Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00199
DEVELOPMENT r O (503) 639 -4171
SERVICES DATE ISSUED: 4/25/00
— 13125 SW Hall
PARCEL: 1 S 126C0 -01107
SITE ADDRESS: 09508 SW WASHINGTON SQUARE RD
SUBDIVISION: ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Electrical TI, installation of 30 branch circuits. Job No. 2641.
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: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 29 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 ELECTRICAL DIMENSIONS INC
BY THE MACERICH COMPANY PO BOX 12146
ATTN: JANET FISHER, ASSET 3961 SW WILLAMS AVE 1\\-- SANTA MONICA, CA 90407 PORTLAND, OR 97212
Phone: Phone: 282 -7255 01C`
Reg #: LIC 00044008 -
SUP 2964S
ELE 26 -432C
FEES Required Inspections
Type By Date Amount Receipt
Elect'I Service
PRMT DEB 4/25/00 $192.65 1667 Elect'l Final •
5PCT DEB 4/25/00 $15.42 1667
Total $208.07
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE J Q�Q „ iM ISSUED B / �0eL4 •
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: � -41 • 0 ._0..�P • DATE:
LICENSE NO: d
5
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Electrical Permit Applicatio l�
,- Plan Che•-
;�
13125 SW HALL BLVD. Rec'd B • Ij(
TIGARD OR 97223 �� Date Rec'd D
n Q� Date to P.E.
�
Phone (503) 639 -4171, x304 p I e "065(6
0 k � ��'t Date to DST
Inspection (503) 639 -4175 af ' Print of Ty �,Q� ow ��OQ Permit# FCC' G
Fax (503) 598 - 1960 Incomplete or illegible will not be aged Called
1. Job Address: 4. Complete Fee Schedule Below:
1 ame of Development Number of Inspections per permit allowed
ame (or name of business) iNN ( HAW �� Service included: Items Cost Sum
Address eWO W 6ln� 4c2i p(t j7 4a. Residential - per unit
n �' 1000 sq. ft. or less $ 117.75 4
City /State /Zip 4117A.6P 042.01 0 4 Each additional 500 sq. ft. or
portion thereof $ 26/5 1
Commercial 181 Residential ❑ Limited Energy $ 60 00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
formation for COT data base). Installation, alteration, or relocation
.. lectrical Contractor t�1 4 c4i2 (AL SI /MI`'T' *Ent.i J$( 200 amps or less $ 64.25 2
) / ddress ( kl WIWtAM ik& 201 amps to 400 amps $ 85.50 2
City ' #L� TStip State O12 Zip 'l122%
401 amps to 1000 amps $ 192.50 2
600 amps $ 128.50 2
n 601 amps to 1
Phone No. 2-Q32 -1 Z4 Over 1000 amps or volts $ 363.75 2
Job No. * 2414 1 Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 'X- 4324 Exp.Date IC /00 4c. Temporary Services or Feeders
OR State CCB Reg. No. L144o) Exp.Date l/ Installation, alteration, or relocation
COT Business Tax or Metro No. OOOO I l7'� p.Date 7 co 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
7 /
401 amps to 600 amps $ 107.00 2
Signature of Supr. Elec'n ,_ ,./f i A / r� Over 600 amps to 1000 volts,
see "b" above.
License No. 14 64 S Exp.Date j all /O ( 4d. Branch Circuits
Phone No. '� '� �S New, alteration or extension per panel
a) The fee for branch circuits •
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 2
Address b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee. �1
Phone No. First branch circuit I $ 37.50 '%f `
Each additional branch circuit $ 5 35 15 5
S 1
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy
panel, alteration or extension $ 60.00
3. Plan Review section (if required): * Minor Labels (10) $ 107.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Per inspection $ 50 00
Service and feeder 225 amps or more Per hour $ 50 00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees:
5a. Enter total of above fees $ 192 .4S
* Submit 2 sets of plans with application where any of the above apply. 00 fi Surcharge ( 95 X total fees) $
Not required for temporary construction services. to
$
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $ ) t 27
r \dsts \forms \electric doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line:. 639 -4171
Date Requested
c P /69/60 AM PM BUP
n BLD .
Location gsoA Lt_5� S1 v ., Suite MEC •
Contact Person I 61r cAY\i Ph 2 2''7 Z 5 5 PLM
Contractor ( (( / / , [ l M eN'SS 0./5 Ph 8 SWR
BUILDING Tenant/Owner l.J I J'eJe/L ELC Z.Q)T — t )I 99
Retaining Wall _ ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab . SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling (.,/t -C -o .
Roof
Misc: -
Final
PASS PART FAIL
PLUMBING imp
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL .
•
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
CTRICAg)
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
i ' PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call fo reinspection RE: [ ] Unable to inspect - no access
ADA '
Approach /Sidewalk
Other Date . . . ,a' Inspector ,ue Ext
Final
PASS PART FAIL ! • NOT REMOVE this inspection record from the job site.