Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
�; DEVELOPMENT SERVICES PERMIT #: ELR2005 -00015
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 DATE ISSUED: 1/18/2005
SITE ADDRESS: 09546 SW WASHINGTON SQUARE RD H -16 PARCEL: 1S12600 -00300
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: 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: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC HONEYWELL INC
BY THE MACERICH COMPANY 15495 SW SEQUOIA
9585 SW WASHINGTON SQUARE RD STE 100
TIGARD, OR 97223 PORTLAND, OR 97224
Phone: Phone: 968 - 3300
Reg #: SUP 941 LEA
LIC 150191
ELE 26- 207CLE APP. SAYS Cf
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 1/18/2005 $75.00 Elect'I Final
[TAX] 8% State Surcharl 1/18/2005 $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 4 l �,,,, _it , A-4/t6v7J Permittee Signature 11-x-- Goo _pJJ -c ,•
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 7:00 P.M. for an inspection needed the next business day
JAN -18 -2005 14: 11 HONEY 1415 503 968 3398 P.02/B2
Electrical rernut A. V •
City of Titgard Received Date/By: t .. /g 86 Permit No: —15 /c
13125 SW [1a11 Blvd., Tigard, OR 97223 n pi 1 1 p Pl Review
Phone: 503.639.4171 Fax: 503,596.1960 JAN 8 ZOOS z'' , ,,' "t +',•- f '� Date/By: OtherPemar.
a
°
r InsyTt:cti�n ?.ine:�03.639.4175 �• ' W , A i' ' D ate Read y /By: Rim 0 Se Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGA '' Notified/Method: ". 7/ j Supplemental Information
�F�'ww.�'_ri: ".� .`:F'�.. y','Ir uW :. �1� ti7 [ .1•,Z _ b ' ' sT ^- . �: t I .' :•r��'ti:... , -,.•� .I,..� ..
_
'3i.. l W ~ te ;; 5rr,: ' ^' ;t ` �� n •�'. • , :- ;:;" S +avl. r ',:r ,i yl 1't >:; �: �� .. i . P4., !T•.Ii *.
r.1`.. '•' �yy�N�r✓'eL , wi l. � S ���_ =• `.` .� ',irl. -�..�: if ��.' jl �i.�y�:. � � _C� rl '.:.' 1 ..e._ '' , ?• ..
�i.i= t:4rj,.l a.�u:a�tiV+CT•'•M )st,':.b:�4.•: ". iii !.. .}1�. . • . • �.i .. .. . �. . r .� � _
❑ New construction [I Addition/alteration /replacement Please check all that apply:
❑Service over 225 amps, comm'l ['Hazardous location
❑ Demolition ❑ Other: ❑Service over 320 amps - rating DBuildng over 10.000 sq, ft„
; J •� n, I t .> - %i A4a ?1t� ` p . •w � P '.4.0 .. III +C '''� "` " ''ii 1 ' of 1- and 2•famil dwellin 4 or more new residential
❑ 1- and 2- family dwelling Cs Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories ['Feeders, 400 amps or more
o Multi family ❑ Master builder ❑ Other: park
, ['Occupant load over 99 persons ❑Manufactured structures or
tr's. - �� ' ,. s. r .• W. R V
-17 ;''',1'•''.''' s - �� iTil` 0 'r .,rt . i f t' ' .k' ;� [ ] ); gress/lightingo lan p
y,� (]Health - care facility ❑Other:
Sob no.:12 4U I'ST 3i Job site address 95� f; 6Y �a�/l_ l l/1 l � 1 [ Submit 2 sets of plans with any of the above.
City /State/ZIP: - DORM, Dr2 lZZ3 The above are not applicable to temporary construction service
Suite/bldg./apt no.: ,Project name: 3Vi rpe1' m � u � ' "° e• 1 ":cu:i+' it,
t
Desertpdaa Q F oe Tout *.
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
' 1,000 sq. ft, or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33,40 l
Limited energy, residential 75.00 2
Tax map/parcel no.: . , Limited energy, non-residential 75.00 2
] �I
� �- . 2• a b .�. r '.<w t e ..l, ry,�o, I tj t .� ;.t
i ,� [ �..'!JA �,s '+%1n'_h' � ~ h•^���r� " ",.`Q ' 7'7' .v nJ � Oi^ : �t� �l•• ' • • .1• ^...[i :e., r Fa _ ch manufactured or m odular
- - dwelling, service and/or feeder 90.90 2
la • 1 J a gyi, A ■ ' LL Services or feeders installation, alteration, and/or relocation
200 amps or le55 80.30 2
y� + � 'c I s'7 201 amps 5 106.65 2
yt.d•S „,,, d ; __ : + { �`a. • :1,'r•'.0 : , 'rtl . i 2:1,17, _. = .Ir::. • • .. • 401 amps to 600 amps 160.60 z •
Natne: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders Installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or loss 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 t 600 a mps 133.75 2
Owner signature' Date: Branch circuits -• new, alteration, or extension, per panel
�� .,, a 4 ,. M a a ,t;,` t.iF�. ,,; .: A. Fee for branch circuits with
, + , �=n ^� a ; :0.i ::fib3'�fF' Y xi - ... .',.'4,-, .,M1aAnu'}sSt':'i�
} ' service or feeder fee, each 6,65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.65 2
each branch circuit ,
Address: _
Each add'I branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) f Fax:. ( ) Signor outline lighting 53.40 2
E Signal circuit(s) or limited -
.rx ry - .,,.c rY. � . 7:: :' : .- ' ':�;_s•r..r• `' . ,'.. . ,.• v panel, alteration or
I ,1. ;.,,:t:,::,: , Page 2
r.' Sn': ' • k �. "• •4. y >� • Plq. ,� y�tl: 1
,Q , �r . a � � i ',� ti +•r• ..I . r >f l ' J;� 1t energy P r ,
s;,? r . '.`.a; ; i�.'... :; »:.:iL.:1:J . L;:_�. s:. �''.. - :;.:'zll a :r extension. Describe: 8 q 2
Business name: nett I J c4 ' ,, n` t p - -
Address: 415 J V sell 1A P'I t u 1/ X * �D D Each additional Inspection over allowable In any of the above
1 t Y `'°I tl Per inspection 62.50
City/StateZlP: PO y t OR 01-17.7.4 Investigation per hour (I hr min) 62.50
tog, �� r , /� �P D p 531 Industrial plant per hour 73.75
I ;
Phone: (J J) �O �J V I Fax: ( ) - I - ' ' , E10011 LA '. _ O 'l f'• '7 "'
CCB Lie.: 1 O 11 I Electrical Lic.: 4 - 1 cm Suprv. Lic.: 611411-al Subtotal '1s
Suprv. Electrician signature, required: � Plan review (25% 0 of permit fee)
` ' State surcharge (8% of permit fee) (
Print name: 5 �{/v4/ 1`- 'drtth,( tc.,.e Date - I l i s b S G
TOTAL PERMIT PEE el 1.W
Authorized signature: ;.. .1 1, This permit application expires If a permit Is not obtained within ISO
days after It has been accepted as complete
Print name: 'r eqe, 1 i l Date: tl 81 e j • Fee methodology set by Tri-County a uilding Industry Service Board
• Number of inspections per permit allowed.
:.tn..:u4...+a.,...ir,1ml1.4,,. hAtm.doc 12/03 440.4615T(10✓MM/COM/WEB
TOTAL P.02
CITY OF TIGARD 24 -Hour
BUILDING. Inspection Line: (50g) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested / AM PM BUP
Location 9 4 1 - • R ° S. RD, Suite MEC
Contact Person Ph ( ) 9 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR a0 000 /S"'"
Crawl Drain
Slab - Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: /
Other: ' � V --
Final \
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan •
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final •
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire larm
a Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE D Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date � \ ��� Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL