Permit 1111- q CITY 1 OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2 -00673
COMMUNITY DEVELOPMENT DATE ISSUED: 12/12
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 126C D -00300
SITE ADDRESS: 09500 SW WASHINGTON SQUARE RD ZONING: MUC
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
PROJECT: JC PENNY
Project Description: (11) services.
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: 11 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:
WASHINGTON SQUARE LLC E C COMPANY
BY THE MACERICH COMPANY PO BOX 10286
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97296
TIGARD, OR 97223
Phone: Contact #: PRI 503 - 220 -5377
FAX 503 - 295 -3012
FEES
Description Date Amount Reg #: ELE 26 - 45C
[ELPRMT] ELC Permit 12/12/200! $1,175.35 LIC 49737
[TAX] 12% State Surchar 12/12/200! $141.04 SUP 3924S
Total $1,316.39 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 obtain copies of these rules or direct questions to OUNC at 503 246.6699 or 1.800.332.2344
Issued By: Valal � ���
(� Permittee Signature: Ii 0 `1✓ �('n
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.
12/1;/2008 19:44 5032205347 PAGE 02
'' Pe rmit �A, licatio -
ECEIVE I ,IIt l(1-1-`,i
City of Tigard -• ive
13125 SW Hall Blvd., Tigard OR 97223 '': "' :Y' 12 12..0941_ PermnNo £ S .�n6
Phone: 503.639.4171 Fax; 503.598.1960 Pty Review
i , t , ., , , , Inspection Line 503.639.4175 DEC � + [ f J ; i 7 Dat R Other Pernut,
Internet: www.tigerd�r.gov v N0 Ready/By -� `i°y+ RI See Page 2 for
ant Noti6ed/Mer
. J �l_' Suppkniental loformadon
: IMF OF OIVISI ®N PLAN RE,
ID New construction ddition/altemtion/replaceme»t i el� all that apply (submit sae of ply w/ items checked below)
❑ Demolition 0 Other: ❑ Service or feeder 400 amps or more ❑ Building over three stones
where the available fault current ❑ Mannar; and boatyards.
1 CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings
❑ 1 - arid 2- family dwelling . 'CommerciaUindustrial less m ground, or exceeds 14
❑ Accessory b uilding CI commercial- Multi-family agrlcrxrrai
amps for all oilier mstallabons buildings
Y ❑Master builder ❑Other: ❑ Fire pump El lnstallabon of 75 K V A or
❑ Ei ' system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION %oN
D Addition of new motor load of ❑ "q g <y _2- 1 3"
Job no.: 13 '11 \ Job site addres uJ S 10011P or mo. Re
Cl Six or more =sideline] units ❑ Recreational vehicle parks
City /State/ZIP: -- ❑Health- care facilities.
on ❑ Supply voltage for more than
5 err Q V R 1 s ❑ Hazardous locatis too volts nominal
Suite/bldg./apt. no.: 1 Project name: ft.
C % 4 d r -Pi q $‘... ❑ Service or feeder 600 amps or more
Cross street/directions to job Site: p� _ FEE SC W
Uaac r Q4. Fee Total •
New residential single- or multi- family dwelling unit
Includes attached garage.
i Subdivision .. Tax map /parcel no.: 1 Lot no.: 1,000 sq. ft. or less 4
Ea. add'I 500 sq. ft. or portion 33.40 1
/B Limited energy, residential 145,15
- DESCRIPTION OF WORK (with above sq ft) 75.00 2
•
"" Limited energy, multi - family
Gr tar p\ �� Li �,s�..1 .1 Si residential (with above sy 0.) 75,00 2
J G Services or feeders installat on and/or relocation
�e 200 amps or less 80.30 2
ra PROPERTY OWNER 0 TENANT 201 amps to 400 amps t l 106.85 1
1 1S1J 2
4
Nettle: 401 amps to 600 amps 160,60 2
City /State/ZIP:
Address: 601 amps to 1,000 amps 240.60 2
Over 1 ,000 amps or voles 454 65 2
rs Temporary services or feede iostallatlon, alteration, and/or
k relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100,30 z
intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel _
❑ APPLICANT A. Fee for branch circuits with
- -
❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch chains
Contact name: without service or feeder fee, 46.85 2
4 ,n
first branch circuit
Address: Each WW1 branch circuit 6.65 2
Miscellaneous service or feeder not included _ �
City/State/ZIP! Each manufactured or modular
90.90 .90 2
dwelling, service and/or feeder _
Phone: ( )Fax:: ( )
Reconnect only 66.85 w 2
E-mail: Pump or irrigation circle 53.40 2
li CONTRACTOR Sign or outline lighting 53.40 2
Business »erne: ' C 14 -
Signal panel, or limited -
$il '� energy p alteration, or
Address: '' o Q 0 x \ a % extension. Describe: Page 2 2
I
City/State/ZIP: ip \ j l�1r O' D r l Each additional inspection over allowable in any of the above
l / Per inspection 62.50
Phone: (
Ea 3) ,Q) D - S 7"11 1. Fax: (SO) 0\ S _ 73 0 l L. Investigation per hour (I hr nun) 62.50
CCB H C Lie,; 11 Electrical Lic. : 2&r- L 5(, Suprv. Lie.: ( 9345 S industrial plant per hour 73.15
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 1 `NS.
c. —
_ 1 �aS
Pei i -. 7 • • . pate: f �( Plan review (25% of permit fee):
`SS +i � �: ..
r -.r -
State Surcharge (12�/r of permit fee): 1 b `A
Authorized sign. re: •J Z 3 --S TOTAL PERMIT FEE: 1' j. 301
!1 a Date: Tub permit application expires ifs permit is oat obtained within 1F0
days after it bas been accepted as complete
• Number of inspections allowed per permit.
t \5r tdIo5\P rror.�Yt C- vermeApp ea 05/23/06 440-461 sip 1/05acaxvwea