Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 -00623
COMMUNITY DEVELOPMENT 6.1 DATE ISSUED: 11/5/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09487 SW WASHINGTON SQUARE RD A05 ZONING: MUC
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
PROJECT: MRS FIELDS COOKIES
Project Description: Installing (1) branch circuit.
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: SIGNAUPANEL:
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: 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 HIGHLIGHT SIGN CORP
BY THE MACERICH COMPANY PO BOX 230428
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97281
TIGARD, OR 97223
Phone: Contact #: PRI 503 - 729 -7978
FAX 971 - 228 -2455
FEES
Description Date Amount Reg #: ELE 517SIG
[ELPRMT] ELC Permit 11/5/2008 $46.85 LIC 104599
[TAX] 12% State Surchar 11/5/2008 $5.62
Total $52.47 REQUIRED ITEMS AND REPORTS
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 ob - of these rules or direct questions to OU at 503 246. • or 1.800 2 2344.
/
Issued By: ��ji� / ` Permittee Signature: „Ipi
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 Application ® FOR OFFICE USE ONLY
`1 Received �J/
1 ' City SW Tigard ® \\ DDate/By (f �� Permit No . /
• 13125 SW Hall Blvd , Tigard, O 3 ���!!! ' Plan Revie
Phone: 503 639 4171 Fax ', Date/By Other Permit. Wirda j gam/ Y q
,
TI G A R D Ins Line 503 639 417 rj Date Ready /By Suns El See Page 2 for `' l J
Internet www tigard or.gov 0 c AO N Noufied/Method. 7' i i Supplemental Information
TYPE OF WO o�� _
PLAN REVIEW
ew construction 'TYPE
Please check all that apply (submit Z sets of plans w /items checked below)
❑ Service or feeder 400 amps or more ID Building over three stories
❑ Demolition ❑ Other: l,0,� � ° where the available fault current ❑ Marinas and boatyards
CATEGORY OF CWISTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 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 ❑ Emergency system larger separately derived system
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
Job no.: Job site address: �i,t)# •QV r� Six or or more residential Recreational
❑ Six or more residential units ❑ Rr vehicle parks
City/State /ZIP: - 9 Am t ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: 41 4,1 1,4 54 �' I �
�, Description I Qty. I Fee. I Total I •
`�C New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq ft. or less 145.15 4
Ea add'I 500 sq ft or portion 33 40 I
Tax map /parcel no.: Limited energy, residential 75 00 2
DESCRIPTION OF WORK (with above sq ft )
Limited energy, multi- family 75 00 2
) o srit Ws" 4 1 pr p, rk t4). to f u, - residential (with above sq II )
r Services or feeders installation, alteration, and/or relocation
200 amps or less 80 30 2
❑ PROPERTY OWNER ( 201 amps to 400 amps 106.85 2
Name: kiel /2..s, plita.p5 oeekli S • l /?f S�L $7 ,2,9 401 amps to 600 amps 160 60 2
/ 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 wrrh
❑ APPLICANT +l 1 I4TACT PERSON above service or feeder fee, 6 65 2
each branch circuit
Business name: M'('k Witt"' 5.1 B Fee for branch circuits
Contact name: �! �, without branch service or feeder fee, 46 85 46
/w rt , / first branch circuit
Address: 01:9 D S.W • Mr/i/74,4.44 , Each add] branch circuit 6 65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: 4-( � t� e Each manufactured or modular 90 90 2
• dwelling, service and/or feeder
Phone: (Q) ) $'( Grp J pAl Fax: : ( ) Reconnect only 66 85 2
E -mail: J s/ — f f ?M S qh gsesn 4 C.4"61 eve-(. Pump or irrigation circle 53 40 2
CONTRACTOR Sign or outline lighting 53 40 2
and] Signal circutt(s) or limited -
Business name: Ztf 5 c � v Q9)
�i
� `' (� energy panel, alteration, or
Address: 91 xOe s . ( Key, extension Describe Page 2 2
City/State /Z1P: .,.I/9 OA t Each additional inspection over allowable in any of the above
Per inspection 62 50
Phone: ( TV)) ,po-p$tp3' Fax: ( ) Investigation per hour (1 hr min) 62 50
CCB Lie.: /04'51/ Electrical Lie.: c c)7 Suprv. Lie.: Industnal plant per hour 73 75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Ael Subtotal L ,1
Print name: Ai 0 1 e / Date: f • lf/ i to Plan review (25% of permit fee)
State surcharge (12% of permit fee): r
Authorized signatu e s� / �� TOTAL PERMIT FEE 5�
Print name: � i T his permit application expires if a permit is not obtained within 0
�� jfl t/�D Date: �/ /s-A, g days after it has been accepted as complete.
/ • Number of inspections allowed per permit
1 \Building\Permns\ELC- PermitApp doe 05/23/06 44046I5T(I I /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information - . .
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
\Buildmg\Permits\ELC- PermitApp doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION * PERMIT #: El C2001 -00623
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/5/2000
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 1 �..
INSPECTION WORKSHEET FOR DATE: 11/6/2008 TIME: 7 :00AM PAGE: 32
SITE ADDRESS: 09487 SW WASHINGTON SQUARE RD A06 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: MRS FIELDS COOKIES
DESCRIPTION: Installing (1) branch circuit.
OWNER: WASHINGTON SQUARE 11C, PHONE #:
CONTRACTOR: HIGHLIGHT SIGN CORP PHONE #: 503 - 727976
Inspection Request Scheduled For: Date: 11052008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1i0 Sign installation 077736 -01 503.515 -1629 N
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Corre ct i s /Comments Instructions:
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d PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G" ---, NU) L-V Date: i Phone #: (503) 718 - 141
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