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Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT Il�j" DEVELOPMENT r S O R9 ICES P #: ELR2005 -00321 _639 -4171 DATE ISSUED: 10/5/2005 PARCEL: 1S12600-00300 SITE ADDRESS: 09368 SW WASHINGTON SQUARE RD ZONING: C -G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG Project Description: Limited energy for fire alarm. Job No.13327 • 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 Surchart 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 follow adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through R 952 -0 1- You may o tain copies of these rules or direct qu- = ions to OUNC`.1503 46 -6699. Issued B : Permittee Signatur•,_ , %j�J�� 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. qr E1ectrieal Per Lli),!il.ff,* - ,1 FOR OFFICE USE ONLY • Received "t�.0I� City of 1 igard Received : 10 Permit N °.:� —4:53? 13125 SW Hall Blvd., Tigard, OR r� Plan Review Phone: 503.639.4171 Fax: 503.60 3 2005 4'a*.4,,r, I ` Date/B : Other Permit: Inspection Line: 503.639.4175 X -• 1.1 � i Date Ready/By. SI See Page 2 for Internet: www.ci.tigard.or.Cj'I'Y OF l'iG Notified/Method: Supplemental Information B l_J LLD OF N N PLAN REVIEW ❑ New construction ® Addition /alterat Pl e ase che ck 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 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 ❑ 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.: 13327 — 7 Job site address: 9314 �111Washington Square Rd ❑Health care facility ❑ � 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.: R3 Project name: Janie & Jack 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'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 ® 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, each branch circuit 46.85 2 Address: 1010 SE 11 Ave Each add'I branch circuit 6.65 2 City / State/ZIP: Portland, OR 97214 Miscellaneous (service or feeder not included) Phone: (503) 234 -9900 Fax: : (503) 535 -2620 Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: loni @oregon- electric.com Signal circuit(s) or limited - CONTRACTOR - energy panel, alteration, or Business name: Oregon Electric Group, Inc. extension. Describe: / Page 2 75 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) 234-9900 Fax: (503) 535 -2620 Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lic.: 203 Electrical Lic.:'�/ Suprv. Lic.: * Subtotal � 7--- d - U - Suprv. Electrician signature, required: ( Plan review (25% of permit fee) .o Print name: /141/1/1 ` Da t . /30/05 State surcharge (8% of permit fee) 6 t � � _ TOTAL PERMIT FEE Of Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: 04441 g y Date: 9/30/05 • Fee methodology set by Tri- County Building Industry Service Board •• Number of inspections per per • allowed. a:.\ Budding \Pemuts\ELC- PemutApp dos 12.03 440- 4615T(10.02.COM/WEB CITY OF TIGARD ;` . BUILDING DIVISION PERMIT #: ELR2005 -00321 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/5/2005 Phone: (503) 639- 4171Qa i I Inspection Requests (24 Hrs.): (503) 639 -4175 44, INSPECTION WORKSHEET FOR DATE: 10/7/2005 TIME: 7:05AM PAGE: 69 SITE ADDRESS: 09368 SW WASHINGTON SQUARE RD CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: JANIE & JACK DESCRIPTION: Limited energy for fire alarm. Job No.13327 OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 -639 -8865 CONTRACTOR: OREGON ELECTRIC CONST /GROUP PHONE #: 503- 2349900 Inspection Request Scheduled For: Date: 10/7/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 017714 -01 503 -793 -7177 N Corrections /Comments /Instructions: A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 1 Inspector: CT • 0 bitiSL- Date: v1411(25-4 Phone #: (503) 718 - Z-LiqJ CITY OF TIGARD WILDING DIVISION PERMIT #: ELR2005 -00321 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/5/2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 63 -4175 INSPECTION WORKSHEET FOR D E: TIME: PAGE: 24 SITE ADDRESS: 09368 SW WASHINGTON QUARE RD CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: JANIE & JACK DESCRIPTION: Limited energy for fire alarm. Jo, No.13327 OWNER: WASHINGTON SQUARE LLC, PHONE #: 503- 639 -8865 CONTRACTOR: OREGON ELECTRIC CONST /GRO • PHONE #: 503 -234 -9900 Inspection Request Scheduled For: Date: 10/31/2005 Pour Time: Code # Inspection Description Confirm • Contact # Message 199 Electrical final 019883-01 503 793 -7177 N Corrections /Comments /Instructions: N Ps i` esN '? PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: cr(bct. Date: 1011110,r Phone #: (503) 7182_40