Permit `,'� ` CITY OF TIGARD ��
DEVELOPMENT SERVICES ELECTRICAL PERMIT
PERMIT #: ELC2005 -00828
�ll DATE ISSUED: 10/21/2005
' I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09500 SW WASHINGTON SQUARE RD JCPEN ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: (4) branch circuits, (1) low voltage for data/telecommunications. Job #C50394.
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: 1
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: 3 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 CAPITOL DATA & COMMUNICATIONS
BY THE MACERICH COMPANY 11401 NE MARX ST.
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97220
TIGARD, OR 97223 '
Phone: Phone: 503 - 255 - 9488
FEES Reg #: LIC 142457
ELE 26- 1054CLE
Description Date Amount
[ELPRMT] ELC Permit 10/21/200: $141.80
[TAX] 8% State Surcharge 10/21/200: $11.34 REQUIRED ITEMS AND REPORTS
Total $153.14
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: , Permittee Signature: cc-e_,
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.
S FOR OFFICE USE ONLY
■
Electrical Permit Application ReceiveY Permit no.: �� �/� i
� E C E I V Date/B %' I� A
City of Tigard E Plan Review
� f Other Permit
13125 SW HALL BLVD., TIGARD, OR 97223 Ali Date/By.
Phone: (503) 639 -4171 Fax (503) 598 -1960 2 1 2E5y OF TIGARD Date Ready /By: Juris: Li See Page 2 for
Inspection Line 503- 639 -4175 OCT 1, 1 WJ Notified/Method. jki— Supplemental Informauon
Internet: www.ci tigard or.us CITY OF TIGARD
TYPE eES/Ir,G DIVISION PLAN REVIEW
H New construction H Addition/alteration /replacement Please check all that apply.
❑ Demolition ❑ Other: ❑ Service over 225 amps, comm'I ❑ Hazardous location
CATEGORY OF CONSTRUCTION ❑ Service over 320 amps - rating ❑ Building over 10,000 sq.ft.
u I- and 2- family dwelling H Commercial /industrial ❑ Accessory building of 1- and 2- family dwellings 4 or more new residential
❑ Multi- family ❑ Master Builder ❑ Other ❑ System over 600 volts nominal units in one structure
JOB SITE INFORMATION AND LOCATION LI Building over three stories ❑ Feeders, 400 amps or more
Job no.: C50394 9500 SW Washington Squat ❑ Occupant load over 99 persons ❑ Manufactured structures or
❑ Egress /lighting plan RV park
City /State /ZIP PORTLAND, OR 97223 ❑ Health -care facility ❑ Other:
Submit 2 sets of plans with any of the above
Suite/ bldg /apt. no.. Project name. JC Penneys The above are not applicable to temporary construction service.
FEE SCHEDULE
Cross Street/Directions to job site Washington Square Mall Description I Qty. I Fee. I Total I "
New residential - single or multi - family dwelling unit.
Subdivision Lot no : Includes attached garage.
1000 sq. ft. or less $ 145.15 4
Tax map /parcel no.: Ea. Add'I 500 sq. ft or portion $ 33.40 1
DESCRIPTION OF WORK Limited energy residential $ 75.00 2
Electrical and Low voltage Limited energy, non - residential 5 75 00 2
Each manufactured home or modular
H PROPERTY OWNER I L I TENANT dwelling, Service and/or feeder $ 90.90 2
Name: Service or feeders installation, alteration, and/or relocation
200 amps or less $ 80.30 2
Address 201 amps to 400 amps $ 106.85 2
401 amps to 600 amps $ 160.60 2
City/State/ZIP: 601 amps to 1000 amps $ 240.60 2
Over 1000 amps or volts 5 454 65 2
Phone Reconnect only 5 66.85 2
Temporary services or feeders installation, alteration, and/or
Owner installation: This installation is being made on property that I own which is not relocation
intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701 200 amps or less $ 66.85 1
201 amps to 400 amps $ 100 30 2
Owner signature: 401 amps to 600 amps $ 133 75 2
H APPLICANT I H CONTACT PERSON Branch circuits - new, alteration, or extension, per panel
Business Name: A. Fee for branch circuits with
service or feeder fee, each
Contact name. branch circuit $ 6.65 2
B. Fee for branch circuits
Address • without service or feeder fee,
each branch circuit 1 $ 46.85 46 85 2
City /State /ZIP. Each additional branch circuit 3 $ 6.65 19 95 2
Miscellaneous (service or feeder not included)
Phone: Fax: Pump or irrigation circle $ 53 40 2
Sign or outline lighting $ 53.40 2
E-mail Signal circuits(s) or limited -
CONTRACTOR energy panel, alteration, or
Business Name: CAPITOL DATA & COMMUNICATIONS extension. Describe: 1 Page 2 575 2
Contact name RAY YOUNGER Each additional inspection over allowable in any of the above
Per inspection $ 62.50
Address. 11401 NE MARX ST. Investigation per hour (1 hr min) $ 62.50
Industnal plant per hour $ 73.75 _
City/State/ZIP PORTLAND, OR 97220 -1041 ELECTRICAL PERMIT FEES°
Subtotal 141.80
Phone: 503- 255 -9488 Fax. 503- 257 -7121 Plan review (25% of permit fee)
State surcharge ( 8% of permit fee) 11 34
CCB Lic.: 48748 IEeectrical Lic.. 26 -496C ISuprv. Lic 3132 S TOTAL PERMIT FEE 153.14
This permit application expires If a permit is not obtained within 180
Suprv. Electrician signature, required � ,� A ,'�^
Jyyl/�i - `i — days after it has been accepted as complete
Print Name. Darrell McNeel Date. 10/2 / 5 • Fee methodology set by Tri- County Building Industry Service Board
Authorized signature .*Number of inspections per permit allowed.
Print Name Darrell McNeel l i't/"
•
T
CI l Y OF ACA■ D
BUILDING DIVISION PERMIT #: ELC2005 -00828
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/21/2006
Phone: (503) 639-4171 .
Inspection Requests (24 Hrs.): (503) 639 -4175 !:W'
INSPECTION WORKSHEET FOR DATE: 11/3/2005 TIME: 7:06AM PAGE: 31
SITE ADDRESS: 09500 SW WASHINGTON SQUARE RD JCPEN CLASS OF WORK:
SUBDIVISION: WASHINGTON 'SQUARE LOT #: TYPE OF USE:
PROJECT NAME: JC PENNEYS
DESCRIPTION: (4) branch circuits, (1) low voltage for data/telecommunications. Job #C50394.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: CAPITOL DATA & COMMUNICATIONS PHONE #: 503- 255 -9488
Inspection Request Scheduled For: Date: 11/3/2005 Pour Time:
•
Code # Inspection Description Contact # Message
199 Electrical final 020243 -01 971 - 533 -9522 Y
a
Corrections /Comments /Instructions: • S `�
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 x(13 Date: 1.I • - j • � j Phone #: (503) 718 - '13•0J/0