Permit C IT 1 WO TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00011
lr DEVELOPMENT SERVICES DATE ISSUED: 1/10/2005
,
1
I 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09432 SW WASHINGTON SQUARE RD K -2
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: (1) service, (16) branch circuits. Located in NE corner of mall near Penny's. Job #104077 -1 -5390.
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: 1 W /SERVICE OR FEEDER: 16 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:
WASHINGTON SQUARE LLC DYNALECTRIC
BY THE MACERICH COMPANY 2904 SW FIRST AVE.
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97201
TIGARD, OR 97223
Phone: Phone: 503 - 226 - 6771
Reg #: LIC 066793
SUP 4817S
FEES ELE 26 -59C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 1/10/2005 $186.70
[TAX] 8% State Surcharge 1/10/2005 $14.94 Rough -
Elect'I Final
Total $201.64
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Speaalty 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:"-Z) W.„.>7% Permit Signature: j j- 4) fa
OWNER INSTALLATION ONLY V �i
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 639 -4175 by 7:00pm for an inspection the next business day
1- 10- 05;10:O3AM;DynaiectrIc service ;503 226 7720 # 2/ 3
•
Electrical Permit Appli� 0 �� ) FOR OFFICE USE ONLY
City of Tigard 1 Date/BY / /D al '1 (� . Permit No .� 'OOS O d 11
13125 SW Hall Blvd., Tigard, OR 97223 I °�' " 1 0 2 D !
g Plan Review
Phone: 503.639.4171 Fax: 503 598.1960 _ Lhrz y, t' +� Date/By Otber Pcrnut 1 . a)L,/ w j '71
inspection Line: 503.639.4175 CITY OF i I `� �• ' Date Ready/By: Juris. El See Page 2 for
P cn_ � .._.. r r: g
Internet: www.ci.tigard.or.us T\1 STOR Notitied/Method: -' )(r Supplemental Information
' . . TYPE OF t t l 1 . PL AN REVIEW • •
® New construction ❑ Addition /alteration/replacement Please check all that apply:
['Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition [ ]Other:
_ ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
• CATEGORY OF • of t• and 2- family dwellings 4 or more new residential • • ❑ 1 - and 2 - family dwelling ® Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
['Building over three stories ['Feeders, 400 amps or more
❑ Multi 0 Master builder 0 Other:
❑Occupant load over 99 persons ['Manufactured structures or
JOB. SI P.ORMATXON AND 'LOCATION. ;` _ ❑Egress/lighting plan RV park
Job no.:104077 - - 5390 Job site address: ❑Health -care facility ['Other: _
9585 SW Washington Square Rd Submit 2 sets of plans with any of the above.
City /State/ZIP: Tigard Oregon 97223 The above are not applicable to temporary construction service.
•• :FEE* SCHEDULE: .•
Suite/bldg. /apt. no.: K02 Project name: Nextel
_ –_ Description 1 Qty. I Fee. I Total 1
Cross street/directions to job site: Northeast corner of mall near JC Penny New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'I 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
_ - . " , . DESCRIPT rON : Ol t WORD •.t ' i Each manufactured or modular
• dwelling, service and/or feeder 90.90 2
New Tenant Space . Services or feeders installation, alteration, and /or relocation
200 amps or less 1 80.30 80.30 2
.' .` r; I• •';';',,-;•'.,:: •••: 201 amps to 400amps 106.85 2
::'❑'1'ROPERT . E . .. . ...` . :': .,.: • . .... "❑ . .... . . r s '
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
Phone: ( ) I Fax: ( ) relocation
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
5 _ : i ;. _ ti A. Fee for branch circuits with
'.:' r :,... . AYP 1`�A !1 ' >'i .;•` . nC •'CO .. ItSQAf
•: I ; ' :;'.::: : service or feeder fee, each
Business name. branch circuit 16 6'65 106.40 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 46.85 2
Address: Each add'l branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax: ; ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E - mail. Signal circuit(s) or limited - -
: CONTR A CTOR• :•; r energy panel, alteration, or
extension. Describe: , Page 2 2
Business name: Dvnalectric Company
Address: 2901 SW 1st Ave Each additional inspection over allowable in a ny of the above
Per inspection 62.50
City /State /ZIP: Portland OR 97201 investigation per hour (t lir nun) 62.50
Phone: (503) 226 -6771 Fax: ( 503) 226-7720 Industrial plant per hour 73.75
CCB Lie.: 66793 Electrical Lic.: 26-59C Suprv. Lie.: V653-.e' Subtotal 186.70
Suprv. Electrician signature, require . 4 Plan review (25% of permit fee)
Print name: Date: State surcharge (8% of permit fee) 14.9 %
Ed R - 10 - 05
TOTAL PERMIT FEE 201.6% ( I __
Authorized signature: ` l _ e _... / / ` This permit application expires if a permit is not obtained within 180
• — � — .. - days after it has been accepted as complete
Print name: ` , r! e Ti Date: - ID •Q 5 ' Fee methodology Oct by Tel-County Building Industry Service Board
•,. Number of insoections ocr oerntit allowed.
CITY OF TIGARD 24 -Houj.
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 63 4171 MST
BUP
Received Date Requested ' AM PM BUP
Location (7 4/3,D, / / IL) i � • JQ, Suite k � Z MEC
Contact Person Ph ( ) g — 13 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner y Ca� - ) ELC °?(3 s ` 000 f /
Footing ELC
Foundation Access: vv
Ftg Drain ELR �QDS" d U 0 c.a,
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
)(t/V
Post & Beam
Under Slab
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
P: PART FAIL
Service
Rough -In
UG /Slab _ wVo tg� l� (7 d Uv I( �� �7 A �J ' \��
A Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
�J S-' PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line cc7�
ADA
Approach/Sidewalk Date .0 G Inspectortg Ext
Other:
Final DO NOT REMOVE this inspection record from the ob site.
PASS PART FAIL