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Permit C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00054 r .�l DEVEWOP M T r SERVICES DATE ISSUED: 2/4/04 13125 CES (503) 639 -4171 PARCEL: 1S126C0-01107 SITE ADDRESS: 09432 SW WASHINGTON SQUARE RD K -2 ZONING: C G SUBDIVISION: WASHINGTON SQUARE BLOCK: LOT : JURISDICTION: TIG Project Description: Install or relocate (2) services and add (42) 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: 42 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 JC ELECTRIC INC BY THE MACERICH COMPANY 118 NW 184TH STREET 9585 SW WASHINGTON SQ. RD. RIDGEFIELD, WA 98647 PORTLAND, OR 97223 Phone: Phone: 360 887 - 7889 Reg #: SUP 4289S ELE 37 -724C FEES LIC 118452 Description Date Amount Required Inspections [ELPRMT] ELC Permit 2/4/04 $440.50 [TAX] 8% State Surcharge 2/4/04 $35.24 Elect'l Service Rough -in Total $475.74 Elect'l Final 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 -23 . Issued By: aiLQ Permit Signature: ■ � A r 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: rP� C I Call 639 -4175 by 7:00pm for an inspection the next business day r ill 3132 04 04: 20p JC Electric Inc . . .. ec r 1 360 887 5584 p . 1 ?e a CO Y-- CO o-70 Et tr1Va I Permit ApligeEN ED .:::::. 1 FOR OFFICE USE iONL Y i . • , :: City of Tigard Received Date/By: A - -1-04 Et Permit No.... C___ 0?e2ozif—e,e,c51( opt' 13125 SW Hall Blvd., Tigard, OR 97223 c c ? B 0 2 ....._ . Plan Review Phone: 503.639.4171 lax. 503.598.1960 F l''' A 6 i t Date/13y: Other Permit: Inspection Line: 503.639.4175 cay OF T I G ":"_..:- t 42,.. Date Ready/By: JuriL Internet: www.ci.tigard.orus DWI • I Notified/Method: r s a up S p ee lem P , a n g tu e 2 i t f • ■ . . , T 7. ' - :PF: ??+ ti— eir -- ' O??.4 ' _ .- ' - - : -. , : - p.i.ASt';iig0t*.:) . .. - ::i:.::...; - :,-.;:k.-: , ,-, - 1 - -; - ::'4i . ,,. ... „.., • • .••• ..„ ..,.. _ 0 New construction ist Addition/alteration/replacement Please check all that apply: .[D Demolition 0th ['Service over 225 amps, Gomel 0Hazardous location 0 er: OSece over 320 amps — rating DBuildng over 10,000 sq. ft, . .: l : '!'::!';',:...:,:. i..' ... ' rvi of 1- and 2-family dwellings 4 or more new residential -- 0 1- and 2-family dwelling It:7! Commercial/industrial 0 Accessory building - ['System over 600 volts nominal units in one structure 0Building over three stories ['Feeders, 400 amps or more . 0 Multi 0 Master builder 0 Other: POccupant load over 99 persons ['Manufactured structures or .. . .. . . . . . . .. , ... .. ... ' . . JOB SITE INFoRmATION AND : LOcAtiON .. . ..,'.: .- - . - - - 0 Egress/lighting plan RV park , 0Health facility ['Other: Job no.: .A s 1 Job site address: .Cirsts----sw 1/4,3N%.k.‘ ,c1 RI t n-k.A. Submit 2 sets of plans with any of the above. 9 Lo 0 5 4 4c) City/State/ZIP: L The above are not applicable to temporary construction service. Suite/bldg/apt, no.. Pm A I Project name: p Icwitz p • . • • ...„ .... .. FEE* . : • • .:.,'L, ..,,:.f.. Descriptiun " , 1 Qq. I Pee. I Total ** Cross streelldirections to job site: New residential single- or multi-family dwelling unit. Includes attached garage. 1,000 sq. tt. or less 145.15 4 Subdivision: I Lot no.: Ea. add'! 500 sq. ft. or portion 33.40 Limited energy, residential 75.00 2 Tax map/parcel no.: _ -- .. . . Limited energy, non-residential 75.00 2 . , DESCRIPTION OF WORK '•: ; r ... :-...':'.. . -, :,• :.. Each manufactured or modular .. dwelling, service and/or feeder 90.90 2 7 - 1W.5i ELECTRICA1 — 10 n)e(/..) TI , . Services or feeders installation, alteration, and/or relocation M DV E t ie() v 142410. ( IQ R ) 4. 11-otsere 50A) 200 amps or less 2 80.30 hp /, 2(ID 2 O. PROPERTY O%% • :-! ii;:1 .. • , • - •_ , :v;,.•:•-'1:1 . 1'.NANy'•: , .. ... ::':1: .:." 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 _ relocation Phone: ( ) I Fax: ( ) 200 amps or less 66.85 i 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 A. Fee for branch circuits with - .:.',. ' ,''' • .. . .EFAPPLICANT . . 11 :-.:,.. : I! ... ;1::1;'ComrAqi '.;.:::1; service or feeder fee, each Business name: branch circuit 1 - 12 6.65 2 2 B. Fee for branch circuits Contact name: without service or feeder fee, 46.85, 2 each branch circuit Address: Each add'I branch circuit 6.65 I 2 City/State/Z1P: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone : ( ) Fax: : ( ) Sign or outline lighting 53.40 2 E-mail: Signal circuit(s) or limited- energy panel, alteration, or , . - • extension. Describe: Page 2 2 Business name: Each additional inspection over allowable in any of the above Address: \ 1 li 1NW A4 'r Per inspection 62.50 City/State/ZIP: ik_ l b cr oc. v. ) A cl%Azika Investigation per hour (t hr min) 62.50 I _ Industrial plant per hour 73.75 Phone: ( ) . ....7 t--‘ Fax: (S1,0 ) V" - '. • .ELEGTRICA . ■ , CCB Lie.: t I Electrical Lie.: - : Supry .: .4..tIck% Subtotal Suprv. Electrician signature, required: _ Plan review (25% of permit fee) .---.• ' State surcharge (8% of permit fee) 3St 14 Print name: ,. ,.... Date: - -D c ,- TOTAL PERMIT FEE L4 -75, 7y ._•. Authorized signature: ..---- .----. This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name. ,__=c.1\,, C C X.) LA eVieL. Date: ...abiaLl :. 1 n ology Set by Tr-County Building Industry Service Board • i: \Building‘PerrnitskELC-PeemitApp.do 12/03 440-4615T( I 0/02/COM/WEB CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISIO Business Line: (503) 639 -4171 MST Ci BUP Receivedr/ 10,00 Date Requested .3 - 2- — 0 (- / AM PM BUP al Location -"=---=-------- II MEC ontact P RO A Ph ( ' ? M 7 PLM Contractor - % ..lam Ph (5be ) -2 7 2 - 2 ?03 SWR /�1 BUILDING Tenant/Owner c- s✓ , P(-e. 5 i- ©C/OSV Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: 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: Final PASS PART FAIL PLUMBING Post & Beam Under Slab 1 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 ELECTRICAL Service Rough -In UG /Slab Low Voltage F ASS PART FAIL III Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE El Please call for reinspection RE: ❑ Unable to inspect – no access Fire Supply Line ( a Approach/Sidewalk Data' 6 a "- 0 Inspecto V S4 1 ` \ 0l Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL