests (24 Hrs.): (503) 639 -4175 �_: `'� I.
I I
. INSPECTION WORKSHEET FOR DATE: 10121/2005 TIME: 7:08AM PAGE: 71
SITE ADDRESS: 09359 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: STARBUCKS
DESCRIPTION: Security cabling. Job #C504&1.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 603- 639-8866
CONTRACTOR: CAPITOL DATA & COMMUNICATIONS PHONE #: 503-255-9488
Inspection Request Scheduled For: Date: 10/21/2005 Pour Time:
Code # ;�. - • ' escription Confirm # Contact '# Message
135 Low voltage 018994 -01 971 - 506 -3396 Y
Corrections /Com - - - uctions:
• ( CL-Is
•
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v e Date: I J ZI ae Phone #: (503) 718-