Permit -CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00239
t DEVELOPMENT SERVICES DATE ISSUED: 4/25/03
.,� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S126C0-01107
SITE ADDRESS: 09426 SW WASHINGTON SQUARE RD K -4
SUBDIVISION: WASHINGTON SQUARE ZONING. C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Alteration of (9) branch circuits for tenant improvement. Job No: 61564
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: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 8 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:
PPR WASHINGTON SQUARE LLC FRAHLER ELECTRIC CO
BY THE MACERICH COMPANY 11860 SW GREENBURG RD
9585 SW WASHINGTON SQ. RD. TIGARD, OR 97223
PORTLAND, OR 97223
Phone: Phone: FX 639 - 4673
Reg #: 161319-4627 37410
SUP 1816S
FEES ELE 34 -13C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 4/25/03 $100.05
[TAX] 8% State Tax 4/25/03 $8.00 Rough -
Elect'I Final
Total $108.05
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 mss. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in O 952 - 001 -001•I through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or
1 -800- 2 -2344.
Issu d By: :� , Permit 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:
n CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: ef��` DATE:
LICENSE NO: arcaZe4
Call 639 - 4175 by 7:00pm for an inspection the next business day
r Lam' , ,
�a
Electrical Permit Application -
y Datereceived: y 0 25 - 0 ' • • _O -
�, .- .. r City of Tigard ® Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blv. T . : F l I r � �,, ' Date issued: EN Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 R 2 '1Qp3 Case file no.: Payment type:
Land use approval: �P .•
TYPE OF PERMIT' "`. ,- •
• ❑ 1 & 2 family dwelling or accessory ❑ Commercial/mdustrial ❑ Multi- family 3 Tenant improvemzen_t
❑ New construction ❑ Addition/alteration /replacement ❑ Other. ❑ Partial
-•JOB SITE INFORMATION - - ' • , - •-
Job address:. '9X(, SW WASHINGTON SQUARE ROAD Bldg. no.: Suite no.: K4 Tax map/tax lot/account no.:
Lot Block: Subdivision:
Project name: NUVO LASER SKIN Cl'R Description and location of work on premises: ADD RECEPTACLES IN NEW WALLS
Estimated date of completion/inspection: FOR TEMPORARY TENANT
_. _ _. CONTRA CT-OR_AP_.PLIC.A.TION _. , __': _FEE SCHEDULE
Job no: 61564 Fee Ma
Business name: FRAHLER ELECTRIC COMPANY Des°'p100 Qty. (ea.) Total no. insp
New residential - single or maid-tautly per
Address: 11860 SW GREENBURG ROAD dwelling wit. btcl sattucledganage.
City: TIGARD I State: OR I ZIP: 97223 Sersicehtt:laaec
Phone: 639 -4627 I Fax: ( . 39 -4671 E-mail: 1000 sq. ft. or less 4
CCB no. 37410 II sec. bus. lie. no: 34_1 Each additional R orpottiontheteof
Limited energy, residential 2
City/metro lic. o.: Limited energy, non-residential 2
G ' 04/24/03 Each manufactured home or modular dwelling
5igna6 o supervtsmg a etxrtc (regdined Date Service and/or feeder 2
Sup. elect- name (print): MIKE WAGNER License no: 2334S Services or feeders —motion,
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 Mailing address: 601 1
amps to 00 amps 2
amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone : I Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own T eul i °ill Y services °r feeders - ti
bwhil
which is not intended for sale, lease, rent, or exchange according to O° '' Orre ' 0 `
200 amps or less 2
ORS 447, 455, 479, 670, 701.
201 amps to 400 amps 2 -
Owner's signature: Date: 401 to 600 amps 2
r Bt - =Ws L
alter
Name: per
A. Fee for branch circuits with purchase of
Addre -ss: service or feeder fee, each branch circuit 2
City: I State: • I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit 1 46.8j 2
Phone: Fax: E -mail: Each additional branch circuit 8 53.2U
• PLAN RE\ 11 W (Please check all that apple) . • Misc. (Service or feeder not included):
❑ Service over 225 amps - commercial ❑ Health -rare facility Each pump or irrigation circle 2
❑ Service over 320 amps - rating of 1&2 ❑ Hazardous location Each signor outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal citcuit(s) or a limited energy panel,
Cl System over 600 volts nominal more residential units in one structure alteration, or extension* 2
CI Building over three stories ❑ Feeders, 400 amps or more *Description:
❑ Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lighdogplan ❑ Other. Per inspection I I I
Submit _ sets of plans with any of the above. Investigation fee
"lbe above are not applicable to temporary construction service. Other
Not all jouilafictions accept cadet cards, curds, please call jurisdiction for more mfg. Notice: This permit application
Permit fee $ 100.05
• ❑ Visa Cl MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number. 1 I within 180 days after it has been State surcharge (8 %) .... $ 8.00
"`s TOTAL $ 108.0 5
accepted as complete.
Name of cardhokler as shown on credit card
Cardholder signature Amount 440.4615 (M)O/COM)
•
Electrical Permit Fees: Limited Energy Fees:
TYPE OF WORK INVOLVED - RESIDENTIAL ON LY
Complete Fee Schedule Below: Restricted Energy Fee..... $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items . Cost Total NI, Check Type of Work Involved:
Residential - per unit
1000 sq ft or less - $145.15 4 El A udio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33A0 1 0 Burglar Alarm
Limited Energy $75.00
Each Manutd Home or Modular Door Opener
Dwelling Service or Feeder $90.90 2 Ell
Services or Feeders ❑ Heating. Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less $80.30 2 V acuum Systems
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 2 Other
601 amps to 1000 amps $240.60 2
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 , 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less x 2 (SEE OAR 918-260 -260) '
201 amps to 400 amps $100.30 2 Check Type of Work Involved:
401 amps to 600 amps $133.75 2
Over 600 amps to 1000 volts,
see' "b" above. I A udio and Stereo Systems
Branch Circuits Controls
New, alteration or extension per panel
a) The fee for branch circuits
with purchase of service or f . Clock Systems
feeder fee.
Each branch circuit $6.65 . 2 ❑ Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service El Fire.Alarm Installation
or feeder fee.
First branch circuit $46.85 H VAC
Each additional branch circuit $6.65 El
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuits) or a limited energy Landscape Irrigation Control'
panel- alteration or extension $75.00 El
Minor Labels (10) $125.00 ❑
Medical
Each additional inspection over
the allowable in any of the above $62.50 Nurse Calls
Per inspection
Per hour $62.50 El Plant $ 73.75 Outdoor Landscape Lighting'
Fees: ❑ Protective Signaling
Enter tatil of above fees $ 17 O ther
8% State Surcharge $ Number of Systems
25% Plan Review Fee * No licenses are required. Licenses are required for all other installations
See `Plan Review" section on $
front of application. .
Fees:
Total Balance Due $
Enter total of above fees $
❑ Trost Account f 8% State Surcharge $
•
Total Balance Due $
i:\dstswirms\eic- fees.doc 10/09/00
CITY OF TIGARD 24 -Hour
BUILDING " Inspection Line: (503) 639 -4175
MST 411.
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date R e}luested — /3 AM PM BUP
Location eti b wA 5? R-D Suite I LI MEC
Contact Person ?12 Ph ( ) �3 -V4a 7 PLM
Contractor / Ph ( ) SWR
BUILDING Tenant/Owner ELC ' 3 ^ 00 A 39
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain -
Slab Inspection Notes: - C"/ SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
C Final
PASS PART FAIL
PLUMBING t ft
Post & Beam
Under Slab •
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole •
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
qtreTRico
Service
Rough -In
UG /Slab
Low Voltage •
Fire Alarm
❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
ASS_TPAR.T FAIL
❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line ,
ADA p � �
Approach/Sidewalk Date `j /5 3 inspect / Ext
Other: -
Final DO NOT REMOVE this inspection record from the ob site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour ,; I ': .
BUILDING Inspection Line: (503) 639 -4175 MST w ' 4 .
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received Date Requested / %27/ ?A PM BUP
Location 7r S Lv w�}� /--/ S7. /ecr f Suite MEC
Contact Person S7.
Ph ( ) 999 7 5 PLM
Contractor /-- e Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing .2003 On 23?
Foundation Access: 7` C _
Cr l Drain -ric/� fi 1t PP wo✓Y ryi ert v r .,'
Crawl Drain t �"�" ~"�
Slab Inspection Notes: (/) el j /t. • S' f -, SIT
Post & Beam 6tt�- o y ,p� � O!u /
Shear Anchors C r n �' \� ' /
Ext Sheath/Shear %� L N
Int Sheath/Shear
Framing
Insulation )—P■4 \,1 I 1c Di-Y ' C 1 \ L
Drywall Nailing 6 ' �/ A
Firewall d 1 1 ` � (S
Fire Sprinkler `1 \ I a t (1
Fire Alarm
Susp'd Ceiling
Roof
Other: �' , S
Final •
PASS PART FAIL C
PLUMBING 1
Post & Beam
Under Slab
Rough -In
Water Service J
Sanitary Sewer ' ~ ° 1
Rain Drains !
Catch Basin / Manhole
• ) +1 .
Storm Drain \
Shower Pan \ N -- k-\ \r\1
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough-In
At■
Line j
Gas Line �—
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
UG/Slab
Low Voltage
Fire Alarm .
T FAIL ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
,. - Please call for reinspection .' E: Unable to ins • 111 p ❑ inspect — no access p
Fire Supply Line /
ADA 0� I
-
Approach/Sidewalk Date Inspector �- _ _' ..I1 _ Ch a• Ext
Other:
Final DO NOT REMOVE this inspection record om the Jo., site.
PASS PART FAIL