Permit A l CITY OF TI CARD ELECTRICAL PERMIT
PERMIT #: i'. DEVELOPMENT SERVICES DATE ISSUED: 7/7/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S126C0-01107
SITE ADDRESS: 09536 SW WASHINGTON SQUARE RD
SUBDIVISION: H -13 ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of (2) branch circuits w/o feeder
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 HMI 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: 1 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 ROSE CITY ELECTRIC CO INC
BY THE MACERICH COMPANY 4012 NE CULLY BLVD
ATTN: JANET I S 9
HE ASSET MGNT PORTLAND, OR 97213 i �
SANTA
Phone: Phone:
287 -6164
Reg #: SUP 2127S
LIC 00003567
ELE 26 -113C
FEES Required Inspections
Type By Date Amount Receipt
Elect'I Service
PRMT GWL 7/7/00 $42.85 0003552 Elect'I Final
5PCT GWL 7/7/00 $3.43 0003552 OR't V I N n L
Total $46.28
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable
laws. All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work
is suspended for more than 180 days ATTENTION: Oregon law requires you to follow rules adopted byth e Oregon Utility Notification Center.
Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0080. You may obtain copies of these rules or direct questions to OUNC
at (503) 246 -1987
PERMITTEE'S SIGNATUR ISSUED BY
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OE TIGARD Plan Check #
Electrical Permit Applicatio
RECEI
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223
Date Rec'd / A ; / 7- 6 -oC
Phone (503) 639 -4171, x304 JUL 0 6 N0® Date to P.E.
Date to DST
Inspection (503) 639 -4175 Print of Type ��pp��
Fax (503) 598 -1960 Incomplete or illegible will not a e d PMENi Called Permit # pp VI u .' /-r q 3$ I
1. Job Address: ' II � 4. Complete Fee Schedule Below:
'
Name of Development '(I ' t/l.�(L ()ill -/ Number of Inspections per permit allowed
Name (or name ofbu ) mamma r.. Service included: Items Cost Sum 4,
Add re s ! 3t, LO as I • V1- S • 4a. Residential - per unit
City /State /Zip 1000 sq. ft. or less $ 117.75 4
..(/ 1
Each additional 500 sq. ft. or
portion thereof $ 26.25 1
Commercial Residential ❑ Limited Energy $ 60.00
Each Manuf d 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
information for COT data e). Installation, alteration, or relocation
Electrical ontractor e__ _,_■ ' ' Lc-.. 200 amps or less $ 64.25 2
Addre IZ�_ _ , y �_t 201 amps to 400 amps $ 85.50 2
401 amps to 600 amps $ 128.50 2
City State �ff Zip 2-(� 601 amps to 1000 amps $ 192.50 2
Phone No. p 6 ..D-,Y 7 cc (( Over 1000 amps or volts $ 363.75 2
Job No. / y 3 - Reconnect only $ 53.50 2
Elec. Cont. Lice. No. .236170. - p.Date 1 4c. Temporary Services or Feeders
OR State CCB Reg. No. 51 `7 Exp.Date it /U 0 Installation, alteration, or relocation
COT Business Tax or Metro No. 10 .1 E p.Date L'61 200 amps or less $ 53.50 2
�J/ / + 201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n 1 i O� 401 amps to 600 amps $ 107.00 2
-- Over 600 amps to 1000 volts,
2i Z7 Exp.Date ID "b" above. /'" see � " •
License No. '7 ` � �I
Phone No. 2_ 1 �i (o -T 4d. Branch Circuits
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
b) The fee for branch circuits
Address without purchase of service
City State Zip or feeder fee. ��
Phone No. First branch circuit $ 37.50 ____-
Each additional branch circuit $ 5.35 ���
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
3. Plan Review section (if required):*
panel, alteration or extension $ 60.00
Minor Labels bels (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
Service and feeder 225 amps or more Per inspection $ 50 00
Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
descnbed in N E.0 Chapter 5 5. Fees: � �
5a nter total of above fees $ ��
* Submit 2 sets of plans with application where any of the above apply. % Surcharge (05 X total fees) $ 3 �J
Not required for temporary construction services. ubtotal $
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 - 1</
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