Permit A
CITY OF TIGARD ELECTRICAL PERMIT
t PERMIT #: ELC2005 -00724
DEVELOPMENT SERVICES DATE ISSUED: 9/27/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09364 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: TI, demo of (1) branch circuit.
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: 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 BOONES FERRY ELECTRIC INC
BY THE MACERICH COMPANY PO BOX 628
9585 SW WASHINGTON SQUARE RD WILSONVILLE, OR 97070
TIGARD, OR 97223
Phone: 503 - 639 -8865 Phone: 503 - 682 -4936
FEES Reg #: SUP 4918S
LLC 88482
Description Date Amount
ELE 3 -223-223
C
[ELPRMT] ELC Permit 9/27/2005 $46.85
[TAX] 8% State Surcharge 9/27/2005 $3.75 REQUIRED ITEMS AND REPORTS
Total $50.60
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Speaalty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspende• • - • .n 180 da s ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules - - set forth in OA' 9 -00 0' • through OAR 952 - 001 -0100 You may obtain copies of tl s ?ules or direct questions to OUNC at
503 46 -6699 or '-23441
Iss ed By: ,k ,�� I ( l� / ! Permittee Sig • • ture: �/; !, ,7"Mr/
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
* NTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. E IT1 ate.. DATE:
LICENSE NO: 9/:5
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
Z,iS 20 05 3:54P BOONES FERRY ELECTRIC No. 7469 P. 1 •
- �. II ,, ��LCaLIUll
'0. Cf o� Tigard FOR OFFICE: us ONLY
13125 SW Hall Iva,, Ti 'V E Phone 503.63 g 171 Fax : 503 g C � • pQ lnapctioLine: 503.639a175 1SE 2 3 2 005 'e jil Da a p _ i<:�.. 7.9.411
13125
V ernet www ci hgard or.ua Date Re - Permit
,.:'...:7=..,..-:,..;;'...:,,...-'‘. ;] No + S P emental Information
❑ •New construction ■ � - n. > �7' ` - _ ,_�,. .. -,. r_ a, J n r
CI Demolition ❑ Other: Illation/replacement
Please ctleclt all ch apply "�sy..
v ( ❑Service over 225 amps, rr$rs, cotnm'1 °Hazardou
` • . ` ' 1 , " , 3 i 1 ` , . I';',.: ❑Service over 320 am — rating s location
� , '. tlrig ❑ 4 o more over residential nti l
❑ 1 - an 2- f a t nly d welling ❑ Co t of 1 - an d 2-family dwellings 4 o trwrc new residential
❑ Accessory b ❑ System over 600 volts nominal units in one shvcorre
❑Multi Eauirly ❑ Master builder 1:1 Other' ❑Buildin o ver three stories °Feeders, 400 amps or more
8
J : ( Jt , y .1 '.'''11, i '' ['Occupant load Over 99 persons Man
Job no.. Yob site a• . • ' �? ['Egress/lighting ' plan P ❑ ufacnued structures or
�8P Ot park
ilr = ve '' Su/ 64u /j 4o Submit 2 sets ❑above:
City/State/ZTP: Submit 2 seta of plans with any of the above. The above are not applicable to to
Suite/bldg /apt no.: O' Project name: Q temp Y construction service.
C41.) 4ai So tnlr,t rN
Cross street/directions to job site: Devolve i T
" = ?' '
rem ..
New residential single- or niolti -family dwelling unit.
Includes attached garage.
IIIIIIIIIIIIIIIIII"IIIIII Subdivisi 1,000 sq. ft. or less .11111:21E11111.11 Tax Ina Lot no.: Ba. add•l 500 s q. ft. or portion 4
p/parcel n0 33.40 .11.11 1 energy, residential
Limited M I _ : Litnited energy. 75 00 r 2
- 13ach m of modular 7S 00 2
0 I . d well in, service and/or feeder III or feeders Installation alt 90.90 2
, r - , - , � erasion, and/or relocation
f n ji : : r 201 amps or less 80.30
� ._ I ,i. 5r . , +, - ;; Drops to 400 a 2
Name: ,
... _ ° _. I ..;j amps 106.85 1111111 2 •
401 amps to 600 amps 160.60 _
601 amps to 1,000 amps r 2
address: s 240.60
Over 1,000 amp or volts r 2
City/StatdZlp: i 454.65 2
Reconnect only 66.85 _
Phone: ( ) Temporary services or feeders installation, alteration, and /or 2
Owner installation: installation is being relocation
intended for sale, l ing made on property that I own which is nbt 200 amps or less r�
ease, rent, or exchange, according to ORS 447, 449, 670 and 701. 201 amps to 400 amps 1
Owner signature: Date: 100.30 11.1111 2
„ n Date 401 amps to 600 amps ® 2
c ' '' � I ( .• i .• F circuits — now aILC tlOrl or extension, panel
A . ee far P
Business name: _. . _ branc circu c
er fee, each . 6 65
Contact name: III B. Fee for b 2
larch circuits
Address: without service or feeder fee,
•
City /Statc/ZlP; i each branch circuit 2
Each add'1 branch circuit 11.1111:91.11111 2
Phone: ( ) i • Miscellaneous (service or feeder not included)
MI E Pump or irrigation circle
Si or o 53.40 2
Sign Outline lighting
�,' i i i; r I Signal circuit(s) or bunted-
53.40 2
Business name: ..r ' ;' energy panel, alteratio or
$ooixes Ferr E e t` • ` extension,. Describe:
Address: p. 0, sox 628
2
City/State/ZIP: /S1aWZ Each additional inspection over allowable lu any of the above
t y IP: W11sonstijl OR 97070 r Par in •action -
0n° (��3) 682— Pa in lion 62.50 MN 4 9 3 6 per hour ( l ir min) 62.50
b°n Lic.: 88482 Electrical Fax (503) 6 82 -7946 Indus
�a1 plant per hour ) _
cal Lic.: _
..S rv. E 3 2 2 • SUM. Lic.: i - 6 ,� J_,': �i , � —
uD lectrician signature, required: �� Plan � -: �1 ":
�� Subtotal 6, s
hint name: �� review ( of
^ Hi3�Ron Date: 9. are (8% of
Authorized signature:
surch g ( pmt fee) •
Print name: TOTAL PI73t14Q j FEE 5' O , S
� Permit appaaedon expires tf a permit b not obtained,rith,n tea
Date: days after it has been Accepted as couplet*
E nseilde , gaemablliLC_
• Pea methodology set by Tri -Coanb solidi Industry
pQ 17/oj '� pY Service Board
` Number of inspections
440- 46 IST(Ic , o2,cOM W,. per p erms *Bowed.
OF GARD ELC2005.00724
ING DIV ION PERMIT #: 9/27/2005
13125 SW Hall Blvd., Tig rd, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 A � A,
Inspection Requests (24 Hrs. : (503) 639 -4175 "'I �..
10/24/ 7:02AM 61
INSPECTION WORKSHEET FOR DATE:. TIME: PAGE:
09364 SW SHINGTON SQUARE RD
SITE ADDRESS: WASHINGTO SQUARE CLASS OF WORK:
SUBDIVISION: OCCHIALI DA LE LOT #: TYPE OF USE:
PROJECT NAME: TI, demo of (1) br.,, ch circuit.
DESCRIPTION:
WASHINGTON SO ' .RE LLC, 503 639 - 8865
OWNER: BOONES FERRY EL TRIC INC PHONE #: 503 - 682 -4936
CONTRACTOR: PHONE #:
10/24/2005
Inspection Request Scheduled For: \ Date: Pour Time:
Co � # I E g .ncarfina ription � ��1 �8R 2 1936 Meilage
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' Date: 1 ' L 4 \ Phone #: (503) 718-