Permit 1 w
C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
'l DEVELOPMENT SERVICES PERMIT #: ELR2006 -00011
- A -
'� II 1312 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/10/2006
PARCEL: 1S12600-00300
SITE ADDRESS: 09377 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Low voltage for security alarm.
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: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: SECURITY. X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC AMERICAN VETERANS
BY THE MACERICH COMPANY 8301 SW 135
9585 SW WASHINGTON SQUARE RD BEAVERTON, OR 97008
TIGARD, OR 97223
Phone: Contact #: PRI 503 319 - 4754
FAX 503- 808 -9018
FEES Reg #: ELE 34- 501CLE
LIC 135086
Description Date Amount
[ELPRMT] ELR Permit 1/10/2006 $75.00
[TAX] 8% State Surcharl 1/10/2006 $6.00 REQUIRED ITEMS AND REPORTS
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 ar- set forth in OAR 952 - 001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct que : at - 6 -6699.
j to N
Issued By: _ Permittee Signature - ' '
OWNER INSTALLATION 0 /
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.
Jlectrical Permit Application roll orrlcE ust: ()Nix
. Received /
City of Tigard Date B _ p - D L/ • ► Permit No� _ , , /
13125 SW Hall Blvd., Tigard
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 /t, *� _,, Other Permit.
(' ' Date/13 .
Inspection Line: 503.639.4175 JAN 10 2006 . J: = , I I . Date Ready/By. Fign Ill See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method Supplemental Information
CIT' TIGARD PLAN REVIEW
B_-, �t V {7t6N Please check all that apply:
❑ New construction I It►o alteration/replacement PP y
❑Demolition \' they: ❑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
DOccupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: 5 7 2._, I Job site address: 9377 i, / , • ,Se,R. ❑Health -care facility ❑der:
Submit 2 sets of plans with any of the above.
City /State/ZIP: The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: 1 Project name: 44 — n -'ye'/enA f 75 2 72_ FEE* SCHEDULE
Dacription I Qty. L Fee. I Taal 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: I Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 I
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 £ tEkr `�� � T-r 41Z,72-17-1 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: 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: ( ) I 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 I ❑ 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: first branch circuit
Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax: : ( ) Pump or Irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
.` CONTRACTOR energy panel, alteration, or
;1 � extension. Describe: ) Page 2 2
Business namew s 1 /2 TGvzmv5 SAC i e i`
Address: 530 / 5 CJ /3 _' f/C Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: g f , i/£,t . t- Investigation per hour (I hr min) 62.50
) 7 / 5 ` r /7) / ?rax:("/Toc,
) I ndustrial plant per hour 73.75
(�
Phone: . 7
ELECTRICAL PERMIT FEES*
CCB Lic.: /3 j' 0 g6 Electrical Lic.: 3 .7 ez PSuprv. Lic.: 217746* Subtotal
Suprv. Electrician signature, required: / �IEr�'�1 Plan review (25% of permit fee)
Print name: 5:„ /£L� 77 Date: / ,/ a-6 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: / 74 / This permit application expires it a permit is not obtained within 180
days after it has been accepted as complete
Print name: - j ���' Date: /,/ � — • Fee methodology set by Tn- County Building Industry Service Board
4 •• Number of inspections per permit allowed.
i \Bwlding\Permits\ELC- PetmitApp doc 12/03 470-4615T(I0/02/COM/WEB
Electrical Permit Application - City of Tigard r
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
El 'Garage Door Opener*
0 Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial system. $75.00
(SEE OAR 918
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i \ Building \Prnnits\ELC- PamitApp doc 04103
CITY OF TIGARD
BUILDING DIVISION PERMIT #:SaktCr16.OW 1 �
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: t 1 11 O 6 TIME: PAGE:
SITE ADDRESS: 9M SW WASVVI tV00 S�• • CLASS OF WORK:
SUBDIVISION: v LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER:Pt 6E9.c.R.O a -b Er1(M PHONE #:
CONTRACTOR: Am um vs s PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
La Plkfor-
Corrections /Comments /Instructions:
%1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 ( C Date: 1" t l ' 0 Phone #: (503) 718- Z4
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: FLR200i 0:10'11
4 4, 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 1/10/2006
Phone: (503) 639 -4171 7ag
Inspection Requests (24 Hrs.): (503) 639 -4175 I �..
INSPECTION WORKSHEET FOR DATE: 4/2712006 TIME: 7:04AM PAGE: 59
SITE ADDRESS: 09377 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: ABERCROMBIE & FITCH
DESCRIPTION: Low voltage for security alarm.
OWNER: WASHINGTON SQUARE I.LC, PHONE #:
CONTRACTOR: AMERICAN VEI - ERANS PHONE #: 503 503
Inspection Request Scheduled For: Date: 4/27/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 028831 -01 503-808.9010 N
Corrections /Comments /Instructions:
C
G
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: `v N)Oe Date: - f i 27 j 0 6 Phone #: (503) 718- Lim)