Permit A C I 1 1 OF TIGARD
GAR® ELECTRICAL PERMIT
PERMIT #: ELC2003 -00117
11i DEVELOPMENT SERVICES DATE ISSUED: 4/30/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S126C0-01107
SITE ADDRESS: 09491 SW WASHINGTON SQUARE RD A -4 ZONING: C-G
SUBDIVISION: WASHINGTON SQUARE
BLOCK: LOT : JURISDICTION: TIG
Project Description: Electrical tenant improvement.
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: 41 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:
PPR WASHINGTON SQUARE LLC NEW TECH ELECTRIC
BY THE MACERICH COMPANY 6950 NE CAMPUS ST
9585 SW WASHINGTON SQ. RD. HILLSBORO, OR 97124
PORTLAND, OR 97223
Phone: Phone: 503 - 648 - 1900
Reg #: LIC 41868
SUP 2113s
FEES ELE 26 -418c
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 4/30/03 $352.95
[ELPLCK] ELC PIn Rev 4/30/03 $88.24 Rough -
[TAX] 8% State Tax 4/30/03 $28.24 Rough -in
Elect'I Service
Total $469.43 Elect'I Final
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 to 0 C at (503 24 -6699 or
1- 800 - 332 -2344. /�
Issued By: (1 �h Ad ; \ c (J 1 Permit Signature: , 7: y /(fH:
,
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: cD /
Call 639 -4175 by 7:00pm for an inspection the next business day
03/07/2003 14:57 2063419177 MURPHYUAREY PAGE 03
vS 3�/ 54
Electrical Permit Application ( )l 1, CE 1.1S1 ONLY
Date received: , �0 Permit no.: Eze . po //
;�''�I , City of Tigard Project/appl. o.: date:
Addicss: 13125 SW Hall Blvd, Tigard, OR 97223 ,
City of Tigard Date issued: 1 %J Recei p t no.;
Phone: (503) 639 -4171
Fax: (503) 598 -1960
Case file no.; Payment type:
Land use approval: . .
'ATE OF PERMIT
❑ 1 & 2 family dwelling or accessory Cl Commercial/industrial ❑ Multi- family `O`I'enant im vema
O New construction ❑ Addition /alteration/replacement ❑ Other. ❑ Partial 461t e/VelW
Job address: 9 9/ _old ) r�gVare Bldg. no.: Suite no.: Tax map/tax Iot/account no.:
Lot; Block: 'Subdivision:
Project name: 2 MI - Z. — re T Description and location of work on premises: It . MOS% s D ' 5 4
Estimated date of corn. letlon/inspection: U i 2.003
( I•RA(' 1 00 APPLICATION I4 :1•: SCHEDULE
Job not Fee Max
Business name : � ' !L F' 1 C16 1) L Gaon Qty. (ea.) Total r►o.lnap
I gleormulti- family per
Address: 9 cc) p i p i ( Newresideuda aOn
i t/S Lt )U- 4 dwelling unit.lncludes attached garage.
City:14tll‹..►bora ' I State:( ZIP: 7 Serrueincluded:
PhoneCl3 1 -I q ) I Pax: I E -mail: 1000 sq. ft. or less 4 4.
CCB no,: Elec. bus. lic. no: Each additional 500 sq. ft. or won thereof
_ Limited enemy, residential 2
City /metro lic. no.: Limited energy, non - residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2 cz.\ '
S. elect t1 (print): A p Z, UMW eW A0: Serv)ceaor ( eedere— installation,
PROPERTY OWNER alteratioaorrelocation:
200 amps or less 60 2
Name (print): Z MI6 Z. Pr AAA Owner? 201 WITS to 400 coups 2
Mailing address: a01 amps to 600 amps 2 `
601 amps to 1000 amps 2
City; I State: I ZIP: Over 1000 amps or volts 2
Phone: I Pax: I email: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary servkcea or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation: k.e•
ORS 447, 455, 479, 670, 701. 200 amps or less 2
2 201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps N 2
Branchdreults • new,alterratton, '
�. �r or exteaslon per panel: TS a s may. A. Pee for branch circuits with purchhase of 1* (
Address: ) 9 s rt t � 7ov0 service or feeder fee, each branch cvtcuit oZ7aa 2 Cn
City: ge s Kr JState ` I ZIP: 'i9 Z03 B. Pee for branch circuits without purchase Phone: s scypO Fax: t25 / 1 ' ,-mail: of service or feeder fee, first branch circuit: 2
Each additional branch circuit: P
MAN REVIEW (Please check :111 Ih:tt apply) Miser (Servlceorfeederootlncluded): T
❑ Service over 225 aomgps`coromerriat ❑ Health -are facility Each pump or irrigation circle _ 2
O Service over 320 amps - rating of 18E2 O Hazardous location Each sign or outline lighting 2
family dwellings ❑ Building over 10.000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure altesadom, or extension" 2
❑ Building over three stories 0 Feeders, 400 amps or more •Desenptiore
❑ Occupant load over 99 persons 0 Manufactured structures or RV park web additional Inspection over the allowable in any of the above;
❑ Egtess/liglttins plan 0 Other; Per inspection I I I I
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all Jurisdictions accept credit cards, please call ia,isdicuvn for more � Notice: This permit application Permit fee $ 3 $ ' a
o Visa ❑ M expires if a permit is not obtained Plan review (at at �? % ) $
Credit card number. I / within 180 days after it has been State surcharge (8%) $ cg ,
Expires accepted as complete. TOTAL $ i7( 9• 1 /3
Name of cardholder as shown on credit card
S
cardholder arttnature Ammmt 4404615 (6/00/Cott)