Permit / ., .• • CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00902
' I n DEVELOPMENT SERVICES DATE ISSUED: 11/17/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09367 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: (2) circuits for sign. Job #29753.
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: 2
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: 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 DRYER ELECTRIC INC
BY THE MACERICH COMPANY 9409 NE COLFAX ST
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97220
TIGARD, OR 97223
Phone: 503 - 639 - 8865 Phone: 503 - 771 - 5667
FEES Reg #: ELE 26-1142C
Description Date Amount LIC 153466
SUP 2876S
[ELPRMT] ELC Permit 11/16/200' $106.80
[TAX] 8% State Surcharge 11/16/200: $8.55 REQUIRED ITEMS AND REPORTS
Total $115.35
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 - 332 -2344.
Issued By: -,a. , 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.
E S lectrical Permit Application FOR OFFICE USE ONLY
`r City of Tigard Received i -/ 1 _
13125 SW Hall Blvd., Tigard, OR 9722 E C E NE* Plan Review
�� Permit No 6,
Phone: 503 639 4171 Fax. 503.598.1960 G "Ir '�I� Date/By. Other Permit
Inspection Line. 503 639 4175 NOV 1_ ' t a 21 6' Date Ready/By ions ®See Page 2 for
Internet' www.ci.tigard or.us - Notified/Method: -` Supplemental Information
TYli t 1 it , � ' ��!! I Q8R) PLAN REVIEW
❑ New construction ❑ Ad"tl'Itl�Pll li a ion rep�ac ION Please check all that apply:
❑ Demolition ❑Other: ❑Service over 225 amps, comm'I ['Hazardous location
OService over 320 amps— rating ❑ Buildng over 10,000 sq ft ,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ I- and 2- family dwelling cstCommerciallindustrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder ❑Other: ❑Building over three stories ['Feeders, 400 amps or more
['Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
Job no.:a 75 Job site address eil S„...) o dorwi A ❑Health -care facility ❑Other:
Submit 2 sets of plans with any of the above
City /State /ZIP: ..---n Q2 I — 7, The above are not applicable to temporary construction service.
Suite /bldg. /apt. no: Project name: ((-� '� / I ` 1 FEE* SCHEDULE ..
S W. 1 l (/r)�') S U e›NOr'a4 Description I Qty. I Fee. I Total
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'l 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
S s. '_ dwelling, service and /or feeder 90 90 2
N eFt ��cl / t 6..)/ / tet N 1 G Services or feeders installation, alteration, and /or relocation
200 amps or less 80 30 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
relocation
Phone: ( ) Fax: ( )
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 6 65 2
Business name: branch circuit
B Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'I branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax:: ( )
Sign or outline lighting 53 40 ipLs," 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe. Page 2 2
Business name: Dryer Electric dba Rose City Electric
Address: 9409 NE Colfax Street Each additional inspection over allowable in any of the above
Per inspection 62 50
City /State /ZIP: Portland, OR 97220 Investigation per hour (I hr min) 62 50
Phone: (503) 287 -6164 Fax: (503) 282 -1060 Industrial plant per hour 73 75
ELECTRICAL PERMIT FEES*
CCB Lic : 153466 Electrical Lic • 26 -I 142C Suprv. Lic.: 2876S Subtotal 1 0G -o
Suprv. Electrician signature, required• /2A . i d �-..--- Plan review (25 % of permit fee)
Print name: E e•) G 1 BSoJ Date' State surcharge (8% of permit fee) s�
TOTAL PERMIT FEE (/ J - -•J
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name Date: • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed
1 \ Build mg\Permes\ELC- PermitApp doe 12/03 440- 4615T(10 /02/COM/WEB
I
CITY QF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00902
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/17/2005
Phone: (503)' 639 -4171 I t W �I�I •Inspection Requests (24 Hrs.): (503) 639 -4175 ,.,_A 5 __..
INSPECTION WORKSHEE OR DATE: 11/21/2005 TIME: 7:13AM PAGE: 89
SITE ADDRESS: 09367 SW . SHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTO SQUARE LOT #: TYPE OF USE:
PROJECT NAME: 1 IAI S SCE 0 A i
DESCRIPTION: (2) circuits for sig Job #29753.
l
OWNER: WASHINGTON SQU . RE LLC, PHONE #: 503-639-8865
CONTRACTOR: DRYER ELECTRIC INS- PHONE #: 503- 771 -5667
Inspection Request Scheduled For: Date: 11/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
140 Sign installation 021965 -01 415 - 254 -7840 N
Corrections/Comments/Instructions:
YI PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: t oV L\ Date: ‘t(2-11 05 Phone #: (503) 718- 24 •
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