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Permit
i. CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT T' ��' li 1 DEVELOPMENT SERVICES PERMIT #: ELR2005 -00320 ..- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/5/2005 PARCEL: 1S12600-00300 SITE ADDRESS: 09360 SW WASHINGTON SQUARE RD ZONING: C -G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG Project Description: Limited energy for fire alarm. Job No. 13310 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: X OUTDOOR LANDSC LITE: OTHER: • HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: : TOTAL # OF SYSTEMS: 1 Owner: Contractor: WASHINGTON SQUARE LLC OREGON ELECTRIC CONST /GROUP BY THE MACERICH COMPANY 1010 SE 11TH AVE 9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97214 TIGARD, OR 97223 Phone: 503 639 - 8865 Phone: 503 234 - 9900 Reg #: LIC 203 SUP 4460S FEES ELE 26 -95C Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 10/5/2005 $75.00 [TAX] 8% State Surchari 10/5/2005 $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 fol adopte• b the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through O 001 -.1�w. ou may obtain copies of these rules or direct • -s ions to OUNi:t 603- 46 -6699. Issued B 4 I' v • Permittee SignaturOp►,' / !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 are required on the job site at the time of each inspection. IP lectrica1-Perwit BEi; " ftj 1' � Fn FOR OFFICE USE ONLY y g d Date/B 0 © / /� 10,4M Permit No.: ,. iii ...46 ...46 ...46 Cit of Ti and 1. 13125 SW Hall Blvd., Tigard, OR 972�r 2005 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 dms� Date/B : Other Permit: Inspection Line: 503.639.4175 pi Date Ready /By. �� ® See Page 2 for Internet: www.ci.tigard.or.us ` A y Of IG �► N n: r.� Notified/Method: r� Supplemental Information • .. p - �6044S PLAN REVIEW . ❑ New construction �J z Addition/alteration /replacement 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 of 1- and 2- family dwellings 4 or more new residential ❑ 1 - and 2- family dwelling ® Commercial/industrial ❑ Accessory building OSystem over 600 volts nominal units in one structure ❑ Building over three stories :Weeders, 400 amps or more El Multi - family 0 Master builder 0 Other: ❑Occupant load over 99 persons ❑Manufactured structures or 1 1 JOB SITE INFORMATION AND LOCATION - - ❑Egress/lighting plan RV park Job no.. Job site address:F3(s, ►W Washington Square Rd ❑Health - care facility ❑Other. Submit 2 sets of plans with any of the above. City / State/ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service. FEE* SCHEDULE ' Suite/bldg. /apt. no.: W19 Project name: Godiva Description Qt I Fee. 1 Total I " Cross street/directions to job site: 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 Install low voltage wiring and cabling for Fire Alarm 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: Washington Square LLC 601 amps to 1,000 amps 240.60 2 Address: 9585 SW Washington Square Rd Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City /State/ZIP: Tigard, OR 97223 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 0 APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: Oregon Electric Group, Inc. branch circuit _ B. Fee for branch circuits Contact name: Loni Martin without service or feeder fee, Address: 1010 SE 11 Ave each branch circuit 46.85 2 Each add'l branch circuit 6.65 2 City /State/ZIP: Portland, OR 97214 Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: (503) 2349900 Fax: : (503) 535 -2620 Sign or outline lighting 53.40 2 E -mail: loni @oregon - electric.com Signal circuit(s) or limited - A..<, CONTRACTOR energy panel, alteration, or i - '` Business name: Oregon Electric Group, Inc. extension. Describe: Page 2 ` 2 Address: 1010 SE 11'" Ave Each additional inspection over allowable in any of the above Per inspection 62.50 City / State/ZIP: Portland, OR 97223 Investigation per hour (1 hr min) 62.50 Phone: (503) 234 Fax: (503) 535 - 2620 Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES' CCB Lic.: 203 Electrical Lic.: Suprv. Lic.: 11/56 S Subtotal 1 Suprv. Electrician signature, required: ./ %% Plan review (25% of permit fee) Print name: �M / 1 Dat • • /30/05 State surcharge (8% of permit fee) 6/ ' 4,44 TOTAL PERMIT FEE )/( — Authorized signature: �/ / This permit application expires if a permit is not obtained within 180 I days after it has been accepted as complete Print name: ./� j�N AJ Date: 9/30/05 " Fee methodology set by Tn- County Building Industry Service Board "" Number of inspections per permit allowed t•\Bwldmg\Pernuts\ELC- PcmutApp doc 12103 440- 4615T(10/02/COMM'EB r 'CITY OF TIGARD BUILDING DIVISION L PERMIT #: ELR2005 -00320 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/5/2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR NDATE: TIME: PAGE: 19 N SITE ADDRESS: 09360 SW WASHINGTON SQUARE RD CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: GODIVA CHOCOLATIER DESCRIPTION: Limited energy for fire alarm. Job', o. 13310 OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639-8865 CONTRACTOR: OREGON ELECTRIC CONST /GROUP PHONE #: 503-234-9900 Inspection Request Scheduled For: Date: 10/ 2005 Pour Time: • Code # Inspection Description Confirm # Contact # Message 199 Electrical final 019883 -03 .03 733 -7177 N Corrections /Comments /Instructions: • • — PS ate',N `t `y vL1S. • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: C3 N 6 S5l_. Date: t 0 I 11 Phone #: (503) 718 - 4 • CITY OF TIGARD '` BUILDING DIVISION PERMIT #: ELR2005 -00320 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/5/2005 \ Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 , „, • INSPECTION WORKSHEET FOR DATE: 10/10/2005 TIME: 7:04AM PAGE: 111 SITE ADDRESS: 09360 SW WASHINGTON SQUARE RD CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: GODIVA CHOCOLATIER DESCRIPTION:, Limited energy for fire alarm. Job No. 13310 OWNER: WASHINGTON SQUARE LLC, PHONE #: 503- 639-8865 CONTRACTOR: OREGON ELECTRIC CONSTIGROUP PHONE #: 503- 234 -9900 Inspection Request Scheduled For: Date: 10/10/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 017827 -02 603-793-7177 N Corrections /Comments /Instructions: • • • • 1 ' *PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ,❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G-N95 N o("6 L ” Date: Phone #: (503) 718-