Permit • ,4
ft',
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
r�i�j' DEVELOPMENT SERVICES DATE ISSUED: 11/3/2005
`�' PERMIT #: ELR2005 -00388
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09378 SW WASHINGTON SQUARE RD ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Data /Phones. Oregon Duck Shop.
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 FIRE PROTECTION SERVICES
BY THE MACERICH COMPANY 5573 SW ARTIC DR
9585 SW WASHINGTON SQUARE RD BEAVERTON, OR 97005
TIGARD, OR 97223
Phone: Phone: 503 -590 -3732
•
Reg #: ELE 34- 488CLE
LIC 154333
FEES•
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Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 11/3/2005 $75.00
[TAX] 8% State Surcha 11/3/2005 $6.00
Total $81.00
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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 thanV180'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.
Issued By: ) � _ � _ 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.
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a
Electrical Permit A titi v . a • F D rOR cirri( I 1;si :ONI.1
City of Tigard J e /B : / — " - Q �� j�- ' I ,I
13125 SW Hall Blvd., Tigard, OR 97221p ,' • ` lnos Plan Review
Phone: 503.639.4171 Fax: 503.598.19tib' � ^11011 '� Date/ . Other Permit:
Inspection Line: 503.639.4175 !1 Date Ready/3y: NMI ® See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGARD Nottfed/Method: Supplemental Information
2 , ;' , ,_ . 1 *4 z . J? - REVWW
� T ,���� �51! ,` , r. rt4s� .roxtarr9 �v= a�F > - -- .
❑ New construction ® Addition/alteration/replacement Please check all that apply:
❑Demolition ❑Other: ['Service over 225 amps, comm'I ['Hazardous location
. d ,, , ; ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATE OF CONSTRUCTION it�r`'� �
, of 1- 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: ❑ Bwlding over three stories ['Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB, SITE INFORMATION AND LOCATION I : . H- - -, « , ❑Egress/lightingplan RV park
❑Health-care facility ['Other:
Job no.: 2318 I Job site address: 9378 SW Washington Sq. Rd. 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
Suite/bldg. /apt. no.: R -06 I Project name: Oregon Duck Shop °' ` : SCHEDI)LE
Description I Qty. I Fee. I 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: I 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
''DES ON < ;OP, WO* << - `.; ` - Each manufactured or modular
Add data & phone cable runs dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
0 PROPER7Y`_T_WNIR ; , - ' 1 __. ` `� �� � : _ ,,- 201 mpsto400amps 106.85 2
-- _'' -> ',, -'' '' <_-'•'-' "" -. • < d- • . - -. • - ...'''''.b' 401 amps to 600 amps 160.60 2
Name: OREGON DUCK SHOP 601 amps to 1,000 amps 240.60 2
Address: 9378 SW WASHINGTON SQ. RD. SPACE R-06 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: ( ) I 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
® APPLI Fee for branch circuits with
� � '' �� PERSON A. service or feeder fee, each
Business name: FIRE PROTECTION SERVICES, INC. branch circuit 6.65 2
B. Fee for branch circuits
Contact name: DAVID M. PHIPPS
without service or feeder fee, 46.85 2
Address: 5573 SW ARCTIC DRIVE each branch circuit
Each add'l branch circuit 6.65 2
City/State /ZIP: BEAVERTON, OR 97005 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (503) 590 -3732 I Fax: : (503) 628 -6214 Sign or outline lighting 53.40 2
E -mail: phipps @fpsnw.com Signal circuit(s) or limited-
CO.NTLtcrOR_ v , _ _ energy panel, alteration, or
_ extension. Describe: / Page 2 2
Business name: FIRE PROTECTION SERVICES, INC.
Address: 5573 SW ARCTIC DRIVE Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: BEAVERTON, OR 97008 Investigation per hour (I hr min) 62.50
Phone: (503) 590 -3732 I Fax: (503) 628-6214 Industrial plant per hour 73.75
',:. gL PERMIT FEES*
CCB Lic.: 15433 I Electrical Lic.: 34- 488CLE S . Lie.: 4120LEA Subtotal
dle Suprv. Electrician signature, required: i �, / ;,//.r� Plan review (25% of permit fee)
I
__is-
' State surcharge (8% of permit fee)
Print name: i / ij Date: 11/02/05
` TOTAL PERMIT FEE
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: 11/02/05 • Fee methodology set by Tri -County Building Industry Service Board
•' Number of inspections per permit allowed
i \Building\Permits\ELC- PermitApp doe 12/03 440-4615T(10/02/COM/WEB
CITY OF TIGARD
B ILDING DIVISION PERMIT #: ELR2005.00388
13125 0 Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/3/2005
Phone: (503 39 -4171 +�
Inspection Requ= is (24 Hrs.): (503) 639 -4175
INSPECTION WORKS . ET FOR DATE: 11/10/2005 TIME: 7:02AM PAGE: 23
SITE ADDRESS: 09378 '3 WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHING - SQUARE LOT #: TYPE OF USE:
PROJECT NAME: DUCK SHOP
DESCRIPTION: Data/Phones. Or ion Duck Shop.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: FIRE PROTECTION SE' VICES PHONE #: 503- 590 -3732
Inspection Request Scheduled For: Date: 11/10/2005 Pour Time:
Code # Inspection Description C. firm # Contact # Message
135 Low voltage 0209; -01 503-314 -0600 Y
Corrections /Comments /Instructions:
X 1 . 3 ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N(38 Date: 11" / tb Phone #: (503) 718- 1146
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005 -00388
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1113/2005
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/10/2005 TIME: 7:02AM PAGE: 21
SITE ADDRESS: 09378 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: DUCK SHOP
DESCRIPTION: Data/Phones. Oregon Duck Shop.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: FIRE PROTECTION SERVICES PHONE #: 503-590-3732
Inspection Request Scheduled For: Date: 11/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 020963-01 503314 -0600 N
Corrections omments nstructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
✓ ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: c3-44- . 1.1e5 LE,. Date: LI • 13.0,5`. Phone #: (503) 718 - Z-4Ltij