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Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00207 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/18/2007 PARCEL: 1512600 -00300 SITE ADDRESS: 09469 SW WASHINGTON SQUARE RD A10 ZONING: C - G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG PROJECT: MAGGIE MOO'S /AUNTIE ANNE'S Project Description: HVAC A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: 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: X PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: WASHINGTON SQUARE LLC OREGON AIRE INC BY THE MACERICH COMPANY 7715 NE 33RD DRIVE SUITE A 9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97211 TIGARD, OR 97223 Phone: Contact #: PRI 503- 335 -2222 FAX 503- 335 -9977 Reg #: ELE 26- 1072CLE FEES LIC 64235 Description Date Amount [ELPRMT] ELR Permit 6/18/2007 $75.00 [TAX] 8% State Surcha 6/18/2007 $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. u r ., obtain copies of these rules or direct questions to OUNC at 503 246.6699 or 1.800.332.2344. AS Issued By: � % _ - Permittee Signature: d■• � 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. 'Electrical Permit A 1 t c,. 1,t FOR OI ICL1iS O \ 1.1 . 1 l'r -- - '. - E1VED • / ' City of Tigard Da e�B o 7 CL2o200 7 - 0 0 , 207 il ,y /A, Permit N o V 13125 SW Hall Blvd., Tigard, OR 9 Plan Review C Phone: 503.639.4171 Fax: 503.5 2007 Date/B : Other PermrtMee Z a 7.... , , G 2a, T I G n R D Inspection Line: 503.639.4175 Date Ready/By furs El See Page 2 for Internet: www.hgard -or.gt v "II o F 1 ItJARD Notified/Method Supplemental Information lY191 re DIVISION PLAN REVIEW [21 New construction ❑ Addition/alteratio placement Please check a that apply (submit 2 sets of plans whtems checked below) ❑ Service or feeder 400 amps or more ❑ Building over three stones ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agncultural ❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Addition system. larger separately derived system. � pp ❑ ddmon of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: o (, f Sub �s N . [-D Ai or more. occupancy ❑ Six x o or r more residential units. ❑ Recreational vehicle parks. City/State/ZIP: --- e ps27 t b a_ ct -1 2 Z ; ❑ Healthcare facilities. 0 Supply voltage for more than /4&.rE ❑ Hazardous locations. 600 volts nominal Suite/bldg. /apt. no.: - Project name: /f 4 ( 1116,,,5 / ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: or F Roi) CUc-Z 2r Ai --- /c-- r Description I Qty. I Fee. I Total I • - (---' New residential single- or multi- family dwelling unit. 70 l N ( S Includes attached garage. Subdivision: v Lot no.: 1,000 sq. ft. or less 145.15 4 Ea add'I 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft ) �� Limited energy, multi - family 75.00 2 =i .2 77 . L© 14...s, 3 t TI}& residential (with above sq. ft) . Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER I E TENANT 201 amps to 400 amps 106.85 2 Name: /n�A 401 amps to 600 amps 160.60 2 5 (-� (5 dtJ c 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 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 599 amps 133.75 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON _ above service or feeder fee, 6.65 2 each branch circuit Business name: B Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 first branch circuit Address: Each add'l branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular dwelling, service and/or feeder 90.90 2 Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53 40 2 Signal circuit(s) or limited - Business name: Otx -c U _ /L.E f energy panel, alteration, or Address: 71 (s— N - - 3 - 3 9_ sb� extension. Describe: f Page 2 75;01) 2 City/State /ZIP: Pa iLrz r n 9-72_ c - 4 7177 Per inspection 62.50 Phone: ( ) 511—/.2,22_ Fax: (597A) ?3 J Investigation per hour (1 hr mm) 62.50 CCB Lic.: X4 3 f Electrical Lic.: 24_1072_ Suprv. Lic.: 7 /3 L &4 Industrial plant per hour 73.75 ,� � r- ELECTRICAL PERMIT FEES Suprv. Electrician sign 9 / 1 / °I Subtotal: 7,S trO Print name: , q Date: — � 7 Plan review (25% of permit fee): /4 -R., " OK State surcharge (8% of permit fee): L , CD Authorized signature: ` 1 ( / ' TOTAL PERMIT FEE: PI , 0 _ F._ c , This permit application expires if a permit is not obtained within 180 Print name: D x Date: 6 / [ days after it has been accepted as complete. • Number of inspections allowed per permit. I \Building\Pennns\ELC- PennitAp doc 05/23/06 440- 4615T(1 I /05 /COM/WEB CITY OF TIGARD ;` BUILDING DIVISION •. PERMIT #: ELR2007- 00207 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 61/8/2007 Phone: (503) 639 - 4171 , 1 Inspection Requests (24 Hrs.): (503) 639 - 4175 ±+ "'lz.. INSPECTION WORKSHEET FOR DATE: 7/9/2007 TIME: 7:02AM PAGE: 51 SITE ADDRESS: 09469 SW WASHINGTON SQUARE RD A10 CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: MAGGIE MOO'S /AUNTIE ANNE'S DESCRIPTION: HVAC • • OWNER: WASHINGTON SQUARE LLC. PHONE #: CONTRACTOR: OREGON AIRE INC PHONE #: 503. 335 - 2222 Inspection Request Scheduled For: Date: 7/9/2007 Pour Time: Code # Inspection Description Confirm - Contact # Message 199 Electrical final • 051623-01 503-516-4142 N Corrections /Comments /Instructions: • \, PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS F ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G---. vv be L'E Date: 11 • cl • t1 Phone #: (503) 718 - Z.tl 1t •