Permit ELECTRICAL PERMIT -
C' ®F TIGARD RESTRICTED ENERGY
� � DEVELOPMENT SERVICES PERMIT #: ELR2005 -00028
.. II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/10/2005
SITE ADDRESS: 09432 SW WASHINGTON SQUARE RD K -2 PARCEL: 1S12600 -00300
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: Installation of data & voice cables.
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 ADVANCED TECHNICAL SERVICES
BY THE MACERICH COMPANY 14865 SW 74TH AVE # 210
9585 SW WASHINGTON SQUARE RD TIGARD, OR 97224
TIGARD, OR 97223
Phone: Phone: 503 620 - 9896
Reg #: L$O3 6204'Xm 2
FEES Required Inspections
Description Date Amount
[ELPRMT] ELR Permit 2/10/2005 $75.00
[TAX] 8% State Surchart 2/10/2005 $6.00
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 ,fj 777 Permittee Signature �� 2 i ()c
OWNER INSTALLATION ONLY e
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 7:00 P.M. for an inspection needed the next business day
Feb 07 05 10:23a FITS 623- 939 -8370 p.2
Electrical Permit A lie ; F OR OFFICE F USE ONLY
EIV ; _:: •
City of Tigard Received .� , f
`J !� . c . .....5.... i'amul IQ 6 T Y
13125 SW Hall Blvd., Tigard, OR 97223
Date/By J _G J �C.GO� dd 0
FEB 4 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 FB I !- I �" uendity. Giber OPenntt:
Mapedion Line: 503.639 4175 ,,, `' ., Date Reedy /tly. taut ® See Pape 2 for
lttlernet: www_ci_tigard.or us CITY OF TIGARD Nonfied/MUhod. [ U Supplemental Information
typE851110111ft DIVISION PLAN REVIEW
❑ New construction Et Please chock all that apply:
Demolition ❑Other; OScrvico over 225 amps, comm ['Hazardous location
['Service over 320 amps — rating C]Buildng over 10,000 sq. ft,
CATEGORY OF CONSTRUCTION of 1- and 2-family dwellings 4 or more new residential
1 - and 2- family dwelling EComenercial/industrial ❑ Accessory building ['System over 600 vohs nominal units in one structure
Q Muni family 0 111astcs builder ['Building ova-three stories 0 Feeders, 400 lamps or more
lii Other:
DOcwpant 1484 over 99 p er ta ins El Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Eg ress/ti n plan kV ptuic
6� BP
Job no.: Job site address: g 13� .5_�t/- to h, Sr ❑Henllh -care facility ❑Other _ _. _ - --
Y � vt 2 't r � $ Pt Submit 2 sets of plans with any ofthe above.
City /StoteJLIY: � . ,- a o p c 7 .� 7 The above arc not applicable to temporary construction service.
Suite /bldgJupt no.: Project name: � / C � C'.?c f p L^ / / FEE* SCHEDULE
V
Descdpbon I Qty. ` rye Tokal I ,•
Cross street/directions to job Sitc: New raaidenUal single - or multi - family dwelling unit.
Includes attached garage.
T 1.000 sq. ft or lass 145.15 4
Subdivision: Lot no.: Fa, add'{ 500 aq. ft. or portion 33.4° 1
Tax rrwp/parccl no..
Limited energy, residential 75.00 2
Limited energy, nun - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and/or feeder 90.90 2
/K. b��lt 1/ Dc-fi c.c e.4.-.61 1, $1-aiLl/ Services or feeders Installation, alteration, and /or relocation
L,l I l.. -, ` e... b1 e. - 4 200 amps or less 8030 2
0 PROPERTY OWNER I r( TENANT 201 amps to 400 amps 106.85 2
401 taps to 600 amps 160.60 2
Name: N F 4- . L 601 amps to 1,000 amps 240.60 2
Address,
q ! c 0 IV - (�.c^ ir e C it pot Over 1.000 amps or volts 454.65 2
Cily /Staic>rLII': _ Reconnect only _ 66.85 2
_�I1 '�� p01 ! c / /V q 6 ? 6 Temporary services or feeders installation. Alteration, and/or
Phone: ( ) Fax: ( ) rrloc dlon
200 amps or leas 66.85 . 1
Owner Installation: This installation is bang 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. 801 amps to 600 amps 163,75 2
Owner signature: Dtttc: Branch circuits — new, alteration, or extension, - `ter panel
VI APPLICANT 0 CONTACT PERSON A. Foo for brunch circuits with
service or feeder fee, each
Business name: A Gy1/40,,..„, C. -Vi. 72Paj,,,,-_,,._,, I _I'd,: - U t C s branch circuit 6,65 2
/ � A Fee for branch circuits
Contract. name: $ cc, 7'- t�Yt. G f'� - fix + without service or feeder fee. 46.85 2
Address: 11i�aJ7n_ {.c _ U each branch circuit
8 1 , , A - 7 _ Each add'l branch circuit 6.65 _ 2
p
City/State/ZIP: h/y. 42 _ / ,c ^ 3 51 Miscellaneous (service or feeder not included)
Phone: (�)) cfji- /3 S ( kg ) %''- /302_ h'umpnrutligatioo lighting 53.40 2
Fax
Sin or outline lighting 53_.10 2
E - mail: Signal circuits) or limited -
CONTRACTOR energy panel, alteration, or
0 n I extension. Describe; / Page 2 2
Business name: /4(40 e,ji\ce C T�U� 176 cC�1 S-c l G e- S
if�h Each additional Inspection over allowable in any of the above
Address:
/ dy 8-65—
's / / g .1 j r -4- / Per inspection 62.50
City/State/ZIP: - r'; ete.A f •
� �j / , L 7rv211/ Investigation per hour (t hr min) 62.50
Phone: (5'"03) 6 d..0,- O / 17 Fax (543) 6 ?Q - / 8 k.E, Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES ■
CCI3 Lie.: j S . &1. Electrical Lic.: Suprv. Lic.: Subtotal ,, j '
Suprv. Electrician signature, required Plan review (25% of permit fee) —
Print name: U Date: GS State surcha 8% of fee)
TOTAL PERMIT PEE .--1 , 0
Authorized signature: e� �,� .. G> Thu. permit (K pp tic.Uon 7tpl ree Ira peanut is not obtained within lN0
.lvyr aver it has been sncepted no complete
Print name: Date: • Foe methodology we by in-County Building Industry Scrvtcc Board
CITY OF TIGARD 24- Hour,. , 5 )
BUILDING Inspection tine: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 63 4171 MST
BUP
Received jj Date Requested • AM PM BUP
Location SCE, ° Suite k �Z MEC _
Contact Person � X.� Ph ( ) g - 2323 /
PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner - n-Q-/C' ELC °2 5 - 000 / /
Footing
Foundation ELC v
Ftg Drain Access: ELR �J b5 ' d U 0 d. 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
)°)
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
CTRIC
Service
Rough -In
UG/Slab
' _
Cbw Volta u D � 0 U 17 2.0 \d{
Fr- larm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
al. S- PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 2 - � G Inspectorg - Ext
Other:
Final DO NOT REMOVE this inspection record from the ob site.
PASS PART FAIL