Permit I . ,. i C I TY O F TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00337
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/10/2007
PARCEL: 1512600 -00300
SITE ADDRESS: 09524 SW WASHINGTON SQUARE RD H - 8,9 ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: RUEHL
Project Description: Low voltage for CCTV
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:
INSTRUMENTATION: OTHER: CCTV X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC SUPERIOR LOW VOLTAGE LLC
BY THE MACERICH COMPANY 6548 LIPSCOMB ST SE
9585 SW WASHINGTON SQUARE RD SALEM, OR 9731.7 . '
TIGARD, OR 97223
Phone: - Contact #: PRI , 877 - 336 -6213 •
FEES Reg #: ELE 26- 1126CLE
LIC 150766
Description Date Amount SUP 3422LEA
[ELPRMT] ELR Permit 9/10/2007 $75.00
[TAX] 8% State Surch'a 9/10/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
This Permit is issued subject to the regul 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
Uti • otification = uter. Those'rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0100. You may obtain copies of these
r es or direct question to ti 'C 503.246.6699 or 1.800.332.2344.
Is ed By: # / ,/ IL l Permittee Signature: / 1 " 1 " ------- 74 -
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.
•
Electrical Permit Application FOR OFFICE USE ONLY
- Cl of Tigard Received P e rmit No ��
g Date/By. q /6 0 7 L t�337
III 13125 SW Hall Blvd , Tigard, OR 97223 Plan Review
C Phone' 503 639.4171 Fax. 503 598 1960 Date/By. Other Permit
T I G A li D Inspection Line: 503.639.4175 Date Ready/By rn 0 See Page 2 for
Internet. www.tigard or.gov Notified/Method 1a Supplemental Information
TYPE OF WORK PLAN REVIEW
EdNew construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards
CATECyORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
( less to ground, or exceeds 14,000 ❑ Commercial -use agncultural
El ❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory building amps for all other installations buildings
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system A
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: l S'5 / 1,' p IOOHP or more occupancy
5 W vvaSni r - 10 h S hi ❑ Six or more residential units 0 Recreational vehicle parks
City/State/ZIP: r ❑ Health -care facilities. ❑ Supply voltage for more than
ty T I )o- �� on q 2 a 3 ❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: Project name: ft u.e,h' ❑ Service or feeder 600 amps or more
J FEE SCHEDULE
Cross street/directions to job site: W h6 1'12,1 A,U re 144411 Description I Qty I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145 15 4
Ea add'I 500 sq ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. R )
Limited energy, multi- family 75.00 2
residential (with above sq ft )
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: (�/f/OlI
/ ),r . _ �, 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: ( ) Fax: ( ) 200 amps or less 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, per panel
Owner signature: Date: A Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: S(f c.r 10 ( LotAi t)o u-c4ye, LLC B. Fee for branch circuits
Contact name: Ma n G first
without branch service or feeder fee, 46 85 2
r O branch circuit
Address: Gs4.2 L; p b - g Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Sc KIP Of C1-) 2 I -7 Each manufactured or modular 90 90 2
dwelling, service and/or feeder
Phone: Fax:
77 >336 -�a13 ( $77 ),),?,( 0 - 6a1 3 Reconnect only 6685 2
E -mail: Pump or imgation circle 53 40 2
CONTRACTOR Sign or outline lighting 53 40 2
Signal circuit(s) or limited -
Business name: // 0
S( �,pGl� 1 Ir0 w U(7 � [,,fie / L LG energy panel, alteration, or //� D
Address: 6 5E-1g L / P`�-o� b S4-- 5 IC exjeimp esc be Page 2 �� 2
City/State /ZIP: S ck A tiviA. 7 OR (4 7 3) 7 A Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) I%t l0� Fax: ( l bD 0 I l l �� Investigation per hour (I hr min) 62.50
CCB Lic.: )so46(„ Electrical Lic.: ®- h-Iia6 Suprv. Lic.: 3yaa_LEA Industrial plant per hour 73.75
F �
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: O :^ Subtotal. 7 � 0
Print name: /14 CO5 A „! Date: C1 / /b /0 Plan review (25% of permit fee).
i �``� State surcharge (8% of permit fee). �Q •OU
Authorized signature: ' TOTAL PERMIT FEE: 5f ,0
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
" Number of inspections allowed per permit
1 \Building\Permits\ELC- PermiiApp doc 05/23/06 440- 4615T(11/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2- Supplemental Information , y\ ' . -
LIMITED ENERGY PERMIT FEES:
- - - -- — - - -- - - -- - - -- -- - - -- -- — -- -- - -- - --
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
El Audio and Stereo Systems*
❑ Burglar Alarm
El Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
T COMMERCIAL WORK ONLY: j
Fee for each commercial $75.00
system
(SEE OAR 918 - 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
El Medical
a Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling , .
El Other
Total number of commercial systems: _
*No licenses are required. Licenses are required
for all other installations
1.\ButldingWermus\ELC- PermitApp doc 03/23/06
CITY OF TIGARD
•
BUILDING DIVISION ' PERMIT #: ELR2007 -00337
13125 SW Hall Blvd., Tigard, OR 97223 r, DATE ISSUED: 9/10/2007
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 7I �.I
.
INSPECTION WORKSHEET FOR DATE: 11/161200 TIME: 7:01AM PAGE: 69
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SITE ADDRESS: 09524 SW WASHINGTON SQUARE RD 11-8,9 • CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: '
PROJECT NAME: RUEHL
DESCRIPTION: Lou voltage for CCTV
OWNER: WASHINGTON SQUARE LLC. PHONE #:
CONTRACTOR: SUPERIOR LOW VOLTAGE LLC PHONE #: 877 - 33(3 - 6213
Inspection Request Scheduled For: Date: 11/16/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 059764 -04 646.6482885 N
Corrections /Comments/ Instructions:
NO $ 71 C r(L oe) S17E ,
•
gj PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
„FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED •
Inspector:r 1 v Date: ‘V ' 4401 Phone #: (503) 718-
.