Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00662
A .DEVELOPMENT SERVICES DATE ISSUED: 12/26/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1 S126C0 01107
SITE ADDRESS: 09487 SW WASHINGTON SQUARE RD A -5 ZONING: C-G
SUBDIVISION: WASHINGTON SQUARE
BLOCK: LOT : JURISDICTION: TIG
Project Description: Install (2) branch circuits for tenant remodel.
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: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 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:
PPR WASHINGTON SQUARE LLC STONER ELECTRIC
BY THE MACERICH COMPANY 1904 SE OCHOCO STREET
9585 SW WASHINGTON SQ. RD. MILWAUKIE, OR 97222
PORTLAND, OR 97223
Phone: Phone: 503 - 462 - 6500
Reg #: LIC 44823
SUP 4025S
FEES ELE 26 -122C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 12/26/02 $53.50
[TAX] 8% State Tax 12/26/02 $4 Rough -
Elect'I Final
Total $57.78
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 or 1 -800 -33 23
Issued By: Permit Signature: /it/ /9-/i C" 777'
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 639 -4175 by 7:00pm for an inspection the next business day
12/23/02 MON 15:57 FAX 5036594968 THE STONER GROUP Z001
4-
Electrical PermitAppiication Iii ill :.l
Datcrcccivcd:/ , Si OZ.- Pea4xnitno_:� • 6 , _
Ai �: l �' City of Ti CEIV E� PL:oject/appl, no.: ii. lire date:
City of Tigard Address: 13125 S C 1 Blvd, Tigard OR 97223 Daft issued: E '� Feet ipt no_:
Phone: (503) 639 -4171 2 3 2002 /i (f " '
Fax; (503) 598 -1960 DEC ( Case file no_! P:: at ent type:
Land use approval:CITY OF TIGARD
ING DIy1610N
TYPE OF PERMIT 1 111111111 1
O 1 & 2 family dwelling or accessory '= Commercial/industrial ❑ Multi- family U Tenant improvement
0 Ncw construction / Addition/alteration/replacemcnt U Other: ❑ .'artial
JOB SITE INFORMATION M A
Job add - , , - ! _ ' - 4 _ Bldg. no - : Suite no_: Tax map/tax 10t/account no -
Lot: Block: Subdivision: `; " • / f, . Se %,
Project ttamc:5Q. - .. a c Description and location of work on premises: / cce i ' 1 ) eL
Estimated date of completion/inspection:
•1 GON'TRACI"OR APPLICATION - - • ; _TEE,Seligi `�i„.E
Job no: Wit/ 2 . ..�. Bee heat
Business me: S �e ct7e_i a
Description Qty. (ea.) Total no. iasp
na esideatcd - single ormanhli per
t Address: 1 ,c,, l+o ea d
welruc melt. Includes attaelred garage. .
City: )41 4f. A4,116 C + Staten ^t� ZIP:9 Setvicelnclude&
' PhoneKA^yLt-GSDb I Fax:4 -e194 I E -mail: t000sq. fzor less 4
Each CCB no.: ¢ 482,3 I Elec bus_ lie. no: 2/ f 2,2 err Limited additional 500 sq, ft, or portion thereof •
Limited energy, residential 2
-l) City/metro "c. ne.: 4 4 / Lp Limircdenergy . non-residential _ 2
/ " ' / 212,5/0 Each manufactured home or modular dwellir c
Signature o f supervising electrician (required) Dare Service and/or feeds . _ 2
Sup. elect. name (print): pb . 1 LAN _ .. Licenuno:3L/3 es SenYice; feeders - Installation,
a l teration or relocation:
PROPERTY OWNER • 2 00 amps or less _ 2 .
Name (print): 201 amps to 400 amps 2
Mailing address: 401 amps to 600 amps _ 2
601 amps m 1000 amps _ _ 2
City: [State: IZIP: Over 1000 amps or volts 2
Phone: I Fax: I E - mail: Recodne tonly _ .__ 1
- Tem services or feeders -
Owner installation: The installation is being made on property I own p O11r t
which is not intended for sale, lease, rent, or exchange according to utstallatlop, alteration, orroloca(iun:
ORS 447, 455, 479, 670, 701. 200 carless 2
201 amps to 400 amps 2
Owner's signature: _ _ Date: 401 to 600 amps 2
-
ENGINEER Brandt circuits- new, alteration,
or extension per panel
Name: A. Fee for brunch circuits with purchase of
Address: service or feeder fee, each branch circuit 2 ^
City: I State: J ZIP- B. Fee for branch circuits without purchase ,, 0K �y
Phone Fax: E-mail: of service or feeder fee, first branch circt : / .'7/�' f55- 2
Each additional branch circuit: 1 , 465 (7,45
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder het included): •-
0 service over 225 amps O ilealthcarefacaity Each pump or irrigation circle 2
0 Service over 320 amps - rating of 1&2 0 Hazardous location Each sign or oudinc lighting - — 2 - -
family dwellings 0 Building over 10.000 square feet four or Signal circuit(s) or a limited energy panel.
0 Systcm over 600 volts nominal more residential units in one structure alteration, or extension' 2
0 Building over three stories 0 Feeders. 400 amps or more • Description: _
0 Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allows a le in any of the ebovc
O egress/Iighting 0 Other- _ - Per inspection i 1 1 1
Submit — sets of plans with any of the above, Investigation fee -
_ . The above are not applicable to temporary construction service. Other
Not all jurisdict aedit accept edit raids. pose call jurisdiction for more information. Notice: This permit application
Permit fee $ x•
Cl Visa ❑ MasterCard expires if a permit is not obtained Plan review i a:t _ %) $ `®' _
Credit card number: - ` / within i80 days after it has been State surchar ie (8%) _. $ i Z
Expires accepted as complete. TOTAL $ 7,7‘g
Name of cardholder as shown on credit card
S
Cardholder signature Amount 440 -4615 (6 /COM)
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested J iL t AM �1 PM BUP
Location /. T� [� - so • .kD Suite // MEC
Contact Person • J -r AJ. L.' Ph ( ) 3O5-91d.3 PLM
Contractor Ph ( / ) SWR
BUILDING Tenant/Owner C Y -) ) (j,i1 ELC
Footing ELC -006a
Foundation
Access:
Ftg Drain ELR
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 7'7"7 /n
Susp'd Ceiling
Roof j J I Y! (° a''1 1
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
PASS PART FAIL
ELECTRICAL
Service C
UG/Slab
Low Voltage
Fi - Alarm
r' PART FAIL El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE 111 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA D � � Inspector -
E� - _ Ext
Approach/Sidewalk �(
- r, p
Other: -
Final DO NOT REMOVE this inspection record from the Job site
PASS PART FAIL
•