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Permit R C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT DEVELOPMENT SERVICES PERMIT #: ELR2006 -10020 "II DATE ISSUED: 3/21/2006 - 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: AudioNideo. Job # 2112. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: X INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: • HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: WASHINGTON SQUARE LLC TRITON COMMUNICTATIONS, LLC BY THE MACERICH COMPANY PO BOX 1091 9585 SW WASHINGTON SQUARE RD HILLSBORO, OR 97123 TIGARD, OR 97223 Phone: 503- 639 -8865 Contact #: FAX 503- 628 -5689 PRI 503- 615 -5800 FEES Reg #: ELE 34- 648CLE LIC 154665 Description Date Amount [ELPRMT] ELR Permit 4/5/2006 $75.00 [TAX] 8% State Surcha 4/5/2006 $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. Issued By: ti Permittee Signature: _ ,, Q► 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. Mar 21 06 10:06a Triton Communications LLC 503 -628 -5689 p.1 ,, El rta=ica i Permit A lication- -' FOR 0 r i l( r: l S l: O N 1., City of Tigard D �� � I ^ 3 ) 06 yrlll � i<No. e c �.i ' nZ rf /�d 13125 SW Hall Blvd, Tigard, OR 9 Plan R i Phone: 503.639.4171 Fax 503.598.1960 • ible t '' i D.,a/By: Other Permit: Inspection Line: 50 1639.4175 MAR 21 20 0 1 , _u 1 •� I .. Date Ready/By. bus- e 1 M Sec Page 2 for • n Internet www.ci. onus Notified hod: (r Supplemental Information t -4 WoiitZlk 1 PLAN REVIEW Et New construction PI, . . _ , i.. :, . I i if ..1 . .. .II ti Please e�eck all that apply: . 1ik .� 1 • ' ❑Service over 225 amps, colonel 0 Hazardous location ❑ Demolition 11! ' e, , ter . ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft, CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential ❑ 1- and 2-family dwelling Ertommercial/industrial 0 Accessory building ❑sue over 600 volts nominal units in one structure El Multi - family ❑ Master builder ❑ Other: ©BuIldiag over three stories ❑Feeders, 400 amps or more Occupant load over 99 persons ❑ Manufactured structures or JOB SITE INFORMATION AND LOCATION q 4/5 ❑ ❑E t i Ling Plan RV park job no.: ' lob site address ❑Healt —care facility ❑Omer I i �' Sl.ti.) ��f�7 t 5 ``� t Submit 2 sets of plans with my of the above_ City/State/ZIP: `� �„ ,, o • ot"'a - The above am not applicable to temporary lion service. r Suitc/bldgJapt. no.: � c� 'C.)C * S[ -tr Project name: `0 CQ l S ll>tED[JLE I For. I Tar I •• Cross street/directions to job site: New residential single- or multi- family dwelling unit. Includes snacked garage. 1,000 sq. ft or less 145. l5 4 Subdivision: Lot no.: Ea add'I 500 sq. ft or portion 33.40 1 limited energy, residential 75.00 2 Tax map/pareel no.: limited energy+. non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular �� ' dwelling, service and/or feeder 90.90 2 �l ' - '4c c C') l \ 1. C 1) C) `� `\ . ` , services or feeders installation, alteration, and/or relocation `. 200 amps or less 80.30 2 ❑ PROPERTY OWNER I ❑ TENANT 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: ( ) Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that 1 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 ❑ APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name withorcr service or feeder fee, first branch circuit 46.85 2 Address: _ Each addl branch circuit 6.65 2 City/StatePLLP: MisceEsneons (service or feeder not included) Phone: ( ) 1 Fax: : ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or extension. Describe 1 Page 2 5 2 Business name: Triton Commanications, LLC _ Address: PO Box 1093 Each additional inspection over allowable in any of the above Per inspection 62.50 City/State/ZIP: Hillsboro, OR 97123 Investigation per how (I Is min) 62.50 _ Phone: (503) 615 -5800 I Fax: (503) 628 -5689 Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES' CCB Lie.: 154665 l Electrical Lie.: 34- 648CLE Suprv. Lie.: 2826LEA Subtotal S Suprv. Electrician signature, required: a ny Plan review (25%ofpermit fee) — Print name: Date: / State surcharge (8% of permit fee) t o 9'14 t Po� 5( "" (d ( 0 TOTAL PERMIT FEE ` Authorized signature: (;(a.4,,,,) T 7 , -- This permit application expires If a permit is cat obtained within 180 days after it has been accepted as complete Print nam � A� F a�4' /eel e7— Date: I ( CJl • Fee methodology set by TriCounty Building Industry Service Board a o •• Norther ofinspections per permit allowed. islauitdiogWermiti C.PatnitApi.doc 12/03 440- 46tJ!(INO21COMIW[9 Mar 21 06 10:06a Triton Communications LLC 503 -628 -5689 p.2 Elesric`al Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fec for all residential systems combined ... $75.00 Check Type of Work Involved: n Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other. COMMERCIAL WORK ONLY: Fee for each commercial system $75.00 • (SEE OAR 918- 260 -260) Check Type of Work Involved: Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ D ata Telecommunication Installation ❑ Fire Alarm Installation ❑ H • VAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls Cl O utdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: 1 *No licenses are required. Licenses are required for all other installations \ Bufldtag■Pamits\ELG?vmitApp.doc 0V03 • y ,_ . _ CIT. TIGARD ( J BUILDING DIVISION PERMIT #: ?c)t f) - Uri y3q 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: /� -/6 Phone: (503)639-4171 o�nl1ll / / Inspection Requests (24 Hrs.): (503) 639 -4175 E _:.:; ;_,. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: . SITE ADDRESS: C L ( 5 q U 1 Al i - y I-u.1 *', gdi 4 1'1 CLASS OF WORK: All SUBDIVISION: LOT #: TYPE OF USE: (OP PROJECT NAME: -p p i"4 i~V DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3 - ?) _ Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments /Instructions: Tee p av Qr r.0 aIi‘ C y C 1 Y1 4eGI CUv Show p „, wl Av et A g 0 (b6. L‘Io ? Ck fo rte t° t o0 4- veT 4. vovrc 5 I ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 7 :- - " , ) [ 1 0 ! l � ( Date: l ' 0 (, Phone #: (503) 718 - OC 4 / 4 7 1 S 7 ZS CITY OF TIGARD BUILDING DIVISION PERMIT #: .Ot i°0-/D 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 4,4 , 400, l Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: g.1.6-5 V Vva crii/ / CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: - DESCRIPTION: OWNER: PHONE #: 57)3 5 -1 30 0 CONTRACTOR: KP PHONE #: Inspection Request Scheduled For: Date: 7- Pour Time: Code # Inspection Description Confirm # Contact # Message • Corrections /Comments /Instructions: • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • Inspector: (NCR)GE V GE Date: 51 211010 Phone #: (503) 718- "f" •