Permit CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
iA DEVELOPMENT SERVICES PERMIT #: ELR2006 -00030
1,L III 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/18/2006
PARCEL: 1S12600-00300
SITE ADDRESS: 09377 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: LV Thermstat.
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: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC ARROW MECHANICAL
BY THE MACERICH COMPANY 10330 SW TUALATIN RD
9585 SW WASHINGTON SQUARE RD TUALATIN, OR 97062
TIGARD, OR 97223
Phone: Contact #: PRI 503 692 - 1565
FEES Reg #: LIC 5193
ELE 34 -47CLE
Description Date Amount
[ELPRMT] ELR Permit 1/18/2006 $75.00
[TAX] 8% State Surchart 1/18/2006 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct . gas ns to OUNC at 503 - 246 -6699.
Issued By: ,� ,� Permittee Signature: i
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DATE:
LICENSE NO:
Call 503 -639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
01/18/2006 10:44 FAX 503 I VE � ITY OF TIGARD ICJ 001
Electrical Permit Application v '. I ir ( t .,
City of Tigard ' JA 1 8 2006 -.... ' - s r
13125 SW Hall Blvd., Tigard, OR 97223 C I
mac: 503.639.4171 Fax: 503.598.19 I TY 60 TY O OF F T I IG G A' cater Await
Inspection Line: 503.639.4175 `. . L 1 - - ''�h _� DaeRea1y/BY
lutemet www.dtigandor.us tietifedlMahot
❑ New construction Addition/alteration/replacement Please chedc all that apply.
❑ Dem � ❑other 0Service over 225 amps, comm'I OHa7ardous location
a. . , ['Service over 320 amps – rating OBuildng over 10,000 sq. ft,
'�; . ` . . ; ;t: . O$ OF' OQQ$1EID l N .,," •: {`' ".. lit.; of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling 1CornmercialAndustrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi-family Master builder ❑ Other: ❑Building over three stories OFteedrrs, 400 amps or more
00o1apant load over 99 persona ['Menu/ea red structures or
• • .... " 1i ;, '"�• ' . 1,0CATEQK :. • OE<9essAightiag Plan RV park
Job 1m,: Job situ:: y` Gl� 14 55 )&.?' Submit hie o fatality f n ❑Other.
Submit 2 sae of plans with any of the about:.
City /State/ZIP: 7 - / ,M / aoe 7 2 2- 3 The above are not applicable to oanporn y construction service. •
Suite/bldg./apt no.: rrro Qli name: ,(%/ / ".e 972 -. .:
tia atnam Qtr. Fee Teter
Cross street/directions to job she: New residential single- or taulli-fawly dwelling atilt.
Includes attached garage.
1,000 sq. R. or lass 145.15 4
Subdivision: I Lot no.: Ea add'I 500 sq. ft or portion 33.40 1
Tax map/parcel no.: Limited porgy, residential • 75.00 2
Limited
. s . w ...1e � . 1,,;.:'..!': mercy, eel non-residential omo
modular 75.00 2
Each manufactured a moduar I
Tol A v 5 />> 1 7 — 1 R/ s , (L -i / e e- dwelling,. service and/or feeder 90.90 2
Services or feeders inatailattoa, alteration, and/or relocation
200 apps or leas 8030 2
• m :: ', Q011ZEl '.• _;,,';; ` ' -•'• ; i7 - :A. , Vi a•• _ 201 ampsto400 amps 106.85 2 '
r 401 omits to 600 amps 160.60 2
Nam: ,Jf /zC PAS ^?, 'c , F 'A-',e / 9 7Z 601 amps to 1,000 amps 240.60 2
Address: 9 S g'S S ce. ' (,,/9 CG, j ( Over 1,000 amps or volts 454.65 z
Rammed only 66.85 2
City/State/ZlP: 7/,,,, 7/ 9) 2 Z r Temporary services or feeders installation, alteration, and/or
Phone: ( ) I Fax relocation ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 „tops to 400 amps 10030 2
intended for sale, l ease, rent, or exchange, according to ORS 447, 449, 670, and 701.
401 amps to 600 amps 133.75 • 2
Owner signature: Date: Branch cirvaib – new, alteration, or extension, per panel
,,Ig r ':y ?:.c.. -. 1a e: e . - . a 3F1200‘.*'"� : < A. Pee for branch circuits with .
service or Header fee, each 6.65 2
Business name: . /L /z0 w /c•1eeHlPi ,96 hrarrch emit
Contact name: ,1fl J--- S•G � � C,y� /Z wio service B. Fee tbs. stanch circuits
thrd Q fe fa. 46.85 2
Address: /p 3 3 p /4 ,, j � e
, 6?,e fast branch Cit circuit Each midi branch circuit 6.65 2
City/State/ZIP: • 7 /;,;?;.. „--,, p4 %7'" 2_ - Miscellaneous (service or feeder not included)
PboOe: ( ) (� J 2 – / 6'&' . I Fax:: ( ) 0 e:// /f_29 Sign r irrigation ig ti 53.40 2
3i�n or online lighting 53.40 2
E-mail: Signal ci mit(s) or limited- � 6 -
' ='ek'1 ',.: b: r' :.: 4 `.; '? 9" • ,"• '. , • - :o -g .k energy panel alteration, or
extension Describe: Page 2 2
Business name: //o 96 S , / - ,-,i k ;�l/t)0 '• �+
Each additional inspection over allowable in as edge above
Address: / Z. y /L7 c- Ai ,477 air i2ef Per inspectio 6130
_ _____[__
City/State/ZIP: /////t-c,/ e / //c , / 7* 2-- Z Co. Investigation per hour (I hr - 62.50
I ndustrial plant hour 73.75
Phone: /7) e/9s - c Fax(�,o�) G/ 9/_ ye?,„ ,p �
CCB Lib.: of/ 9 3 j Electrical Lic.: �1 24/– / 76(.�I S • c.: 2-LI I t E( Subtotal 7 3 —
$uprv. Electrician sitptature, required: • Plan review (25% ofpermit fee) ..--- •
Print name: �.evt>r`'t c\\42 I Date: I-18.06 state anrcharBe (895 of permit fee) (�
TOTAL PERM![ FEE 67 –
Authorized signature: ma permit applleatim ezplres It a permit is not obtained within 180
daps anerit has bem mewled as complete
Print name: I Data: • Fee methodetogy see by Tei -CemIy Beading Wintry Service Beard
• • Number of iaspecboes per permit allowe&
i:llhel toelhomm19.C- PtmitApp.doe 17100 4es461STtINO2/CO1tME5
CITY OF TIGARD ...
BUILDING DIVISION PERMIT #: ELR 200 -00030
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: itifii200ri
Phone: (503) 639 -4171 ��
Inspection Requests (24 Hrs.): (503) 639 -4175 •
INSPECTION WORKSHEET FOR DATE: 4/27/2006 TIME: 7:04AM PAGE: f32
SITE ADDRESS: 09377 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: ABL=RCROMBIE & FITCH
DESCRIPTION: I V Thermstat.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR. ARROW MECHANICAL PHONE #: 503 - 692 1Li6
Inspection Request Scheduled For: Date: 4/271"2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 028821••02 503. 692 -1565 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6- 1<t-t V 08 LE. Date: L f ` Phone #: (503) 718- 2.446 `