Permit r CITY OF TIGARD GAR® ELECTRICAL PERMIT
PERMIT #: ELC2003 -00251
,.l�i� DEVELOPMENT SERVICES DATE ISSUED: 5/5/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S126C0
SITE ADDRESS: 09426 SW WASHINGTON SQUARE RD K -4 ZONING: C G
SUBDIVISION: WASHINGTON SQUARE
BLOCK: LOT : JURISDICTION: TIG
• Project Description: I ea. sign lighting.
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: 1
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: 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:
PPR WASHINGTON SQUARE LLC E S +A INC
BY THE MACERICH COMPANY 19380 SW MOHAVE CT
9585 SW WASHINGTON SQ. RD. TUALATIN, OR 97062
PORTLAND, OR 97223
Phone: Phone: 503 - 691 -8474
Reg #: LIC 145755
SUP 700SIG
FEES ELE 20 -255CL
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 5/5/03 $53.40
[TAX] 8% State Tax 5/5/03 $4.28 Rough -in
Elect'I Final
Total $57.68
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 • C at (503) 246 -6.99 or
1- 800 - 332 -2344.
r t •
Issued 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:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N• DATE:
LICENSE NO:
- Call 639 -4175 by 7:00pm for an inspection the next business day
•
Electrical Permit Application OFFICE USE ONLY
Date received:s -S.Q Permit no. . Zo 3 .GDP-S/
,,'1L1"•iii City of Tigard Project/appi. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By > Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: P96° .X f 7 •
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory , Commercial/industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction. ❑ Addition/alteration /replacement 0 Other: ❑ Partial
_ .10B SITE INFORIIMATION
Job address: !9`)/(e SIN) IQP61-11NGTLN Si Vu. Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: Subdivision:
• Project name: I , t k f \ / a [ Description and location of work on premises: I $ M 1 U 1 Wp l ` Stal ( t —
Estimated date of completion/inspection: • I jZCIJT Ej I R.AINlC ' , Sib _ j,L
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: Fee Max
Business name: Y t
A, A S NIQkiI f' V !C Description Qty. (ea) Total no. insp
New residential - single or multi -family per
Address: lt213 (QC MAP-4 dwellingtnri t.Includesattachedgarage.
City: i'ORT LA I D I State:OP- I ZIP:g122t� Serviceinduded:
Phone: 503 - 542 Fax:r542r I E -mail: _1000 sq. ft. or less 4
CC : O.: �9 `/ 5'� lr (� -3 Elec. bus. lic. no: �S J CI - Each additional 500 sq. ft. or portion thereof
Limited energy, residential 2
,[[r�IC. n � (p' l -0 , 5 Limited energy, non - residential 2 •
Each manufactured home or modular dwelling
Signature of supervis g electrici (required) Date /0 —/ -05' Service and/or feeder 2
Sup. elect name (print): Mille '5 (a PSC..11J License noqOOS lb Services or feeders - installation,
alteration or relocation:
200 amps or less 2
Name (print): {VRS4-1I106TVILII SQU 201 amps to 400 amps 2
Mailing address: ew,ss �' w I 0Q 1 (A &� R.D.
401 amps to 1000 amps 2
601 amps to 1000 amps 2
cit pop_T1.Akro I State: pR I ZIP: CI-12_2z Over 1000 amps or volts 2
Phone:03- t,m -asGs I Fax: G20 -5(012- I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installatioo, alteration, orrelocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
Name: or extension per panel:
A. Fee for branch circuits with purchase of •
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
Phone: Fax: E - mail: of service or feeder fee, first branch circuit: 2
Each additional branch circuit:
PLAN REVIEW (Please check all that apply) misc. (Service or feeder not included):
❑ Service over 225 amps commercial ❑ Health -care facility Each pump or irrigation circle 2
O Service over 320 amps- rating of l &2 ❑ Hazardous location Each sign or outline lighting ' 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2
❑ Building over three stories ❑ Feeders, 400 amps or more *Description:
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lighting plan ❑ Other: Per inspection 1 I I
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $ S'?)• 4/0
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) $ "r .°.- d
Expires accepted as complete. TOTAL $ ,57.
Name of cardholder as shown on credit card
Cardholder signature Amount 440 -4615 (6/00/COM)