Permit # ` CITY OF TIGARD ELECTRICAL PERMIT
„
PERMIT #: EL 007 -00300
° - .. COMMUNITY DEVELOPMENT DATE ISSUED: 5/2
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09510 SW WASHINGTON SQUARE RD H -1 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
PROJECT: TRADE SECRET
Project Description: (1) 200 amp temporary service.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: 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 J.C. ELECTRIC, INC.
BY THE MACERICH COMPANY 118 NW 184 STREET
9585 SW WASHINGTON SQUARE RD RIDGEFIELD, WA 98642
TIGARD, OR 97223
Phone: Contact #: PRI 360- 887 -7889
FAX 360- 887 -5584
FEES
Description Date Amount Reg #: ELE 37 -724C
[ELPRMT] ELC Permit 5/2/2007 $66.85 LIC 118452
[TAX] 8% State Surcharge 5/2/2007 $5.35 SUP 4289S
Total $72.20 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 B / .// Permittee Signature: 5, 1 /9f) //ctcht�
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.
' 05/02/2007 11:04 3608875584 5.C. ELECTRIC, INC. PAGE _02/03 ' -
I► ADD lb txg.:>tav t -001 + ' e ` Ct z 1'O . • K , 17 - It)
E ectri ;al rerlmi.t Anpiic y t n, c ., : „ ) . .. ` .` , . . FOR OF I( Ii 1.15E O' L
City of Tigard "' t J. • eceived
Date/8y. Permit No.' Gi G?� , 3ry1
1 - 13125 SW lfall Blvd. Tigard, OR 97223 {�j Vt:G
m Plan Review
... Phone: 503 639.4171 Fax; 503,598.1960v 2 Date B Other Permit: r2�� - CoZZ`1
l'1 G A l: b. Insp ection Lino; 503,639.4175 ilk( l 0 < 2001 Date Ready/By: mss: El See Page 2 for
., Internet: www.tigard or.gov Noti6ed/Method: Supplemental Information
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E New construction ❑ Addi / � tjj ' : ; Please check all that apply (submit a sets of plans w /items checked below)'
�
El 'Demolition ❑ Service or fader 400 amps or mars ❑ 13uildiatg over three stoles.
�. er where the available fault anent ❑ Marinas and boatyards. •
, t
Rp 1� F! ' 1 I f 1 t ` {, {7 . i u j P Vtin t ear+ rI I ` # p° 31!33 3,r i•ir1el `
zl I'I i i i 5`13'_ I ! r l { exceeds l0.000 1 t; �tl . = 4'EEi lll l i f u� I. r ?r�ft , H 4 1�1 1 1 1 ,h i 0111131i3•3113133 l r l t l tij n , 1 l �! I r 1111 * �I ti �: amps at 150 volts or ❑ Floating buildings. I'll less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- ftunily dwelling ® Commercial/industrial in Accessory building amps for all outer installations. buildings
❑ Multi- family 1 y} ❑ Master builder ❑ Other: III Fire pump. 0 lnstallation 0f75 IC VA or
R � j ti i fl l + t i t i l 3 t i ii t i `t } n { , i t�� ? �I err {l F`Ii , llfj) t i! }}si c f ell I 3 i� 1• i , f }�!I<ri � i't` � I � . ! l l� ' `I ; { ft r t } I . }61 ❑ Emergency system.
;1 ;i i,i,i) II, 1,r ,:I I I i I!xr Ir, " }'r r cJr;rO uttr,,:6:4?Itiltbil �,_. ��?fBill ,, t4,1;'i #a ;r.Rtlu;dn :t:� :� �,I �r! f # t a� f�,14 ,. , fi` ❑ Addi larger separately derived system.
af m otor l oad of ❑
Job no.: Job site address: 09510 SW WASHINGTON SQ RI) 10011P or more. o a°cy
❑ Six or more icaidemial twits, CI Recreational reLir.lc parks
City /State/ZIP: TIGARD OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ klazainlous locations. WO volts nominal.
Suite/bldg. /apt. no.: K - Project name: TRADE SECRET ❑ Service or fader 600 an •s or more
if'f I'tI t 7} " 1 �l t ' u u1l l : I `' (4 „1i�1, , ,} � , 1 ,}t � } r } �i rt j 1 f i}} tt t E)
li 1„ItliTi Ifl� !i r�lllrflr :�llIt�Il 1,1i lcni311:ii'�11 i14i!f {l �iit��lilillltl,�y MBi { RT
Cross street/directions to job site: WASHINGTON SQUARE MALL nescriptioa Ow. pee, Tong •
New residential single- or multi- family dwelling unit.
SPACE K -1 Includes attached garage.
Subdivision; I Lot no.: 1,000 sq. ft. or less 4
Tax map /parcel no
Ea. add'I 500 sq:.It. or portion _ 33.40 1
. , ti i ,t) Limited energy, residential
X91 � t} I l� �s1 I ( "t 'C.� t,tt`i 1ltII } } t t ]] t� 3 i1 t I)'yP,, , iris �l. i,! {i1 qulitlt r n;..t I, � t,Jllir -�; 1 ,t,', +{ ! I l�1t t1 } }�i r�1 {•�iy0,lS 1 11 � ,1y.1 {1 {, � 1 {1}{1l ° t1t 75.00 2
Litni
110. .ci't117W1 Illli ftii1V.4 1. ri +iitt 1. �rh!41� 'I 7C T!ilfl�ll�ICYISCit_ Ittl!i��t 41 1 111 tll[t� �,i7i71 3 #tISIIGIIiI ` (with abOve3G. ft) ted energy, muiri-family
(1) 200A SERVICE residential (with, above eq. ft.) 75.00 2
_Services or feeders installation, alteration, and/or relocation
I n c r { ie{ '''s1;111?r r!sl
+ r5rr t rtm r l il l nn e t ! r r 1 ' ` t t 3 i i , t -, 200 amps or less 80.30 2
i GI#.I i #.l. !I }.. A , t; ∎mft + rtt t l,11,,,lr;;l try E 13 , � 3 3. : 1 #t I i i ,, , 3 i, 5m # '' • tlii33i }! !; ' 4 1 �3 3.. 201 amps to 400 amps 106.85
Name: 00,41\ Y( o.r e 401 amps to 600 amps 160,60 2_
601 amps to 1,000 amps _ 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) i Fax ( ) 200 amps or less 1 66.85 _ 66.85 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 599 amps 133.75 2
Branch circuits new, alteration, or extension, er panel _
Owner signature Date: A Fee for branch circuits with
r ` - ? r „t v i r i tyc hi1�11 t ti,i 31 .ir i i I ' u , ` , a `'n��Jiilr�i l r ;iy }n ,mt}r {n n nAet[
Rant tgliMilf,7 ,.1!Ili lk„ .i.,.,,, ,,E,�., lliiii l #'rE111111f ]hill f�rf {I;::, t�ean�'14 ,n i ilnYli,t�,1�,41� edit l laif1E1J above service or tbeder fee. 6.65 2
each branch circuit
Business name: Be for branch circuits
Contact name; without service or feeder fee, 46.85 2 • first branch circuit
Address: Each add'l branch circuit 6.65 2
—
' City/State /ZIP: Miscellaneous feeder not included)
Each manufactured or modular
Phone: ( ) I Fax :: ( )
dwelling service and/or feeder 90.90 2
Reconnect only 66.85 2
•• t��tE -TTin}} ]ail: f (�f�) i f� }� { {�4�{ { ( I' �I `p ���� I t t p Pump or irrigation circle 53.40 2 _
tttiir _ii{fi :��i�F ��kt j;1" .H t ffillTINIR.1 4�r��iR idiTil r j llgIiili '!If`I;it;. titG1r1111� }��I�I�ilIi tifal� illllt "I'11ll114(, Sign or °tulles lighting $3.40 2
Business name: J.C. ELECTRIC, INC. Signal circuit(s) or limited -
energy panel, alteration, or
Address: 118 NW 184 ST extension. Describe: Page 2 2
City/State/ZIP: RIDGEFIELD, WA 98642 Each additional inspection over allowable bt an of the above
Per inspection 62.50
Phone: (360) 887 -7889 Fax: (360) 887 -5584 Investigation per hour (1 hr min) 62.50
' CCB Lie.: 11845 Electrical Lic.: 37 -724C Suprv. Lie.: 4289S Industrial p per hour y q { 7 P 73.75 { 1} �}�t} �(1
I.' ll �It1l ltirtlifiHi! 1 V `llll'fl.Aau�liii_i,lhl;ilja:8i il'�jl�il ti;. .Y }� I(MIE 1 r.l
ill?ifYit!I::tlll�ti '!1113Pi,
ii r,C. ,, Ili I 1 I �” �. 1 � C
Suprv. Electrician signature, required: Subtotal. 66.85
- , Print name: JON COUL1MORE Date: 5/2/07 Plan review (25% of permit fee):
— _ State surcharge (8% of permit fee): 5 35
' Authorized signature: ^ TOTAL PERMIT FEE: 72.20
This permit application expires if a permit is not obtained within 180
Print name: JON CO IMORE Date: 5/2/07 days after it has been accepted as complete.
l ;\ utndiasae iu\ELC- PoraitApp.doo 05/2,/06 40- 46ts7tiUOS /co�lnwEB • Ntaaabero £iospecdonsallowadperpamit.
,
CITY OF TIGARD
BUILDING DIVISION PERMI 6r, -l•l0 cuack ,
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: a. 'p" TIME: PAGE:
SITE ADDRESS: W 4, 61.) 5 ®, • y510 - N -∎ CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 6 Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: Cr -1 1\\(361-i + Date: s CT] Phone #: (503) 718 - I k