Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
JI I f . " DEVELOPMENT SERVICES PERMIT #: ELR2006 -00149
' =- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/12/2006
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PARCEL: 1S12600-00300
SITE ADDRESS: 09461 SW WASHINGTON SQUARE RD A13 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Limited energy for voice & data. Job No. 11455
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC PTSC
BY THE MACERICH COMPANY 710 NE CLEVELAND
9585 SW WASHINGTON SQUARE RD GRESHAM, OR 97030
TIGARD, OR 97223
Phone: Contact #: PRI 503 665 - 4900
FAX 503- 665 -4830
FEES Reg #: ELE 26- 1117CLE
LIC 150175
Description Date Amount
[ELPRMT] ELR Permit 6/12/2006 $75.00
[TAX] 8% State Surchar€ 6/12/2006 $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 low r les adopte by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
thr ugh OAR 952 - 001. 10 ./You may copies of these rules or direct questions to OUNC at 503 - 246 -6699.
Is ued By: r1 r aal Permittee 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 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.
f'
Electrical.Penmit Application / , , FOR OFFICE USE ONI.1
`J Tigard Date/B CGII% � &/ _ 3 /
City of Ti and Permit No .
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
A uthOM; 1 ` OtherPerm it
Phone: 503.639.4171 Fax: 503 598 1960 Date/By
Inspection Line: 503.639. _-.44, ■ =EL Date Ready/By. to ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method ( ' , Supplemental Information
TYPE OF WORK PLAN REVIEW '
L' New construction ❑ Addition /alteration/replacement Please check all that apply.
❑ Demolition ❑Other: ❑Service over 225 amps, comm'l ❑Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
. CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ I- and 2- family dwelling 21 Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ID Master builder ❑ Other: ❑Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND e LOCATION DEgress/lighting plan RV park
1 L 9y6/ s� i 45». sy. izG+l' ❑Health -care facility ['Other: no.: Job site address:
Submit 2 sets of plans with any of the above.
City/State /ZIP: A,21 4.vD Q4 The above are not applicable to temporary construction service.
/
FEE* SCHEDULE
Suite/bldg. /apt. no.: Project name: e
Swat' A- y Description I Qty. I Fee. I Total
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq ft. or less 145.15 4
Subdivision: Lot no.: Ea. add] 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and/or feeder 90.90 2
V D t t-'c.r 4 PA-TA Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
CI PROPERTY OWNER ❑ 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 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
❑ APPLICANT ❑ 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: without service or feeder fee, 46.85 2
Address: first branch circuit
Each add'I branch circuit 6.65 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) 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 7 5 2
Business name: PT-5 (_-
Each additional inspection over allowable in any of the above
Address:
—) 1 b N Cl_f_0 Ls4/JD SO CC 12.0 Per inspection 62.50
City/State /ZIP: C., ,Q N , , Cui-. 9 7 p3 a Investigation per hour (I hr min) 62.50
Phone: ( ) Industrial plant per hour 73.75
S 6S' 9QD 0 Fes; (✓` X65 �`fk3 ELECTRICAL PERMIT FEES* `
CCB Lic.: 0-07 '7 S Electrical Lic.: Z4—) // 7 F prv. Lic.: Subtotal
75 --- Suprv. Electrician signature, required: .14 c�„ Plan review (25% of permit fee)
State surcharge (8% of permit fee) 4 °
Print name: 57tL.' e9Cv
C& s Date: 4/9/0 b G/ €,E>
TOTAL PERMIT FEE 0
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: i7 VE ' Acjej v5 Date: e_./7/6 c_ • Fee methodology set by Tn -County Building Industry Service Board
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Lj tOO b
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 0 I LI
Phone: (503) 639 - 4171 %dn
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: L • I l • % V TIME: , PAGE:
SITE ADDRESS: C M b W A 5 }�� N q , O N CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: S �• `p f C 64-V6
U
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: fo• ) • o6 Pour Time:
Codee # 'Inspection Descriptio Confirm # Contact # Message
`� ` Nr-O - v 6:1 1 •
Corrections /Comments /Instructions:
0 yvv
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • WW5-1.4 � Date: b 1 .6 Phone #: (503) 718- 214 •