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Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT I DEVELOPMENT SERVICES PERMIT #: ELR2005 -00411 JI- - 13125 SW Hall Blvd., Tigard, OR 97223 503 - 6394171 DATE ISSUED: 11/15/2005 PARCEL: 1S12600-00300 SITE ADDRESS: 09378 SW WASHINGTON SQUARE RD ZONING: C -G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG Project Description: Audio and stereo. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: X 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: TOTAL # OF SYSTEMS: 1 Owner: Contractor: WASHINGTON SQUARE LLC MUZAK LLC BY THE MACERICH COMPANY 3318 LAKEMONT BLVD 9585 SW WASHINGTON SQUARE RD FORT MILL, SC 29708 TIGARD, OR 97223 _- Phone: Phone: 503 889 - 3848 Reg #: LIC 142760 ELE 26- 1055CLE FEES Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 11/15/200: $75.00 [TAX] 8% State Surchart 11/15/200: $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 -101 -0100. You may obtain copies of these rules or direct que ons to OU 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. ctrical Permit A �a� 0NIQ"II FOR OFFICE USE ONLY v9l City of Tigard R _L t, Received DateB : I lh / Permit No _ // _p O 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revue � Phone: 503.639.4171 Fax: 503.598.1960 T AON �w ,r � I Date/B Other Permit: Inspection Line: 503.639.4175 al.� �`� Date ReadyBy See Page 2 for Internet: www.ci.tigard.or.us Notified/Method Supplemental Information , . PLAN REVIEW ® New construction ❑ Addition/alteration /replaceme Please check all that apply: ❑ Demolition ❑ Other: ❑Service over 225 amps, comm'l ❑Hazardous location ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential ❑ 1- and 2- family dwelling ® CommerciaUindustrial ❑ Accessory building ['System over 600 volts nominal units in one structure ['Building over three stories ['Feeders, 400 amps or more El Multi- family 0 Master builder 0 Other: JOB SITE INFORMATION AND LOCATION ❑Occupant load over 99 persons ❑ park ured structures or RV 0Egress /lighting P Job no.: Job site address: 9378 Washington Sq. Rd ❑Health -care facility DOther: 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.: R06 Project name: Duck Shop FEE* SCHEDULE Description I Qty. I Fee. Total I ** Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. Washington Square 1,000 sq. R. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non- residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular Sound System 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 ❑ 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 / "LIP: Temporary services or feeders installation, alteration, and /or Phone: ( ) 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 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, Address: each branch circuit 46.85 2 Each add'I branch circuit 6.65 2 City/State /ZIP: Miscellaneous (service or feeder not included) Phone: Pump or irrigation circle 53.40 2 ( ) Fax:: ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or extension. Describe: Sound Page 2 2 Business name: Muzak system Address: 12449 NE Marx Bldg 10 Each additional inspection over allowable in any of the above Per inspection 62.50 City/State /ZIP: Portland, Or 97230 Investigation per hour (1 hr mm) 62.50 Phone: (503) 889 -3848 Fax: (503) 889 -3883 Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lic.: 142760 Electrical Lic.: 26- 1055CLE Suprv. Lic.: 2016LEB Subtotal Suprv. Electrician signature, required: , Q Q r „ (7 Plan review (25% of permit fee) �� 11 1 � ]'l l � C - Date: 11/15/05 � State surcharge (8% of permit fee) Print name: 712.... 1, �)S 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: • Fee methodology set by Tn- County Building Industry Service Board I's Number of inspections per permit allowed. i \Bwldmg\Pemuts\ELC- PernutApp doc 17/03 440- 4615T(10 /02/COM/WEB CITY OF TIGARD BUILDING DIVISION PERMIT #111..R,1005 O ij 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (50 .39-4171 1447',,„ Ili Inspection Req :sts (24 Hrs.): (503) 639 -4175 INSPECTION WORKS ET FOR DATE: \L— V - OS TIME: PAGE: SITE ADDRESS: C V37 W Lviy%t‘ $� CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: ® % ) itze DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: - Pour Time: Code # Inspec 4 Description • onfirm # Contact # Message F � Correctio - - omments /Instructions: v 6 © 6 • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: VI Phone #: (503) 718 - I-06 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2005 -00411 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/15/2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 11/16/2005 TIME: 7:03AM PAGE: 83 SITE ADDRESS: 09378 SW WASHINGTON SQUARE RD CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: :10I" DESCRIPTIO : udio and stereo. - OWNER: WAS GTON SQUARE LLC, PHONE #: CONTRACTOR: MUZAK LLC PHONE #: 503 - 889.3846 Inspection Request Scheduled For: Date: '11/16/2005 Pour Time: Code # Inspection Description Confirm # 'Contact # Message 135 Low voltage 021387 -01 803- 242-7874 N Corrections/Comments/Instructions: (AN ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718-