Permit v CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
•
° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00195
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/8/2008
PARCEL: 1512600 -00300
SITE ADDRESS: 09567 SW WASHINGTON SQUARE RD B03 B ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: FRED MEYER JEWELERS
Project Description: Installing (1) low voltage data system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC APPLIED TECHNICAL SYSTEMS INC
BY THE MACERICH COMPANY 6024 SW JEAN RD
9585 SW WASHINGTON SQUARE RD STE E -200
TIGARD, OR 97223 LAKE OSWEGO, OR 97035
Phone: Contact #: PRI 503- 684 -9611
FAX 503 -598 -0498
FEES Reg #: ELE 2 -71 CLE
LIC 89511
Description Date Amount SUP 2997LEA
[ELPRMT] ELR Permit 7/8/2008 $75.00
[TAX] 12% State Surch 7/8/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 or 1.800.332.2344.
Issued By:," , i / / Permittee Signature:
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.
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Electrical Permit Applicati0 ECEW f ' ` , ' I 1. 11 I l ti !.. (), 1 , t C 1 ' 9 L ' . :1 .' ;1-; ' '' t
1 '' _ Cit of Ti l 1 Q Z Received 4 :1 M.: • ' • !3125 SW Hall Blvd., Tiglyd, OR 97223. �
® • :.. Phone; 503.699.4171 Fax: 503.598.1960 RD S 'p�GUF!'= 000/ `'," Inspection Line: 503.639 4175 a ° p "f IG� Dale Ready/By runs Page 2 for
si ' ,. Internet; www.Iigard- or,gov C - ,GDw1S1� B ®
Notified/Method; (p Supplemental information
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C T yy * r l y ,: t x i „C.' r ¢
.ti+,�•- �r '�nw`�.n>san�...._�r,..- .w.xl „ �;� -,- r .. o',�c�c,F ��: �`�.:,.9.,'Jt71"Sl'lra � ..•:tr:l:';t'�r1
❑ New construction ® Addition /alteration/replacement Please check all that apply (submit 2 sets of plans whi mx checked below):
❑ Service or feeder 400 amps or more 0 Building over three stories,
[] Demolition ['Other: where the available thult current ❑ Marinas and boatyards.
�?.lgr .1 ° f ". (; a , exceeds 10,1100 amps al ISO villa or 0 Floating buildings
x a f ''rat : less to ground, or exceeds 14,000 0 Commercial -use agricultural
0 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps fbr all other installations buildings,
❑ Multi- family ❑ Master builder ❑ Other: 0 r,rn pump. ❑ Installation of 75 KVA or
i ,! ,. {a } .0 ;�.� ❑ Emergency system larger separately del ivcd system
'w ., , _. ,., ,, „ , . .. - ' -fc 4 ' ■ ❑ Addition of new motor load of ❑ "A", "E", "1.2 I "'i ",
Jul) no.: 00505 Job site address; 9567 SW Washington Sq. Rd 1 or more. occupancy.
0 Six x o or r more residential units. 0 Recreational vehicle parks
Ciry /Statc/ZIP: 97223 ❑ Health.care fact 0 Supply voltage lei awe than
CI Hazardous loeatimu. 600 volts nominal,
Suite/bldg. /apt no.: BO3B Project name: Fred Meyer Jewelers 00505 ❑ Service or feeder 600 snips or more
Cross street/directions to job site: Green bur Rd ` "'
ti _ Description Qrv. woo. � Tnr.l 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
Tax map /parcel no.. •
Limited energy, residential
.., . ; f w1+ tii1FS .., ...- , i w ,.1 c N i "+xv 75 00 2
a ".'" ' ' .' ^" M ] (�{ ) +� 'i: <av 3 y. a ^ ,:' . with above ft
<'l ic..•�a ..�..nkr,.wwaa. �a..3..n,w � ivJ/R�,C .lV •A 1 1T/E � 2 ( �1 ) —. —. _ ■
Phone and Data cable Install Limited energy, multi- family 75 2
residential (with above sq. ft )
Services or feeders installation, alteratun, and/or relocation
200 amps or less 80.30 ' 2
xM I �K',:', t e Y • , '# , ..
�3 t r ' * ,.� .< r _ ; s : s u �i l ?l 201 amps to 400 amps 106 85 2
Name: 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 1 own which is not 201 amps to 400 amps 100,30 2
intended for rule, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature; Date: Branch circuits — new, alteration, or extens per panel
A Fee for branch circuits with
: y
f f ''' -,. viig 7 l! .14:,t1.1, ,'!1' , 4 t , ;r.3a . S rt ,;-4..•,;;;,.;,,z31 I. above s ervice or feeder fee, 6.65 2 •
each branch circuit
Business name: Applied Technical Systems B. Fcc for branch circuits
without service or feeder fee, 46.85 2
Contact name: Matt Phillips first branch circuit
Address: 6024 SW Jean Rd NE - 200 Each odd'I branch circuit I. 6 65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Lake Oswego, Oregon 97035 Each manufactured or modular 90,90 2
dwelling, service and/or feeder
Phone: (503) 6849611 Fax: : (503) 5980498 Reconnect only 66.85 2
E -mail: m.phillips(atatsdata.com Pump or irrigation circle 53,411 2
ganlantitaMfdx ° .. e=�;: - 3.1A•71.;.,KItiW; Sign or outline lighting 53.40 2
Business name: Same Signal circuit(s) or limited -
energy panel, alteration, or I CIO
xt
Address:
extension. 1)escrir. - s itt:Y -7S 2
V ��
,_ City /State/ZIP: Each additional inspection over allowable In an of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lie.: 89511 Electrical Lic.: 2 -71 CLE Suprv. Lie.: 2997LEA Industrial plant per hour 73.75
Suprv. Electrician signature, required: „ ,...Z Subtotal: 75. a0
Plan review (25% of permit fee): " If,--- Print name: Matt Phillips hate: 7/8/08 - --
State surcharge (12% of permit fee): .00
Authorized signature. lliEVtg TOTAL PERMIT FEE: 84.00
Print name: Matt Phillips Date: 7/8!08 This permit application expires if a permit in not obtained within 180
days after it hos been accepted as complete.
' Number of inspections allowed per permit
nnoa a, „ „,,„F,\i- PeovsAppdo: 012)/00 440- 46iS't'(I1105lCOist'WtD
Z d S 1800000SL ' °N /Ztr : L '18/817:L 8002 8 1n ( 3n11) HOad
CITY OF TIGARD
. BUILDING DIVISION' PERMIT #: ELR200I3.00195
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/0/20013
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 _ " 'IL .
INSPECTION WORKSHEET FOR DATE: 7/16/2008 TIME: 7:00AM PAGE: 11
SITE ADDRESS: 09567 SW WASHINGTON SQUARE RD B03 B CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: FRED MEYER JEWELERS
• DESCRIPTION: Installing (1) low voltage data system.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: APPLIED TECHNICAL SYSTEMS INC PHONE #: 503-684 -9611
Inspection Request Scheduled For: Date: 7/16/2008 Pour Time:
Code # ' Inspection Description Confirm # Contact # Message
135 Low voltage 07272f3 -01 503-860-0790 N
Corrections /Comments /Instructions:
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•
•
•
t ASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
H •FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
, Inspector: 6 ` N Q5 Date: 1,l Phone #: (503) 718-
CITY OF TIGAR®
BUILDING DIVISION PERMIT #: ELR2008- 00195
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/0/2008
Phone: (503) 639- 4171Qi'II�
Inspection Requests (24 Hrs.): (503) 639 -4175 s' 1 L.
INSPECTION WORKSHEET FOR DATE: . 7/15/2008 TIME: 7 :00AM PAGE: 39
SITE ADDRESS: 09567 SW WASHINGTON SQUARE RD B03 B CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: FRED MEYER JEWELERS
DESCRIPTION: Installing (1) low voltage data system.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: APPLIED TECHNICAL SYSTEMS INC PHONE #: 503-684-9611
Inspection Request Scheduled For: Date: 7/15/2000 Pour Time:
Code # Inspection Description Confirm - # Contact # Message
135 Low voltage 0'2621-01 503 -660 -0790 N
Corrections /Comments /Instructions:
•
.11ZASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �' o• Le Date: ill gI a Phone #: (503) 718- 140