Permit CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00036
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/7/2007
PARCEL: 1512600 -00300
SITE ADDRESS: 09500 SW WASHINGTON SQUARE RD JCPEN ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: JC PENNEY. Relocate data lines for registers.
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:
WASHINGTON SQUARE LLC ST JOHNS ELECTRIC INC
BY THE MACERICH COMPANY 4415 NE MINNEHAHA
9585 SW WASHINGTON SQUARE RD VANCOUVER, WA 98661
TIGARD, OR 97223
Phone: Contact #: PRI 360 - 693 -5100
FAX 360 - 699 -1345
Reg #: ELE 37 -350C
FEES LIC 43135
Description Date Amount SUP 3024S
[ELPRMT] ELR Permit 2/7/2007 $75.00
[TAX] 8% State Surcha 2/7/2007 $6.00 REQUIRED ITEMS AND REPORTS
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 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: �iT . Permittee Signature: _s ( pq
a 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.
EEB - 7 -2007 07:34 FROM: ST. JOHNS ELECTRIC 3606991345 TO: 15035981960 P.2
ElPCtricai- Permit .A lice I OU 01 l It I. t:SI_ ONI
City of Tigard • `'° ' 4, � � ��� - Received � -
• 13125 SW Hall lvd., Tlgard, OR 97223 Date/8 T' _ �A ) Pam1t No.: „,/ 1 ��o •
■ ir'7i .
Phone: 503.639.4171 Fax: it 503.598.1960 F- l 0 A, °.�- I . . - "Other Permit: - - — — - - - - - --
:i ;: I , - natd9y: -
Inspection Line: 503.639.4175 �I' � Date Ready/By: Judo: I ® See Page 2 for
Internet www.ci.tigard.or.us C1TY OF - za D Notified/Method: Supplemental Information
❑ New construction ddition/alteration/replacement P ease - k . I .. apply:
❑ Demolition ❑ Other. - - -- - --- - - - - -- - --•- — °Service over 225 amps, comm'I ❑Hazardous location -
°Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
°Building over three stories ❑Feeders. 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other:
❑Occupant load over 99 persons ❑Manufactured structures or
ifo) LI!iiI •li(ulti.iyr. \in(ui r ': II _ctI/I ;‘%II (uN . RV park
❑Egresslllghting plan
Job no.: Job site address: ,, / ❑Health -care facility °mew
I500 SW iO* ?S f - n// S. Pd Submit 2 sets of plans with any of the above.
City/State/ZIP: , The above are not applicable toy m construction service.
Tq� -ol
Suite/bldg./apt. no.: I Pro name: -- /I 1 / ST �
(� r4•YI VJD( /Yl�l Dem cripaon Qty. Fee. Total
Cross street/directions to job site: / New residential single - or mul - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less _ 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33 40 1
Limited energy, residential 75.00 2
Tax map/parcel no.: Limited energy, non - residential 75.00 2 • ii) C ice` 911[0,- Ti \ Xii110 Ea ch man or modular
J dwelling, service and/or feeder 90.90 2
A ' - A-' . . . i i - ... . Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
i C) A.443 A etaMy li DI `I0 1 °', 201 amps to 400 amps 106.85 2
•_ — -. — - --..__ -- _. _:-- -_. _,L . - - - - .---- �__ -_ .. - 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/ State/ZIP: Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
r _ • a -fla i A r T n C7 tl r 6I p sR$Ov A. Fee for branch circuits with
service or Business name: branch circuit
fee, each 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
Address: each branch circuit
. Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Pump or irrigation circle 53.40 2
I Fax: ( ) Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited-
' o '. "- o �,7i1 et o i ' ---' , -"' -- - '- energy panel, alteration, or
Page 2
extension. Describe:
Business name: .S/ . 3 - 1 ,7). 11 , 7c ,'
jr,-c. -/r
te / 7 `v o 2
Address: L.,}4,2_ Each additional inspection over allowable in any of the above
yY/ S /A � /ham{ Per inspection 62.50
City/ State/ZIP: a W - 1'66 / Investigation per hour (I hr min) 62.50
Phone: (360) 6 93 _ S /D 0 Fax: (34.0) 613— industrial plant per hour 73.75
CCB Lic.: 93 /3 Electrical Lie.: 37 5,c, S� . Lic.: 3062,(fs Subtotal 7500
Suprv. Electrician signature, required: _ // 40.1 ' Plan review (25% of permit fee)
State surcharge (8% of permit fee) G oQ
Print name: / er r ' rate: . 1_ 6 — Q TOTAL PERMIT FEE g/� D
Authorized signature: // ' This permit application expires if n permit is not obtained within 180
eC1c j Date: days after It has been accepted as complete
Print name:
R , - 1 l I j to —o 7 Fee me thodology act by Tri -County Building Industry Service Board
• • Number of inspections per permit allowed.
i:\ Building \Permiu\ELC- PermitApp.dac 12/03 440-4615T(10/02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: at 82007.00036
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: J/' 7/ )0;a7
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175 �' `''��
INSPECTION WORKSHEET FOR DATE: 10/4/2007 TIME: 7:02AM PAGE: 67
SITE ADDRESS: 09500 SW WASHINGTON SQUARE RD JCPEN CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: JC PENNEY
DESCRIPTION: JC PENNEY. Relocate data lines for registers.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: ST JOHNS ELECTRIC INC PHONE #: 36(1693.5100
Inspection Request Scheduled For: Date: 10/4/2007 Pour Time:
Code # Inspection Description ;Confirms# Contact # essage
199 Electrical final 056911 -01 360-693-5100 Y
Corrections /Comments /Instructions: .� - J6p_ 7 Z \ q l'b
00N
V
4 /
Ai
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ( — f ' AL3 Le Date: 1101 ql 'Y) Phone #: (503) 718- 11.14