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Permit 'it- ,. Iii" 'C q CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00441 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/30/2007 PARCEL: 1512600 -00300 SITE ADDRESS: 09422 SW WASHINGTON SQUARE RD K06 ZONING: C -G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG PROJECT: SELECT COMFORT Project Description: Low voltage: voice and data. 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 SPRING 2 SOLUTIONS BY THE MACERICH COMPANY 12011 NE 14TH AVE. #1550 9585 SW WASHINGTON SQUARE RD VANCOUVER, WA 97682 TIGARD, OR 97223 Phone: Contact #: PRI 360 - 635 -0200 FAX 3604W-0201 FEES Reg #: ELE CLE -09 LIC 17609 Description Date Amount SUP 3621 LEA [ELPRMT] ELR Permit 11/30/2007 $75.00 [TAX] 8% State Surcha 11/30/2007 $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 questions to OUNC at 503.246.6699 or 1.800.332.2344. 4 .. L ittlec.ala Issued By: Permittee Signature: -/ 1 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. ' ..)%/ 4 . 30 ctrical Permit Applic V 30 07 11:15a 360 635 0202 p. • E 'eza on `" fl)I(()FI I <. 1. l:.l: U \`I.l' .I City of Tigard NOV 0 2001 Rc «ived 13125 SW Hall Blvd., Tigani, OR 97223 nste/8 : I 3d O 7 � Permit No.: _ _ Phone: 503.639.4171 flax: 1 �S �g60� � ,. e p U ,, , • Review r t c ; n l) Inapttt tiort Line: 503.639.4175-' % `' + g N Y � y 8, / ,, , Other Permit .. lrgard -or : I 9 ( `r Y : � "i f ® be P 2 far ernewww ...111 r . ,C' 51 Y777.7, r.",;;; ..♦ > c 1 R ` _,., , .� .....:. 4 4' i'zkii,: a i_.r.4u'�_', 1,��: : ,�_ : : v ' r _air .`1'.. ii , 1�ti , V, �,L .,, ';1Z4,' t e.J,x u m.• :.a,,,�u „ �aa. , lntus_.-..,,...n:�,d.4 i.SaF1',:i. 21. ' ''VQ':i i ❑ New construction L' Addition/alteratf laeemcnt Please check all that (submit se of prep apply ( � plans writeros checked below): 0 Demolition ❑ Other: ❑ Service or feeder 400 amps or more El Building over three stories. } -f } }" r 7 gY „y , v ( rr rte �I,rr� r where the available fault current ❑ Marinas and boatyards. t ` � . ; i � ,''•• %: rG .1.1.4:1111.42 ..'l ; i /' . ,,. �' ! .J T of;' " 7 +t .Cl, r R � : J : i � , 1 x , meats l0.fl1U1 am at 150 volts or 10 Flouting build ❑ 1- and 2- family dwelling C otluncrcial/industrial ❑ Accessory building legs to mow., or exceeds 14,000 0 Commercial use agricultural 0 Multi family ❑ Master builder 0 Other O 1,kt for all other installations. buildings. ��•- -• r 11 lr y pump El installation of 75 KVA or �M lTIV, i , 1 ;; , r , x n t E . , , , t , r 1' < t 1. 1 �3 i l S r i V pry - - K , 4 , � . , t, Emergexry ayet m. ger aep u y dertvea system, c,... ,.. L.g' .1, ..� _dam . ` : �.. ,` * ' +r '� m• "fi at2l �.• , ._ , � - -.. * ......,_ .l_: � Addition of new motor load of [] "A ". "E', "1,2 ". "I -3 ". Job no.: ((2_ / (- .lob site address:Afg7- Sup loomIP or more, occupancy. Wi�Mr f a� sr4 � ❑ Sin or more residential writs. ❑ Romeational vchr ie parks. City /State/ZIP: rib, A q � 9 7 223 ❑ Nealthl:AM lociliticP. ['Supply .•oltagc for uwte dean ❑ Hazardous locations. 600 volts nominal Suite/bldg. /apt, no.: k- o/o Project name: sEac CornA vettE dr D4-7-14, ❑ Service feeder 6°0, amps or more Cross street/directions to job site: 1L S r7tE : 1 ' , '(+ "?'.y, - ` g t ` 5 ' 'q 1 a } tti`r . y' e a rl pia T s t 4.1:t: /+1 a riw tli 2. ! } 4, naartauna vet.. "" • Si><I Sea •k �4 New residential single- or multi•famlly dwelling unit. S f' e ' 20 (f..bC41- . (0.15 'DE Witsli. Stptotak- A1rt•r r . Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less _ 145.15 4 Tax map/parcel no.: r Ea. add'l 500 eq. ft or portion 33.40 1 P��d'fFlrB� > /dTn' f n r�� rrq di l t�S�sg ua ,rnrr,,.r r c Limited , residential il�"` i 'i, �;� • iwa � `tt ,:.ti..isi � 1 _r k: :` ,„77 i : r t. r� ^ 1�7' L7�M;' n r , 5 t^ i TP �,Z (with abov 8 4- 11 .) �) � t ,rtt ; � ,4 F• 75.00 2 try:; �'. 11...3.�1..1Y_.�+. s .,,e..� _.r .. r.: Limited energy, multi - family 75,00 2 i ✓'E V'd LEE 8- bArrA CAMS 4 r N G F,£.1-0( TsrrLP . Sat Tr, it 6f residential with above ... ft - 16 �j�+ tj l r1tA�jf $t! l 1-C Services or feeders Installation, alteration, and/or relocation K ©� '� f'I• e � � l'�T. �'� t - t ri 'x -- ' T� �' t +'� h F ` ! It i ,. r � �t•1 hr �r ti v i �b, t�' �'��� v� f'�� riT"gP� � r )� 200 amps or less 80.30 7 .,, _�v_x.._.1 -T `_.(y.,., "_ . ._- a_c",ih.i.,.,.- VIT.7 �,�S.,! 5 1un }`6 �`1 ; Y 201 amp5 to400amps 106.85 2 LECT ( es 401 amps to 600 amps 160.60 2 Name: Se. Address: 601 amps to 1,000 amps 240.60 2 4 e, i 0 �C.� LykSi�t 1.1GTOfJ tt g-F-- ' Over 1.000 amps or volts 454.65 2 City/State/ZIP: - , j e. q'jZ2 3 Temporary services or feeders installation, alteration, and/or relocation Phone; (5153 ) Ia'70 t i $-1- Fax: ( ) 200 amp, or leas 66.83 t 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 599 amps 133.75 2 Owner signature- Date: Branch circuit.- new alteration, or extension, per panel S ' 2 1 Jr1 �� 1 7 21r�` c '�`r c " ' "�4 a , n �,� f - F , � a 7.'; 1 i. , ,. A. Fos for branch circuits with . �.�. 1 ."`. i.. Z`.; x j �` ; .r. - ,ZI,�'T � � �'�nv�:�` E'Y: ,r :' 7 t;R above service or feeder fee., ' each branch circuit 6.65 2 Business name: SPILtsaG 2 t . T1o1.15 13. tree fur branch circuits Contact name: Na1� 6 Q without service or feeder fee, 46.85 2 is a t '�r first branch circuit Address: 0 t h P.1 E 1 /� � �i 7 Each add'l branch circuit i 6.65 2 City /Statelzlp: , . Miscellaneous (service or feeder not iaduded) , v exu_v. et p a1 o t, g Each manufactured or modular 90.90 2 Phone: dwelling, service and/or feeder (�) Le3S- DZ@() Fax : (3too) U35: DIo 1 Rccxrnttect only 66.85 2 E-mail: • Dr bti let(� • n 1. golu ti exS " .�' r , r r, i • cirp>,- Pump or irrigation circle 53.40 2 � rift i. � id' +;. L"4�,,�'ll�f v? 4�w1 y1C "5.t . :; ,at : n 4rat i � 1 sti' -.'i `ih'„7, 1 j0 � T '.1i T j •�i b,rr, , i *„ y .W,. �M .:k:r. i;s„ ,�tis�, ,s.4�!�;•:;1�.t.,?.'�,:; +.z "x��y� Sign or outline lighting 53.40 TT Business name: Q t> + 4-to Signal citcuit(s) or limited- energy panel, alteration, or Address: l2 6 1 1 E extension. Describe: Page 2.00 2 City/State/ZIP: v• . �, . E � \ ' LeJ FE 9 (o 2 . t . e Each additional inspection over allowable in any of the above Phone: Pcr inspection _ 62.50 hone: ( tt Lt 3 5 • _02_61),:27 O - Fax: (3(,,,D) Lt 3 $ - •D 2O ( ti Investigation per hour (1 hr min) 62.50 CCB Lic.: !7 Electrical Lie.: t(,g Suprv. Lic, hid_ ustnal lane erhour lfQ� �g p '� ..f.151D � p 73.75 Suprv. Electrician signature, required: 7 / r / _ =" 5,.. ;i, ,l x- '• ! i;.;, name: P lan review (25% of Subtotal: 1 Print Wa �/n1 JF,�U I - Date: '3 � - ( permit foe Authorized signature: t _ State surcharge (8% of permit fcc): (. (� gn �/ " i Q k7 (, l) "' TOTAL PERIMIT FEE: (Di, Print Hanle: (;i d -fi . Chic: 4 O . This permit application expires if a permit Is not obtained within 180 3.. -' days after it has been accepted as complete. naildmgePennhs\6C ,C•permitapµooc 05/23/06 ' Number of inspections allowed per permit I: � 4d0 -46I5T(11 /05/COMWEB CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2007 -00411 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11t3012007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 �' INSPECTION WORKSHEET FOR DATE: 12/3/2007 TIME: 7 :00AM PAGE: 28 SITE ADDRESS: 09122 SW WASHINGTON SQUARE RD KO6 CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: SELECTCOMFfRT DESCRIPTION: Low voltage: voice and data. • OWNER: WASHINGTON SQUARE LLC, PHONE #: CONTRACTOR: SPRING 2 SOLUTIONS .PHONE #: 360.635.0200 Inspection Request Scheduled For: Date: 12/3/2007 ° Pour Time: p q Code # Inspection Description Confirm # Contact # Message 135 Low voltage 060649-01 , 360 - 635-0200 Y I Co rrections /Comments / Instructions: (r,„9 N \ A \ \\ N PASS ❑ PARTIAL APPROVAL ❑ CANCEL\ ❑ NO ACCESS • ❑ FAIL ❑ CALL FOR INSPECTION' ❑ ADDITIONAL FEES ASSESSED Inspector: Ob LE Date;.- 1 Phone #: (503) 718 - 7 I'P