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Permit
is C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT PERMIT #: ELR2005 -00138 DEVELOPMENT SERVICES DATE ISSUED: 6/1/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600 -00300 SITE ADDRESS: 09516 SW WASHINGTON SQUARE RD H ZONING: C - SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG Project Description: Installation of camera & alarm system. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: X INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: WASHINGTON SQUARE LLC FIRST RESPONSE SYSTEMS GROUP BY THE MACERICH COMPANY 4970 SW GRIFFITH DR 9585 SW WASHINGTON SQUARE RD BEAVERTON, OR 97005 TIGARD, OR 97223 Phone: 503- 639 -8865 Phone: 503- 207 -5300 • Reg #: LIC 111713 ELE 26 -956CL FEES Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 6/1/2005 $75.00 [TAX] 8% State Surcha 6/1/2005 $6.00 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. Issued By: Permittee Signature: _ ct-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. Jun. 1. 2005 7:49AM First Response -__•..W No.1415 P. 1/3"' •' Electric ffotAygbation FOI; OHICE 11Si_ ONLY • Received Date/BY: 6 - / - � i , erTT t City, of Tigar Planning Approval Sign Permit 2 0D� �/DI, j 13125 SW ]`fall Blvd, Dat&8y Permit No.: Tigard, Oregon 97223 JUIJ ®1 2005 Plan Ravie�+ , other -- Phone: 503 -639.4 Lennie e 171 Fox• 503 -5 8 gin.. ,, Post R ev i ew tine Use Internet: warw.ci.(g .Vr.G)F TIGAKU ti 41'1 Date/13y: Case No.: g��r���9 ntf� ! Contact 11141 rei See rage 2 for 244101.1f InSpectt `C7'S�i •i0 ' ' ' Narne/Me0wd: / � I Supplemental Information. New construction ' r: C0115'b'l1ChOn ..•::• ..a R ;a i'a.. .: %•r Y =� = '- ��''•'t�7p.IS" • �rtt� -,. .(�69aC:�E��I',p u, Demolition - ❑ service over 225 amps. p Nea1t.carc facility AddiLin/alterati0n/replacemeut Other: copal 0 Hazardous tocad000 � � ❑ Service over 320 amps - rating of ❑ Building over 10,000 uarc fee • l r �O>t :CO i s • • 1IlCT�ON:..•a_ . ';•:: • sR - rr - . � 1 & Z family dwellings four or more residattial units in azta 1 & 2- Fily dwelling Imo- • ercial/Industrial ❑ SYstGm over 600 molts nominal one structure t7 Accessory Building Multi - Fam ❑Binding over three stories 0 Feeders, 400 amps or more Master Builder ooeupant laud over 99 persons © Manufactured structures or RV park • — 1171 O ther : _ ❑ Ege34/Iiehrmg plan ❑ Other e' ` . c ":i', .40.*SITE:I'NEORIFATl•�1: eL CA1 ON! L.p•`,• .. submit _ sere of plans with any of the above. Job site address: (✓ the above are cot applicable to temporary as%i#i ^ � d �: +r p nary coaatraction service. Suite #: Bid /A r. #: Nutsber Of insistaloha per permit allow - ''"s' .: ri._ a .1 :: ,.�i_ : 'S!C� s3�: A? - - :;; :7 p .ec:; allowed Pro ect Na1n • e t Q I S Deserlodon Qry Pea tea.) Tpcat I Cross street/Directions to job site: New Idential -sin or apuiti -fwnuy per + I dwelling ann. Includes attached garage. • Sanite included: 1000 se. fl- or less 145.15 _ , 4 tech additional 500 R or pion there 33.40 I Subdivision: X ,ot #: ' Limited enertty..widenrial 75.00 2 Tax tnap/pareel #: L mited . non residential 75.00 2 is : ,.,:,,,!;)::,),::,.r......, ,. Fzchm / or f redhomeormodulardwelling DFS A . u OPr.AF]1 ORIE- :' .. i.: •;1;`,' ;; , :: ane andor sander 90.90 2 ?Teal J c�1M4o‘ J. o•Ldt,f �' sM i1 e. Smi aYfr� or feeders - iaaiialtadoo, J 'Iteration or rdocatioo; 200 amps or less _ 80.30 2 - 201 sinus to 400 temps .106.86 ' Z 401 stress to aPROP 1711 :0W FC1 :iy� 4' ®, 3- I a . ' :! ; ;:":�u'e,;.;;:c,7: ;s:' am 601 p. 160.60 2 '; rO 1 000 amps 60 2 sto Name: 66 Over 1000 =Ds or votes — _ 454.65 _ Reconnect only 2 66.85 2 Address: Temporary aarvicug or faders - installation, City/State /Zip: alteration, Or relocation: 200 amps or less 66.85 1 Phone: Fax: 201 amps m 4OO�p$ 100.30 " 2 ra?1 :CON'TRCT :t' c t , .;e „ . 401 to600ampr 133.75 2 Bran e -flew. alteraeiee, er Name: aRetnlon per panel: • _ Address: - a Fee f o r circuits With purchase of service or feeder fee. each branch circuit 6.65 2 City /State/Zip: B. Fee for branch circuits without t phase or Phone: 'Fix: service or r«eer�ti rust bnineb circuit 46,85 2 ,�� Each additiat>al branch circuit 6.65 2 E- 121ail: Mise_(Servlee er feeder not included); .v �. � :.N_.. .,,: L! r u c : Rea mop at irrimtioncircle 5340 2 Each 8 o r o utline it tin Job No 2� 4. 53,40 a 1 Signal c� s Or a tinned energy panel, ! - Business Name: F_ � 5 r /Pe: Bel sue, alteration. or extension P ete 2 7 2 Add ress: s w (j' p "'°" I ri i1 City /State /Zip:�� 1�bn OR 47005 Each additional inspection over the allowable is any of the above; Per itupeetior hour (min. 1 hour) . 62-50 Phone: sirs zo .5 Fax„ Zo 7- 5 Jo/ ' Investigation fee: CCB Lk. #:i//7/3 Lic. #:26- 9S�'GL c opt - Supervisin electrician r— -" :k, :.. 1` ?. ':F "aft tperUb Subtotal n ... : ?H -� si • attire re. uired: , / . , Subtotal S ' 7 5 Plan Review (7.5% of Permit Fee) $ Print Name: r . _ - .izs4 - zrifirjr: c.,46 a y Z State Sure ge (8% of Permit co) F S 4 .q uthorizcd , TOTAL PERMIT FEE S S/ Si attire: S Notice; This permit application expires If a permit is oot obtained wlthua ' Dauer 180 days after It has been accepted as complete.. 'Fee methodology set by Tri- Counry Building industry Service Board. J 'CS s{ , /V Please t name) is \Osts\Permit Farms \ElcloermitApp.doc 01/03 OF TIGARD t ti BUILDING DIVISION PERMIT #: ELR2005.00138 • 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/1/2005 • Phone: (503) 639- 4171 +� Inspection Requests (24 Hrs.): (503) 639 -4175 • I INSPECTION WORKSHEET FOR DATE: 9/912005 TIME: 7:07AM PAGE: 90 • SITE ADDRESS: 09516 ; . WASHINGTON SQUARE RD r=4; CLASS OF WORK: SUBDIVISION: WASHING , AN SQUARE LOT #: TYPE OF USE: PROJECT NAME: wN , JEWELERS DESCRIPTION: Installation of :mera & alarm system. OWNER: WASHINGTON So„ ARE LLC, PHONE #: 503633.8865 CONTRACTOR: FIRST RESPONS \YSTEMS GROUP PHONE #: 503-207 -5300 Inspection Request Scheduled For: Date: 9/9/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 015212 -01 503 - 207 -5340 N Corrections /Comments /Instructions: • Isg PASS • ❑ PARTIAL APPROVAL ❑ CANCEL • ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED r Inspector: Date: 2 ` Phone #: (503) 718- � .