Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
2 DEVELOPMENT H BMENq Tigard, ) 639 -4171 DATE SSU 8/13/03 3 -00250
- 13125
SITE ADDRESS: 09493 SW WASHINGTON SQUARE RD A -3 PARCEL: 1S126C0 -01107
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: JOB NO. 24546 Tenant Improvement, panel for phones
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:
PPR WASHINGTON SQUARE LLC OREGON ELECTRIC CONST /GROUP
BY THE MACERICH COMPANY 1010 SE 11TH AVE
9585 SW WASHINGTON SQ. RD. PORTLAND, OR 97214
PORTLAND, OR 97223
Phone: Phone: 503 234 - 1001
Reg #: L91/3-23423600
SUP 4460S
ELE 26 -95C
FEES Required Inspections
Description Date Amount Ceiling Cover
[ELPRMT] ELR Permit 8/13/03 $75.00 Wall Cover
Elect'I Final
[TAX] 8% State Tax 8/13/03 $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 throuc
Issued by Permittee Signature�(JY)
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 7:00 P.M. for an inspection needed the next business day
•
AUG -13 -03 09:19AM FROM - Oregon Electric Estimating 5032313587 T -082 P.001 /001 F -964
A
(Electrical Permit Applicatio ---4 „On -c o 5
_ - ,- — ; OFFICE USE ONLY
R Permit no.:
City of Tigard Date received
.. r_ 13125 SW Hall Blvd A 13 003 Project/apph no.: Expire date:
Phone: (503) 639.4171, F ) 598-19 0 Date issued: By: I Receipt no.:
Internet address: www.c1.6 , , rd.or- Case file no.: I Payment type:
24 -Hour Inspection R -t , e: r I75
U 182 family dwelling or accessory BU 4-a''•' "1a1 U Multi- family [] Tenant improvement
❑ New construction : IS :addition/alteration/replacement ❑ Other. 0 Partial
JOB SITE INFORMATION
Job Address: 09493'SW Washington Sq Rd Bldg. No.: Suite no.: A3 Tax map /tax lot/account no_:
Lot Block: Subdivision
Project Name: Motherhood Maternity Description and location of work on promises: Amend permit to add (1) LE panel for phones
Estimated Date of corn le tionfins • ection:
Will ou call for ins.... on within 24 hours? Yes L..I No ❑ Project Contact Mark Welnbender (603) 288 •8450 Phone
CONTRACTOR APPLICATION FEE SCHEDULE
, ,no.
Job No 24.540 Description Qty Fee (ea.) Total +ma
1tow cra�gTiil4'
multifamily per dwelling unto
Business name: Oregon Electric Group Includes attached garage.
Service Included:
Address: 1010 SE 11th Ave. _ 1000 so. ft or loss S 145.00 $ - 4
City: Porlland1State: OR Zip; 97214 Ea Addl 50° SF or Portion S 33.40 1 $ -
Phone: (503) 234-9900 Fax: (503) 234 •1001 1E-mail; ,Ea
Energy, 1 8 2 Family _ $ 75.00 $ - 2
CCB no.: 203 Elec. bus. tic, no.: 26-95C IJndted Energy. mutb•Farnilr S 75.00 $ -
City /me'•• li . o.• Each manufactured home or
modular dwelling. service
s, •.,,,,, • .. — 4 A_:_:. '/811312003 end /or feeder. S 90.90 $ _ - 2
Service or Feeders -
Su • . -ot- Name i 'IlIEM,PM License no: 44605 Installation, Alteration or
Relocation:
- -- - -- - - - - - -- - - PROPEkt Y OWNER - -- - - -- -- - zoo am.sorless $ 80.3o $ - z
Name (print): _ 201amps - 400ampo $ 106,65 $ - 2
Mailing Address: , 4013m05 - 600ampa $ teo.60 $ - 2
City State: Zip: 6Olamps • too0amps S 240,60 $ • 2
Phone; Fax; 1E Over 1oo0A or Voles $ 46455 5 - 2
Owner Installation: The installation is being made on property I own which is Reconnect Only $ 66.55 $ - T 0
a accordi to ORS 447, 455, Focde - services
not intended for sale, lease, rent, or exchange do
9 n9 Foceors- lnstalladon,
479, 670, 701. mention or Relocation:
Owners si nature: Date: 200 am or lost $ 66.85 $ - 2
201amps - 400amps $ 100.30 $ 2
Name; over 401emps- 600amvs $ 733.75 $ - a
Branch Circuits • New,
Address Alteration or Extension Per
Panel: A, Foo for branch
City: State: ZIP: _ circuits with purchase of service
or foedor fon. cinch branch
Phone: Fax, E -mail: dreult $ 6.55 $ - 2
p, Fee for branch circuits W /Out •
Purchase of Sarvite or Feeder.
let Branch CM $ 46.es S • 2
❑ Service over 225 amps-comm. ❑ Health -care facility Each additional branch drank s 6.65 $ -
❑ Service over 320 amps-rating of El Hazardous location Miscellaneous - (servioo Or
feeder not included)
18,2 family dwellings ❑ Building over 10,000 square foci four or Each pump or Irrigation circle $ 53.40 5 - 2
O System over 600 volts nominal more residential units in one structure Each Sign or outline lighting S 62 $ 2
El Building over three stories ID Feeders, 400 amps or more Signal Circui(s) or limited Energy
Panel Attor don or F_xtenSien"
O Occupant load over e9 persons CI Manufactured structures or RV pork I $ 75,00 S 75.00 2
❑ Egress/lighttng plan ❑ Other, - ooscnoon: -----------
Submit 2 sets of plans with any of the above.
The above are not applicable to temporary construction service. Each Additional inspection over
Hat ail ham,er m a Tempt cruet curds goaw can tt,n.. for r,m,,, tire. the Aildwat)!e 1n any of the
Notice! This permit application Above' Per Inspection
e� Iles If a permit I5 not $ 02.50 $
, o - + / . .: . i '' ' `L' obained wok) CRC days a fter ! lnvestiaadon foe:
White '''f- :' has been accepted as 1000r C rt �as on complete. $7$ -
Permit Fee
i Plan review 25% $0_00 i
signature of cardholder Amount State Surcharge 8% $6_00 %.9
Total $131.00
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: . (503) 639 -4171 MST
BUP
Received Date Requested S AM PM BUP
Location ' 3 - .Q . Suite MEC
Contact Person / Ph ( ) 7 cl _ R 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR 3 - d o a Sd
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
PASS PART FAIL
ELECTRICAL
Service
•
Rough -In
UG/Slab •
Low Voltage
Fire Alarm
40 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
••A - T FAIL
SI Please call for -inspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA Date _ - 6' Ins ecto rL. Ext
Approach/Sidewalk C P
Other:
Final DO OT REMOVE this inspection record fr ' m the ob site.
PASS PART FAIL