Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00872
. DEVELOPMENT SERVICES DATE ISSUED: 2/27/2006
"11111 ° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09459 SW WASHINGTON SQUARE RD A14 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: TI electrical.
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 INSP4CTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 2 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 3D ELECTRICAL SERVICES INC
BY THE MACERICH COMPANY PO BOX 173
9585 SW WASHINGTON SQUARE RD OREGON CITY, OR 97045
TIGARD, OR 97223
Phone: 503 - 639 -8865 Contact #: FAX 503 - 655 -7140
PRI 503 - 657 -9173
FEES
Description Date Amount Reg #: ELE 3 -460C
[ELPRMT] ELC Permit 2/27/2006 $60.15 L[C 135234
[TAX] 8% State Surcharge 2/27/2006 $4.81 SUP 4478S
Total $64.96 REQUIRED ITEMS AND REPORTS
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.
Issued By:
7Y-/Z(LC Permittee Signature: 3Q.. `� `` f
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.
FEB -27 -2006 MON 02:50 PM P. 001 /002
E lectrical Permit E® 101; c►1 l t( 1.1 ,1. O.i,
City of Tigard we. ! i ' Pamit Ne.: C a - i -,1.2-
13125 SW Hall Btvd., Tigard, OR 97 2 F. 0 1 Plan Review
..!:, t•a:
Phone: 503.639.4171 Fax: 503.39 , I {`' Dal � x . Other Permit
1
Ins Line: 503.639.4175 D . , I I Dam • : y. t `• See Page 2 for
Internee www.citigard.or.us 1SY O FTIGA NotifiaUHtotlod ) � ( Supplemental ta
Istorstlon
+ ,,7'. !+ i:yrI0 71,111 Fy.•,±I. - , 'a` • 3, 0 11;: a, , Rv:?,,11 Fyt; 4•.s�1 i., . ?' l 9y,-.A ', )
�;�1 +. "''`�' r • : i ' S, F pg �: 1 eft �1 , win .���,�� m�� . die , j ,
r . } 1r i1� f ! � 1, .,(. 5 7� ^We. { xw• "t• �.•'.1 - .a •i�e':�: N.
,,,• ���+ ? .'P•a J �• dY lrgT;'•f �;ir :ir 1i ;`•4Y�.�: %'`; ►,•,
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
Denim DM 225 amps, oom,n'1 ['Hazardous location
Q Demolition 0 Outer: OService over 320 amps - rating IJBulldng over 10,000 sq. ft.,
•t; r,. :: ;'. � '•',.' L^ - fl �: i pti, WReoePt� ;k•e! . - c�,y, ' .1. `.,•� - y of I.. J t. and •24kmllydwell• 4 or more new residential
::N•._. � q . '4• t:•:.;,. 0,774-1, 1 'C lT ,„ r:-.3 G . ....F I\ .: :. ,' F, r 4 U , . / AIR ' p. : :: I.A ,.,.. 14% � :1 �� d,: 0,4pdtem Queer 600 volts nominal emits in one alminre
1,3 1 - and 2Commercial/Industrial mlly dwelling i Commercial/Industrial ❑ Accessory building []Facdus, 400 amps or more
Opuilding over three stories
❑ Multi-famil ■ ::.• builder ❑ Other: QOooupant load over 99 persons QMmufactured structures or
} p I V, , t • ,a �. 11t ��rr N ; v; a '� . , , / , ,+ I ]Sgrnss/hg g Ph RV ark • ' r ,',, ' t1 r�.Qf '' r' . ' _ �� e � ' ? '" , �I..:, � � Q. �.�P � �� * s ❑ Other:
p
❑ueelth -care facility •
Job no.: Job skeet. 42 4/59 ft , Ai, _ Jbn : • Submit .2 sets of pla ns with any of the above.
City /State/ZIP: -7-7 1 6 /4 The above are not applicable to temporary construction service.
Sulte/bldgfapt. no.: A /9 Project name: ev • G „re. v uerettnuoo Qtr. Fee. 'row
Cross street/directions too job site: New residential single- or Mid-family dwelling unit.
Wtz f /1. f au f l t fQ A (( 1,000 s. attached garage.
1,000 sq. 8 or less 145.15 4
Subdivision: Lot no,; 13a, add'1500 sq, ti. or portion 33.40 1
' - - limited -+ . . , residential 75.00 2
Teat neap /parcel tic.: _ Limited ch m enufabaued or energy, nonrre l a 75.00 �8
1''. ;:: > �;;35 i:(!; , .i: �Ii' ",` 4.00, 'W i�r' �Si�l] 0. ; ;
:.�'i 4lk,S Bach m modular
(?) (� /' G u f dwel , :, service. and/or feeder 90.90
Wdr G Serviced or feeders Installation, alteration, and/or relocation
200 amps or less 80.30 2
„r 'Ilk "... r► s e , ,.�`.. 1 � , r •i ' 201 amps to 400 amps 106.85 2
ii st i n r x N` 40l 60 2
":4;.:'.
�.. ' . . a R.... .. ' ... „, - - - .. fitii amps to 600 amps 160
Name: 601 amps to 1.000 amps 240.60 2
- Over 1,000 amps or volts 454.65 2
Address:
• Reconnect only 66.85 2
City /State/ZIP: Temporary services or birders installation, alteration, and/or
Phone: ( ) I F ax: ( )
relocation
amps or less 66.85 1
Owner installation; This instdlation is being made on property that l own which is not 201 flo to goo 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
. RssN -i .. -. ; ' •'� i s ,4 , &roc for branch circuits with
t r.: +�i 4.�: ';;• E � 'r '^�la < F . �` Es t service or feeder fee, each
Business name: branch circuit 6.65 2
B. Feet! branch circuits
Contact name: without service or feeder fie,
Address: each branch circuit / 46.85 i gr. 2
._ _ Each add"( branch circuit 2 ,_ 6.65 r 2
City /State/ZIP: - Miscellaneous (service or feeder not Included)
Phone: ( ) Pump or irrigation circle 53.40 2
I Fax: : ( ) Sign or outline lighting 53.40 2
E-mail; Signal c irouit(s) or limited.
,,. fir'; ' ,t: i g ' fICs I..: �t:`' i�r ., , l '1 i el a`. im Zili energy panel, alteration, or
Business name: S
D el rQ Ica L 5 v c5' in aactedeion D scribe: Pegs 2 2
Address: p0 t r... /- 3 Each additional Ins , . . on over allowable In any of the above
1 Per inspection 62,50
City/State/ZIP: ) t a.E6 o/ J ', r p / a /' '77 415 Investigation . er hour tt hr min) 62.50 II
Phone: (g,3) 657, 7 I Feat' 3 C r 1 pla per hour 73.75 il nt -�
7r (� ) CST - 7/V) Industrial �. ! ':1,rig.: �i ` risil ;' .�.1 T .. t �• IT.:} %gigii Y
CCB Lie.: • 5 Electrical Lie.: ,.. DU Suprv. Lie.: ' e . 0 Subtotal IrmsEs
Suprv. Electrician signature. required; • 1111111/A , Plan review (25% of permit fee) 4/ R/
`` State surcharge (8% of permit fix) 7
Print name: t { ��- 4 . Du >p t Date: Z 23 0 b 1/5 •
Authorized signature; This pent application eorptres Ifs penult is act obtafif'ed vdlthln tao
days atter it has been accepted as eamplete
Print name: Date: * Pee methodology eel by T -County Building industry Service Board
• - " Number of inspections per penult allowed.
usu1101040Paln11e1ltePuu4iApp ,doe 12/03 440d81sT(10/0VOOM/W®
CITY OF TIGARD
BUILDING DIVISION • PERMIT #:S/Co — OO$7 .
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 �wP
Inspection Requests (24 Hrs.): (503) 639 - 4175+
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: e,14-6 kf s /� / IT! Lt-- CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
O W N E R : ® � 1 w PHONE #:' 7/ — 6 — 3'S-60 CONTRACTOR: W PHONE #:
Inspection Request Scheduled For: Date: 3 -��' -D�o Pour Time:
Code # Ins ection escriptio Confirm # Contact # Message
q
/ q
Correc • s /Comments /Instructions:
•
P b ;[J c Art E .
4 e
1111 ° F Wok
•
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: to Ov 1Z ' Date: 3 2140 Phone #: (503) 718- vigv'