Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00629
DEVELOPMENT SERVICES DATE ISSUED: 9/21/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600 -00300
SITE ADDRESS: 09360 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: Electrical 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: 2 W /SERVICE OR FEEDER: 30 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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 J.0 ELECTRICAL, INC.
BY THE MACERICH COMPANY 118 NW 184 ST.
9585 SW WASHINGTON SQUARE RD RIDGEFIELD, WA 98642
TIGARD, OR 97223
Phone: 503 - 639 -8865 Phone: 503 - 887 -7889
FEES Reg #: ELE 37 -724C
LIP 1189
Description Date Amount
SUP 4289S 5
[ELPRMT] ELC Permit 9/21/2005 $360.10
[ELPLCK] ELC Pln Rev 9/21/2005 $90.25 REQUIRED ITEMS AND REPORTS
[TAX] 8% State Surcharge 9/21/2005 $28.81
Total $479.16
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 or 1- 800 -33
Issued By: (..(14-%//b Permittee Signature: d i Gwlic !
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.
-
Electrical Permi D ggZ �5 8'
FOR OFFICE USE ONLY
Cit �f Tigard tiji Received Permit N. li 6 a4905 -0Cv,,pi
' 13125 SW Hall Blvd , Tigard, OR 97223 1 2 Q0t Plan Review
Phone 503 639 4171 Fax 5034369 u Ai Date/By Other Permit
Inspection Line: 503 639.4175 °./ / e: Date Ready/By Jnris ® See Page 2 for
Internet T www.ci tigard.or us Gi -`Y OF 1 Il N AD Notified/Method. Supplemental Information
801
M 99 1)',A1r � �1ORK t f 1 �V Wl'�
PLAN REVIEW
® New construction ❑ Addition /alteration/replacement Please check all that apply
❑ Demolition ❑Other: ❑Service over 225 amps, comm'I ❑Hazardous location
['Service 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
['Building over three stories ❑Feeders, 400 amps or more
❑ Multi family 0 Master builder 0 Other:
['Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
Job site address: r ❑Health -care facility ['Other: Job no.:
goz- c� v , 5�� g`'`� W 1 tnL Submit 2 sets of plans with any of the above.
City /State /ZIP:MG.4\th i SQ • W101 The above are not applicable to temporary construction service
Suite /bldg /apt. no.: Project name: � � Av Q ` ^^- s (� FEE* SCHEDULE
r..t"� \ 11 Descnpnon I Qty. I Fee. I Total
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
\-N. N %I\ 4�J\ SQ 2 . Ll_ 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
ppr
_ dwelling, service and /or feeder 90 90 2
\S\ \ \ 4-0.1 T-- Services or feeders installation, alteration, and /or relocation
200 amps or less Z 80 30 WI 0 2
❑ PROPERTY OWNER ❑ 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
Phone: ( ) Fax: ( ) relocation
200 amps or less 66 85 I
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 ❑ CONTACT PERSON A Fee for branch circuits with
service or feeder fee, each
Business name: branch circuit 6 65 zo , , 2
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)
Pump or irrigation circle 53.40 1 2
Phone: ( ) Fax::( )
Sign or outline lighting 5 3.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension Describe Page 2 2
Business name: . C . aVZ IC , \'nQ .
Address: S Each additional inspection over allowable in any of the above
1 � W 1 �
Per inspection 62.50
City/State /ZIP: C .-\ 1, \E \h , \ G\3, Investigation per hour (I hr min) 62.50
Phone: c&o) �6 Fax: (3 j) ,�� - ��L
Industrial plant per hour I 73.75
_ 49e:
ELECTRICAL PERMIT FEES*
CCB Lie.: 11� Electrical Lie.• 3 ae uprv. � "T ' Subtotal 0 r:A
Suprv. Electrician signature, required: /� /0 0 ' Plan review (25% of permit fee) /
Print name: State surcharge (8% of permit fee)
Covtx / TOTAL PERMIT FEE `,'
d •'4'C�
Authorized signature: — This permit application expires if a permit is not obt ned within 180
days after it has been accepted as complete
Print name: ..:=c ( \ CCU Date: • Fee methodology set by Tn- County Building Industry Service Board
•• Number of inspections per permit allowed 1 /1q. I& r \Buddmg\Permns\ELC- PermnApp doc 12/03 440 4615T(10 /02 /COM/WEB
3¢ 8/2° 005 08:46 Burnhamonline Denise Buehring -aVal Henzel 2/7
�� '�� FOR OFFICE USE ONLY
` Eletstfical Permit Am l io
i i \
City Received , /� /� I ' /�I
City of Tigard Received : • , �', permit No :1/e. . �OD(�
n,�� 9 OQ
13125 SW Hall Blvd., Tigard, OR 97223 , ;,, � 'L / it no 1 Plan Review 01herPen
Phone: 503.639.4171 Fax: 503.598.1960 � � l i ,,.III Date/By: 21 See Page 2 for
Internet www.ei.tigard.or.us ,
Inspection Line: 503.639.4175 .,, -AL of Date Ready/ay: n
C Y 0 - fl(JAHL) Nutified/Metliod: //(2 . Supplemental Information \
Please check all that apply:
New construction Addition /alteration replacement ['Service over 225 amps, cumn'1 ['Hazardous location
❑ Demolition ❑ Other: ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
., CATEGORY ;.;OR;; CONSTRIJ TION; !',. ' . ,- of 1 -and 2- family dwellings 4 or more new residential
❑System over 600 volts nominal units in one structure
❑ 1- and 2- family dwelling [i;'Gommercial /industrial ❑Accessory building ❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons ['Manufactured structures or
' JOB iSiTE INFOI(MATION AND DEgress/lighting plan RV park
1 ['Health-care facility ❑Outer: __
Job no.: 1 Job site address :Ov t - ) I p(hl,nef Submit Z Sets of plans with any of the above.
City / State/ZIP: c 1 0,9 9.'-12,a. The above are not applicable to temporary construction service.
1 / �� F E4.:,$C1iCDULE
Suite/bldg. /apt. no.: 1, I Project name: = poc�1'A- �NNOC 01e+tti i?{?, ne.erhttbn Qtr. Fee. Ta 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:
S9 Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
` 1 P Q -. Limited energy, residential 75.00 2
IJ�i� 5��� - 1
Tax map /parcel no.: Limited energy, non-residential 75.00 2
. , , : '' , DESCRIPT1Qly• Or WORK',,;, ' - „ f Each manufactured or modular
"' 1 _
�,� dwelling, service and /or feeder 90.90 2
, r ) lakt., t&(31n' - 1D cut q j,e M � 7,e- r-ezLl Services or feeders installation, alteration, and/or relocation
200 amps or less 2.. 80.30 1 bts14 2 3
..., SP (� LL ` . 201 a m p s to 400 amps 106.85 2
❑ . PROPERTy, .OWNERI' ' : ,,, `�! ; , : 1" r. - '
, •., . , •' ' , it EI4ANT _ : , . , 401 amps to 600 amps 160.60 2
Name: ' nr.11_1dA 0 !nnc o, --(1„ / T">P1.1 r�I-A-k1' 601 amps to 1,000 amps 240.60 2
` � Over 1,000 amps or volts 454.65 2
Address: n� �Q !AL C3• M \ t9. ' • I ?Air3 Reconnect only 66.85 2
City /State /ZIP:r t-. a , �koO 1 _ Temporary services or feeders installation, alteration, and /or
relocation
Phone: (l i t) ) � �-A •5 S Fax: (C 1 155- 5 200 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
„
;; .
A. Fee or branch circuits with
ID CON . ,PERSON' service or feeder fee, each '30 6.65 19ei. 2
branch circuit
Business name: el&
��[�i � � _ � + -� B. Fee for branch circuits
Contact name: \''' ,A ^ �� l�__ p•[�Jyl(2lq%1 without service or feeder fee, 46.85 2
each branch circuit
Address: E a ch add'I branch circuit 6.65 2 • •
City /State/ZIP: � r+ c `. �C) (0Q� -- Miscellaneous (service or feeder not Included)
- _ . l � Pump or irrigation circle 53.40 2
Phone: ('tZ) 4409. 1 1 O t. ^ ° gyp I Fax: (31x L ) y� - '? ells- Sign or outline lighting 53.40 2
E- mail: JIx\ek Q. 2X1 LYVl tSYL II Cre �� Signal circuit(s) or limited -
,unR energy panel, alteration, or
CON R 1tAGTOR extension. Describe: Page 2 2
Business name:
Each additional inspection over allowable in any of the above
Address: Per inspection 62.50
City / State/ZIP: Investigation per hour (1 hr min) 62.50 1
Industrial plant per hour 73.75
Phone: ( ) Fax: ( ) ELECtRICAL'PERMIT FEES•' •
CCB Lie.: Electrical Lie.: I Suprv. Lie.: Subtotal 3 60.1 Q
Suprv. Electrician signature, required: Plan review (25% of permit fee) 90.25
State surcharge (8% of permit fee) 2.
Print name: I Date: TOTAL PERMIT FEE '1 9 a 1 6
Authorized signature: This permit-application expire% if a permit is not obtained within 180
days after it has been accepted as complete
Print name: I Date: • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
iinoilding\Permlts1m.C- 1'mnhAPP doe 12/03 440 -4613T(10 /02/COM/wna
Ia
CITY.- OFTIGAR®
BUILDING DIVISION A PERMIT #: ELC2005 -00629
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/21/2005
Phone: (503) 639 -4171 �di�;
Inspection•Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/13/2005 TIME: 7:04AM PAGE: 42
SITE ADDRESS: 09360 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: GODIVA CHOCOLATIER
DESCRIPTION: Electrical TI
•
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639-8865
CONTRACTOR: J.C. ELECTRIC, INC. PHONE #: 360 - 887 -7889
Inspection Request Scheduled For: Date: 10/13/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 Ceiling cove 018248 -01 360 - 772 -2700 N
Corrections /Comments /Instructions:
•
•
cs.4N\ et.AZ 2C)06' o0 32
• K
•
•
❑ PASS 11 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: %VQ [ Date: 1 Oil Phone #: (503) 718-
CITY - OFTIGARD •
BUILDING DIVISION PERMIT #: ELC2005 -00629
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/21/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/14/2005 TIME: 7:02AM PAGE: 101
SITE ADDRESS: 09360 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: GODIVA CHOCOLATIER
DESCRIPTION: Electrical TI
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639.8865
•
CONTRACTOR: J.C. ELECTRIC, INC. PHONE #: 360 -887 -7889
•
Inspection Request Scheduled For: Date: 10/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 018344-01 360-772 -2700 N
Corrections /Comments /Instructions:
•
2 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: "-� Date: lot `I 0 Phone #: (503) 718- 1-4•
CITY OJ TIGAR® =!
BUILDING DIVISION A r PERMIT #: ELC2005"00629
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/21/2005
Phone: (503),639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/18/2005 TIME: 7:10AM PAGE: 83
SITE ADDRESS: 09360 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: GODIVA CHOCOLATIER •
DESCRIPTION: Electrical TI
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639 - 8865
CONTRACTOR: J.G. ELECTRIC, INC. PHONE #: 360 - 887 -7889
Inspection Request Scheduled For: Date: 10/18/2005 Pour Time:
Code #. Inspection Description Confirm # Contact # Message
115 Electrical service 018547 -01 360- 772 -2700 N
Corrections /Comments /Instructions:
•
•
•
PASS' ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ dI LL - • R INSPECTION ❑ ADDITIONAL FEES ASSESSED
9
Inspector: ��� Date: 10 I a Phone #: (503) 718- VIVO
CITY.OFTIGARD f `
•
BUILDING DIVISION PERMIT #: ELC2005 -00629
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/21/2005
Phone: (503) 639 -4171 �
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/3/2005 TIME: 7:06AM PAGE: 60
SITE ADDRESS: 09360 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: GODIVA CHOCOLATIER
DESCRIPTION: Electrical TI
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 -639 -8865
CONTRACTOR: J.C. ELECTRIC, INC. PHONE #: 360 -8B7 -7889
Inspection Request Scheduled For: Date: 11/3/2005 Pour Time:
Code # Inspection Description C. it . Contact -# Message
.199 Electrical final 120216 -01 360.772 -2700 N
Corrections /Comments/ Instructions:
•
X PASS ❑ PARTIAL APPROVAL V ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector t€S w Date: kt i 3 - Phone #: (503) 718 - Z--Ti'