Permit C ITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
PERMIT #: ELR2005 -00391
DEVE H BMEN9 Tigard, I -639 -4171 DATE ISSUED: 11/4/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09374 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: LV telephones cabling.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC E C COMPANY
BY THE MACERICH COMPANY PO BOX 10286
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97296
TIGARD, OR 97223
Phone: 503- 639 -8865 Phone: 503- 220 -5377
Reg #: ELE 26 -45C
LIC 49737
FEES SUP 4040S
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 11/4/2005 $75.00
[TAX] 8% State Surchar€ 11/4/2005 $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 rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 -0 1 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: Z ,.V.!/b Permittee Signature: 2i rt. B"" 41),
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.
11/03/2005 15:38 5032283353 E C COMPANY DBSIGN B PAGE 02
4f.ctrical Permit Application 1 , I 'NI „ ,
• City of Tigard' Iteeeivea
13125 SW Hall Blvd., Tigard, OR 9722 �� IL O V p++ I Q47 gV Permit No. ♦I ...op a
Phone: 503.639.4171 Fax 503.598.1960 e.;,f,� Plan /By Other Nan
Inspection line: 503 639.4175
NOV 3 201 1 -'- Dine ine&me�; as Pe 2fe
Internet: www.ei.tigard.or.us No NotiBed/Mptbod Sng iee ragr tal for rorma .
• • E'i' Y �c _ ■ PLAN *REVIEW •
❑ New construction ® AdatiO4991 Please check all that apply,
❑ Demolition ❑ Other: ['Service over 225 amps, comm'I ❑Hazardous location
CATEGORY OF � Ut'i [ON ['Service over 320 amps - rating ❑Bunting over 10,000 sq. R.,
. of 1- and 2- family dwellings 4 or more new residential
❑ 1 and 2 family dwelling N Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
builder ❑ Other over three stories ['Feeders, 400 amps or more
CI Multi- Palnily ❑ lvlag
JOB SITE INFORMATION AND LOCAxICUV []Occupant load over 99 persons OManufactured structures or
• ❑ ss/lit;ng plant RV park
Job no.: 310-17 rlob site address: 9585 SW Wa. Sq. Road s. 'US ❑Flcalt - care facility ®Otber:
Submit .1. sets of plans with any of the above.
City /State/ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service.
Suite/bldg. /apt no.: Space R05 Project name: Papyrus • BC�EDULE
Daaiptloa T Qty. I Fee. l 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
Alf�9F'R�'>F1CO b WO1tIC _ 1-im�itcd energy, non - residential 75.00 2 -
Each manufactured or modular
Install TELEPHONE CABLE for customer dwelling, service and/or feeder - 90.90 2
Services or feeders iustulladon, alteration, and/or relocatio
200 amps or less 80.30 2
® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
•
Name: Macerich 401 amps to 600 amps 160 60 2
601 amps to 1,000 amps 240.60 2
Address: 401 Wilshire Blvd., Suite 700 Over 1,000 amps or volts 454.65 2
City/State /ZIP: Santa Monica, CA 90401 Reconnect only I [ 66.85 2
Temporary services or feeders Installation, alteration, and/or
Phone: (310)394-6000 I F ax: ( ) reloeadou _ i
Owner installation: 'This installation is being made on property that I own which is not 20 to or 40 s 06 30 1
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 201 amps to 400 amps 10030 2
Owner signature: 401 amps to 600 amps 133.75 2
Date: Branch eireuilli new, alteration, or extension, per panel
SI AtirucANT ❑ CONTACT pliatSON ' A Fee for branch circuits with
Business name: E C Company service or feeder fee, each 6.65 2
brooch circuit
Contact name: Roger Reed B. Fee for branch circuits
without service or feeder fee, 46 85 2
Address: PO Box 10286 each branch circuit
Each add'l brunch circuit 6.65 2
City/State/ZIP: Portland, OR 97296 _ Miscellaneous (service or feeder not Included)
Phone: (503) 220 - 533d I Fax: : (503) 295 - 3012 Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E - mail: rogerr@e-c-co.com Signal circuit(s) or limited -
CONI`BACTOIR energy panel, alteration, or IS CIP
Business name: extension. Describe: telephone Page 2 ' 2
cable
Address: Each additional Inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: Investigation per hour (1 to min) 62.50
Phone: ( ) F ax: ( ) Industriai�larrt per hour 73. —
f :, subtotal ' -7 5 • o�
gI,�C110CAL PERMIT FEES'
CCH Lie.: I I .itlf�
Suprv. Electrician signature, required: 1, rJtav Plan review (25% of permit fee)
Print name: Date S tate surcharge (8% of permit tie) b • ea
r C / a TOTAL PERMIT FEE ' / . tM
Authorized signature: Tats permit appllcaiimr esp ies if a permit a ea not obtaiwd within 160
Print name: days after it tta bean accep co mple te
I Date: • Fee methodology act by Ili -County Building Industry Service Board
•" Number of ioseeaions oQ permit allowed
CITY,OF TIGARD
BUILDING DIVISION r PERMIT #: ELR2005 -00391
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/4/2005
Phone: (503) 639 -4171 474. ii 11#
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/7/2005 TIME: 7:05AM PAGE: 41
SITE ADDRESS: 09374 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: PAPYRUS
DESCRIPTION: LV telephone cabling.
OWNER: WASHINGTON •QUARE LLC, PHONE #: 503-639 -8865
CONTRACTOR: E C COMPANY PHONE #: 503- 220 -5377
Inspection Request Scheduled For: Date: 11/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
13r a e 020467 -01 503-407 -6779 Y
ctions /Comments/ ions:
X I PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 11V 6g LE Date: I 1 • ( 1 ' W Phone #: (503) 718- 10