Permit � CITY OF 1'I BARD ELECTRICAL RESTRICTED ENERGY PERMIT
II ►� DEVELOPMENT SERVICES PERMIT #: ELR2005 -00383
Ai- All 13125 SW Hall Blvd., Tigard, O R 97223 503 - 639 -4171 DATE ISSUED: 11/1/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09378 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: LV for fire 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: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC OREGON ELECTRIC GROUP
BY THE MACERICH COMPANY 1010 SE 11TH AVE
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97214
TIGARD, OR 97223
Phone: Phone: 503 234 - 9900
Reg #: LIC 203
SUP 4460S
FEES ELE 26 -95C
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 11/1/2005 $75.00
[TAX] 8% State Surchart 11/1/2005 $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 95 x:01- 100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246-66 9.
Issued By: 4 Permittee Signature: ,r1
OWNER INSTALLATION ONLY J"
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.
FROM—Oregon Electric Estimating 5032313587 T-358 P.002/005 F-575
gard — -- -- -----"----°
(V_-c\i' ---:- - •-• Date/By: 11 Pia< 7)19 Perfeit N°1 - 1 ?..lat — 003va
all Blvd., llgard, Ongt- ' Plan Revie
6394171 Fax: 50 3 .1960 Dare/Br Other Fermin
1 ik; 503.6304175 4 - ' . ' 1-M „.,...11 '.s'i I ' Date Rew3y/By: lurk 1 EZI See Page 2 foe
'
Internet: www.ciaigard.orus . ;, Notiftedadethod: I Supplemental Information
r§ 4 • ,4P771 1 ,7WIT I M-; 7 7.eff377 1; vrACT : .: 5 74 1 4 , - , Mireagnatief t 5.:1::=
'''.. — " ''' • • • • •
0 Ncw construction El • Ar .. : - on/replacement , Please check all that apply:
0 Demolition EJ%dier: ['Service over 225 amps. comm "1 01-Lazardous location
0 Sia over 320 amps - rating 0Buildng over 10,000 sq. ft.,
Ol tOgrstitbef043t'lleilitkggiztO of I- and 2-family dwellings 4 or more new residential
El 1- and 2-family dwelling El Commercial/industrial 0 Accessory building OSystcm over 600 volts nominal units in one structure
El Building over three stories OFeeders, 400 amps or more
CI Multi-family El Master builder 0 Other. ['Occupant load over 99 persons ElManufacturcd structures or
'
!ti El Egress/lighting Plan RV park
Inlicalth-care facility InOther
Job no.: 13354 [ Job site address:q3VW Washington Square 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 scrvicc.
:;;Wi;:k?'4 FEESCHEDULE :A
Suite/bIdgJapt. no.: R6 Project name: The Duck Shop
Deserlptlee 1 Qty. I F. 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
- . Limired energy, residential 75.00 2
Tax map/parcel no.:
Limited energy. non-residential 75.00 2
....".! 0 , Okictk- Each manufactured or modular
Install low voltage wiring and cabling for Fire Alarm dwellinj service =kr feeder _ 2 -
Services or feeders installation, alteration, on, and/or relocation
200 amps or less 80.30 2
: : .. 1.:.... : E...c... Ea vi - - wahl - w, . - 7 201 amps to 400 _amps 106.85 2
2 -
- • 40t amps to 600 amps 160.60
Name: Washington Square LLC 601 amps to 1,000 amps 240.60 '• 2
Addrcss: 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 I 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amp% 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
• .
--,' j0"1■146,0*004.ji.A1:4,;':`,F;a:^.,[1'...PONTiCt PERSON ::?.:•;.',:a:.1. A. Fee for branch circuits wirh
,4, service or feeder fee. each
6.65 2
Business name: Oregon Electric Group, Inc. branch circuit —
B. Fee for branch circuits
Contact name: Lori Martin without service or feeder fee,
- . 46.85 2
each branch circuit
Address: 1010 SE 11 Ave
Each 20'1 branch circuit 6.65 2
City/State/ZIP: Portland, OR 97214 Miscellaneous (service or feeder not included)
Phone: (503) 234-9900 I Fax : (503) 535-2620 Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E-mail: loni@oregon-eleetric.com Signal circuit(s) or limited-
..-4)
.%
:• ' ' ''.- N
: "1;;':.e..%!'..;•;'!).51:544.. energy panel, alterarim or
extension. Describe: / Page 2 7 2
Business name: Oregon Electric Group, Inc. . _
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 (I hr min) 62.50
Phone: (503) 234-9900 I Fax: (503) 535-2620 industrial plant per hour 73.75
7:tr';'..'•, :04
CCB Lie.: 203 Electrical Li.. e Suprv. Lic.: 23q is Subtotal --/C.
Suprv. Electrician signature, required; tarivitel, Pian review (25% of permit fcc)
, State surcharge (8% of permit fee)
Print name: & .5 44 Dare: 10/2,8/05
Toro, PERMIT FFIX. p ''':!"-
Authorize signature:
ThiS permit application expires It a permit is not obtained within 180
days after it has been accepted as complete
Print narn : Date: 10/28/05 • Fee sreshodology on by rri-Couoty Building Industry Service Board
\ • " Number of impeetiorn per permit allowed.
IABoildinaTemuccOELC.Perrampp-doc 12103 4404615T( / MC/C014/W1513
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005- 003133
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/1/2005
Phone: (503) 639 -4171 �
Inspection Requests (24 Hrs.): (503) 639 -4175 ° 'f � ..
INSPECTION WORKSHEET FOR DATE: 1'1/10/2005 TIME: 7:02AM PAGE: 85
SITE ADDRESS: 09378 SW WASHI \ TON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SOU 'E LOT #: TYPE OF USE:
PROJECT NAME: DUCK SHOP
DESCRIPTION: LV for fire alarm.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR. OREGON ELECTRIC GROUP PHONE #: 503- 234 -9900
Inspection Request Scheduled For: Date: 11/10/2005 Pour Time:
Cod- s section Description Confirm •• Contact # Message
020926 -01 503 - 7937177 N
1 t - tJAL
Correc - _ •mments /Instructio .
\PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: � N O Date: 11 ' 10 ' W Phone #: (503) 718 -1)4 v