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Permit
9/3" � C ITY F TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00717 DEVELOPMENT , c Ir SERVICES DATE ISSUED: 9/26/2005 • 503 - 639 -4171 PARCEL: 1S12600-00300 SITE ADDRESS: 09378 SW WASHINGTON SQUARE RD ZONING: C -G SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG Project Description: (2) 200 amp service, (10) branch circuits. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 2 W /SERVICE OR FEEDER: 10 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: WASHINGTON SQUARE LLC TIMBERLINE ELECTRICAL CONTRACTORS BY THE MAC ERIC H COMPANY PO BOX 298 9585 SW WASHINGTON SQUARE RD LAKE OSWEGO, OR 97034 TIGARD, OR 97223 Phone: Phone: 503 - 969 -8488 FEES Reg #: LIC 160037 ELE 26 -121 IC Description Date Amount SUP 4957S [ELPRMT] ELC Permit 9/26/2005 $227.10 [TAX] 8% State Surcharge 9/26/2005 $18.17 REQUIRED ITEMS AND REPORTS Total $245.27 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 questions to OUNC at 503 - 246 -6699 or 1 -800 32 -2344. Issued By: Q ,f t Q 64 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. Electrical Permit ^,� ii' ■�i c :1 I WED FOR OFFICE USE ONLY • City of Tigard D a c t e / B y ' I O)) �v 6) PeimitNo �'�� ` �00 ) 1 SW Hall Blvd , Tigard, OR 97 26 2005 Plan Review Phone: 503.639.4171 Fax 503 5981V y 1 1u •1 'I(Ji ;;%t (i Date/By Other Permit. Line. 503.639.4175 P'I � Date Ready/By Juns El See Page 2 for r Internet www.ci tigard.or.us CITY OF TIG • a Notified/Method /(` Supplemental Information �; _ °,i , - ' '. PLAN •REVIEW ew construction ❑ Addition/alteration/replacement ` 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 2ommercial/industnal ❑ Accessory building ['System over 600 volts nominal units in one structure ❑ Multi - family ❑Master builder ['Building over three stories EFeeders, 400 amps or more ❑ Other: ['Occupant load over 99 persons ['Manufactured structures or • JOB SITE INFORMATION AINID 'LOCATION - LOCATION • - ['Egress/lighting plan RV park - SP .1� ❑Health -care facility ['Other. Job no.: Job site address: 7378 g,I.O U1116Illl wroth juke ep 12 KAPSubmit 2 sets of plans with any of the above. City/State /ZIP: l"14keco 09...- c iw3 The above are not applicable to temporary construction service Suite/bldg. /apt. no.: 59 •., c L n :, FEE * - SCHEDULE -', -OIO I Project name: O c.g. �I�or Description Qty. l Fee. 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: 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 r .. - _ - DESCRIPTION - OF WORK - Each manufactured or modular dwelling, service and /or feeder 90.90 2 T.T. ('t 'W . Irl Milk yl.. Aril OA Services or feeders installation, alteration, and/or relocation 200 amps or less 2. I 80.30 /'60.01 2 ' - '1=1 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 Phone: ( ) I F ax: ( ) 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 S .APP.LICANT % " : • ®f CONTACT'PERSON A. Fee for branch circuits with service or feeder fee, each Business name: branch circuit 10 6.65 6.6, cA 2 B. Fee for branch circuits Contact name: without service or feeder fee, each branch circuit 46.85 2 Address: Each add'! branch circuit 6.65 2 City/State /ZIP: Miscellaneous (service or feeder not included) Phone: ( ) 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 extension Describe Page 2 2 Business name: 1 IrhEL12-1.1114E Elez LIC.AtV T2At -ToC.S •Irlc.• Address: et) e 4119 Each additional inspection over allowable in any of the above Per inspection 62.50 City / State /ZIP: ( zCcp , 17 `� Industnal plant per hour (1 hr min) 62 50 Phone: (5 q 03) . F lo Fax: (So3 ) 2$y- yam ELL , lant p hour 73.75 PERMIT FEEEE S* CCB Lic.: 14(031 Electrical Lic.: Z(,- IV i G Suprv. Lic. c+,e48 Subtotal 7) b Suprv. Electrician signature, required: Plan review (25% of permit fee) — - State surcharge (8% of permit fee) %•,.. J' Print name: CP aic Grit - y - Date: TOTAL PERMIT FEE L signature: ob within 180 days after it has been accepted as complete Pnnt name: Date: • Fee methodology set by Tn- County Building Industry Service Board °• Number of inspections per permit allowed. i\ Bui lding\Pemuts\ELC- PermitApp.doc 12/03 440 4615T(1 0/02/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: := RESIDENTI.AI :W ORK�=ONL;Y:, : K•. � � . °,�. -! 'j Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: Q a'�RCIAI` hOl�IIY:.,"_"�'_;� "'��'�• Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) 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 \Building\Pemms\ELC- PettmtApp doc 04/03 r. CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2005 -00717 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/26/2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 - INSPECTION WORKSHEET FOR DATE: 10/1212005 TIME: 7:04AM PAGE: 63 • SITE ADDRESS: 09378 SW WASHINGTON SQUARE RD CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: DUCK SHOP DESCRIPTION: (2) 200 amp service, (10) branch circuits. OWNER: WASHINGTON SQUARE LLC, PHONE #: CONTRACTOR: TIMBERLINE ELECTRICAL CONTRACTORS PHONE #: 503 - 9638488 Inspection Request Scheduled For: Date: 10/12/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message Thlg fle 018074 -01 503313.0331 N wALL t -© vEQ- Corrections /Comments /Instructions: A . O C \ L . r cAly - ' �( r S 'P i frY PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G4t1 ' V . Date: )6 11 -2 -1 0 6 — Phone #: (503) 718 -2A4 • CITY OF TIGARD BUILDING DIVISION PERMIT #: 6.14 2A06 4 :)0111) 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 I Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WOR " . EET FOR DATE: TIME: PAGE: SITE ADDRESS: \11 S W •rp S • CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: DV 0 CA% ob PHONE #: CONTRACTOR: PHONE #: • Inspection Request Scheduled For: Date: Pour Time: C•.- # Inspec • • sescription Confirm # Contact # Message C ' F-i rbfkL, Corr- . • • - 1 - - -: -- _ - - uctions: • 1■‘661€ ZQ k- a . 't v,5 6/0.3 at C.ov • v s:a(isea-Av P ' • %PASS , ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector:. . G ° 'i • W Date: \'‘111 Phone #: (503) 718- 241k4Z)1 CITY OF TIGARD l i p BUILDING DIVISION PERMIT #: EL 2005 -00717 13125 SW Hall Blvd., Tigard; OR 97223 DATE ISSUED: 9/26/2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 '_ INSPECTION WORKSHEET FOR DATE: 11/16/2005 TIME: 7:03AM PAGE: 27 • SITE ADDRESS: 09378 SW WASHINGTON SQUARE RD CLASS OF WORK: • SUBDIVISION: SHl� SQUARE LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: (2) 200 amp service, (10) branch circuits. OWNER: WASHINGTON SQUARE LLC, PHONE #: CONTRACTOR: TIMBERLINE ELECTRICAL CONTRACTORS PHONE #: 503 - 969.8488 Inspection Request Scheduled For: Date: 11/16/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 021446.01 503 -313 -0331 N Corrections /Comments /Instru ••ns: CAN • • • • ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL • ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- • i CITY OF TIGARD BUILDING DIVISION • PERMIT #: ELC200E00717 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/26/2006 Phone: (503) 639 -4171 , �,1.. �I Inspection Requests (24 Hrs.): (503) 639 -4175 _,. , "__... INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7:12AM PAGE: 60 SITE ADDRESS: 09378 SW WASHINGTON SQUARE RD CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: DUCK SHOP DESCRIPTION: (2) 200 amp service, (10) branch circuits. OWNER: WASHINGTON SQUARE LLC, PHONE #: • CONTRACTOR: TIMBERLINE ELECTRICAL CONTRACTORS PHONE #: 503 - 969 -8488 Inspection Request Scheduled For: Date: 11/14/2005 - Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 021138 -01 503-313-0331 N Corrections /Comments /Instructions: O 155 �s�3 N (1ccL • ❑ PASS APARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • Inspector: " T` N OV Date:11 1` Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2005 -00717 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/26/2005 Phone: (503) 639 -4171 44 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11/2/2005 TIME: 7:04AM PAGE: 13 SITE ADDRESS: 09378 SW WASHINGTON SQUARE RD CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: DUCK SHOP DESCRIPTION: (2) 200 amp service, (10) branch circuits. OWNER: WASHINGTON SQUARE LLC, PHONE #: CONTRACTOR: TIMBERLINE ELECTRICAL CONTRACTORS PHONE #: 503- 969 -8488 Inspection Request Scheduled For: Date: 11/2/2005 Pour Time: Code # In • - ' • • Description Confirm # Contact # Message 115 Electrical service 020142 -01 503 -313 -0331 Y Corrections /Commen s . 03 (L% 30 (41 1(0 •, $01.s0 tki-- S6 i`f Pte- Z5c1•10. Ag. 16-0- - 6,0 i772.,.g 6 19 /1 , 11arg. 144 .M e■bi? • � . PASS 111 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: v N Date: ` 1 - 1 Phone #: (503) 718- 244 CITY OF TIGARD BUILDING DIVISION ('► PERMIT #: ELC200 &-00717 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/26/2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ...' INSPECTION WORKSHEET FOR DATE: 11/1/2006" TIME: 7:06AM PAGE: 109 SITE ADDRESS: 09378 SW WASHINGTON SQUARE RD CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE-OF USE: PROJECT NAME: DUCK SHOP - DESCRIPTION: (2) 200 amp service, (10) branch circuits. OWNER: WASHINGTON SQUARE LLC, PHONE #: CONTRACTOR: TIMBERLINE ELECTRICAL CONTRACTORS PHONE #: 503- 969 -8488 Inspection Request Scheduled For: Date: 11/1/2005 Pour Time: Code # - : - - : - • a - scription Confirm # Contact # Message 115 Electrical service 019892 -01 503 -459 -4089 N Corrections/Comments/Instructions: • E o LL, N O IZ _.sol • •s M: 0 0 q It S' f ViA o� ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS AFAIL ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • G� L� Inspector:, 77a Date: U _l _O " Phone #: 503 718 - 244, CITY OF TIGARD BUILDING DIVISION )" PERMIT #:E4.C.7,00re 001n 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 1 Inspection Requests (24 Hrs.): (503) 639 -4175 ..-!1+L .. INSPECTION WORKSHEET FOR DATE: 16 TIME: PAGE: SITE ADDRESS: 3`vt 6U gol V 0 5 4. 1 CLASS OF WORK: SUBDIVISION: Y" LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: v 5‘.top PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message 13 b -izr:v. GS' Li CO TEC U flM'1 -6 Corrections /Comments /Instructions: ‘ (Z.-eh°ry.) oK c� o NtSt vait- v L Fr,R k 4. of AL- a • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED � Inspector: NYS Date: 1C l 2 IICV Phone #: (503) 718- 2-4 • CITY OF TIGARD BUILDING DIVISION t 410 PERMIT #: ELC2005 -00717 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/2&2005 Phone: (503) 639 -4171 i t . Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/28/2005 TIME: 7:18AM PAGE: 14 SITE ADDRESS: 09378 SW WASHINGTON SQUARE RD CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: DUCK SHOP DESCRIPTION: (2) 200 amp service, (10) branch circuits. OWNER: WASHINGTON SQUARE L.LC, PHONE #: CONTRACTOR: TIMBERLINE ELECTRICAL CONTRACTORS PHONE #: ` 503 - 969 -8488 Inspection Request Scheduled For: Date: 10/28/2005 Pour Time: Code # 'Ins. - 'on Description Confirm # Contact # Message 115 Electrical service 019718.01 503.313 -0331 • N Corrections /Com n T+ - N6 • • ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ( - ' ° ` — ` " Date: IC /2. o Cr Phone #: (503) 718 -`S b • CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2005 -00717 13125 SW Hall Blvd., Tigard, OR 97223 DATE _ISSUED: 9/26/2005 Phone: (503) 639 -4171 1 Inspection Requests (24 Hrs.): (503) 639-4175 - 1 1 . INSPECTION WORKSHEET FOR DATE: 10/16/2005 TIME: 7:10AM PAGE: 20 SITE ADDRESS: 09378 SW WASHINGTON SQUARE RD CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: DUCK SHOP DESCRIPTION: (2) 200 amp service, (10) branch circuits. OWNER: WASHINGTON SQUARE LLC, PHONE #: CONTRACTOR: TIMBERLINE ELECTRICAL CONTRACTORS PHONE #: 503 969 - 8488 Inspection Request Scheduled For: Date: 10/18/2005 Pour Time: Code # - • - - ' : • l escription Confirm # Contact # Message 130 Ceiling cover 018626-01 503-313 -0331 N Corrections /Comments /Instructions: -21b • C.0 1.1 --IN 5 to" • • • • • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL F•R INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: </_ i V Date: l g Phone #: (503) 718- 2)4 . r: CITY, OF TIGARD BIJiLDiNG DIVISION PERMIT #: ELC2005 -00717 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/26/2005 Phone: (503) 639 -4171 A , 1 o 01 Inspection Requests (24 Hrs.): (503) 639 -4175 P' ' �.. INSPECTION WORKSHEET FOR DATE: 10/17/2005 TIME: 7:04AM PAGE: 5 SITE ADDRESS: 09378_SW WASHINGTON SQUARE.-- CLASS OF WORK: SUBDIVISION{ASHINGTON=SQUARE LOT #: TYPE OF USE: PROJECT NAME: DUCK SHOP DESCRIPTION: (2) 200 amp service, (10) branch circuits. OWNER: WASHINGTON SQUARE LLC, PHONE #: CONTRACTOR: TIMBERLINE ELECTRICAL CONTRACTORS PHONE #: 503969 -B4BB Inspection Request Scheduled For: Date: 10/17/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 130 -selling coy- 018538 -01 503-313-0331 N Corrections /Comments nstructions: � , I d n . " ® C N s vIsl i a f=og E LEcz-(6 c1L LeIL-1 cn,J-ka. iNS�a�e ®N o I c6� (..€‘1_41 tAA%c, U ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G V Q LE Date: 16 1 1 6 Phone #: (503) 718 Zattik)