Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ICAL PERMIT 8
COMMUNITY DEVELOPMENT DATE ISSUED: 5/28/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
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: TI. Installing (21) branch circuits.
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: SIGNAUPANEL:
MANF HM/ 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: 20 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:
WASHINGTON SQUARE LLC A & A ELECTRICAL CONTRACTORS INC
BY THE MACERICH COMPANY 1588 SKY TERRACE
9585 SW WASHINGTON SQUARE RD SALEM, OR 97306
TIGARD, OR 97223
Phone: Contact #: PRI 503 - 949 -3193
FAX 503 - 378 -9085
FEES
Description Date Amount Reg #: ELE 36 -38C
[ELPRMT] ELC Permit 5/28/2008 $179.85 LIC 153711
[TAX] 12% State Surchar 5/28/2008 $21.58 SUP 3769S
Total $201.43 REQUIRED ITEMS AND REPORTS
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 800.332.2344.
Issued By:�� � _ de - ermi ee 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.
Electrical Permit Application eipr- -� , FOR OFFICE USE ONLY
City of Tigard \ti
Ill Received _y' Permit No L C v�C.�O �0
Date/B
- 13125 SW Hall Blvd , Tigard, OR 97 5: CO Plan Review
' lir Phone: 503.639 4171 Fax 503 598 ' . 3 � oo � DateBy. i Other Permit i� ?O�� l lf
l' I G A R IJ . Inspection Line. 503 639.4175 Al % Date Ready /By Jur 66 See Page 2 for
Internet www tigard -or gov IG k � �' fied/Method m j supplemental Information
TYPE OF WO ' Q ����s,� P LAN REVIEW ,
❑ New construction • - Addition /alteratid RC Please check all that apply (submit 2 sets of plans w /items checked below)
\ ❑ Service or feeder 400 amps or more ❑ Building over three stones
❑ Demolition ❑ Other: where the available fault current ❑ Mannas and boatyards
CATEGORY OF. CONSTRUCTION . exceeds 10,000 amps at 150 volts or ❑ Floating buildings
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 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
❑ Emergency system larger separately denved system.
JOB SITE INFORMATIO 114 • .4 ON 0 Addition of new motor load of ❑ "A ", "E ", "I - 2 ", "1 - 3 ",
,( Nor 100HP or more occupancy
Job no.: re WI Job site address:
LL — , ne f (� , r��f
I / / Je'_- • ❑ Six or more residential units ❑ Recreational vehicle parks
City/State /ZIP: 51A) Sh i+�j J'v`- s-tohe gev '1 4
,f) ❑Health-care
s, 0 Supply voltage for more than
(0f / ❑ Hazardous locations 600 volts nominal.
Suite/bldg. /apt. no.: 130 3 Q Project name: � e � t < t��.Ll�l S ❑Service or feeder 600 amps or more
M FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
/ �� New residential single- or multi- family dwelling unit.
1 (,-C 4,,, i ,,, A fe _ 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 I
Tax map /parcel no.: Limited energy, residential 75 00 2
DESCRIPTION OF - WORK - (with above sq H )
Limited energy, multi- family 75 00 2
M C.>ry ' - - tl ( ,,.,1 A, ) c i ,.. residential (with above sq II )
Services or feeders installation, alteration, and/or relocation
200 amps or less 80 30 2
❑ PROPERTY, OWNER I ❑ TENANT 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: ( ) I 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
T each branch circuit
Business name: A < Q a . S -- -c�C B. Fee for branch circuits
without Contact name: �� 6 r k first branch circuit
service or feeder fee, 46 85 K�_ 2
first r
rr – Each add
'I branch circuit dL Q 6 65 3. �i2
Address: / ' 1 , , 1"�� CP S
( ` � � Miscellaneous (service or feeder not included) �
City/State /ZIP: S (el t.-� 0Re--2 o-v- Each manufactured or modular 90.90 2
S dwelling, service and/or feeder
Phone: (5-603) 9 $ / 9 3 Fax: : (563 )3 7 Y ?U 8 S Reconnect only 66 85 2
E - mail: Qq e Ae G si . < c. /Z, ; ( ,. Ccvv _ Pump or irrigation circle 53 40 2
CONTRACTOR ', Sign or outline lighting 53 40 2
/e Signal circuit(s) or limited -
Business name: I ty .. f c s �6.„..., L) / ..v`_._ energy panel, alteration, or
Address: extension Describe Page 2 2
. 8 S ley - r-nor P s •
City/State /ZIP: S' -` v� d (4 6 9 7 3 � Each additional inspection over allowable in any of the above
/ Per inspection 62 50
Phone: (,53) 9 yq 3' 9 3 Fax: ( Se3) 3 2 ( 9 0 3 Investigation per hour (I hr min) 62 50
CCB Lic.: ectricac.: Suprv. .: Industnal plant per hour 73.75
. 3 � `t �, Electrical Lic.: 3 ' - 3 �� Su ry Lic
.:3 �' • s ELECTRICAL . PERMIT FEES —
Suprv. Electr�c'a i ridttire, required: �f_ ' / I/ !J 1 / I.
v' S ubtotal
Print name: t P / ` Date: Plan review (25% of permit fee)
J T e State surcharge (12% of permit fee) 9. /,
Authorized signature: 07- TOTAL PERMIT FEE 0---(7( This permit application expires if a permit is not obtained within 1
Print name: Date:
days after it has been accepted as complete.
• ■iiinber of inspections allowed per permit
I.\ Building\Permits\ELC- PermnAppdoe 05/23/06 440-461 5T( 11 /05/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
4
LIMITED ENERGY PERMIT FEES: '"'
m RESIDENTL LWORK`ONLY:
Fee for all residential systems combined $75.00 y .
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
IT WORK ,ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*■o' licenses are required. Licenses are required
for all other installations
I \Budding\Permits\ELC- PermtApp doc 03/23/06
CITY OF TIGARD
, w
BUILDING DIVISION PERMIT #: ELC200I -00298
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/28/20018
Phone: (503) 639 -4171 4
Inspection Requests (24 Hrs.): (503) 639 -4175 R,_..
INSPECTION WORKSHEET FOR DATE: 7/16/2008 TIME: 7: 00AM PAGE: 22
SITE ADDRESS: 09567 SW WASHINGTON SQUARE RD 503 "B CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF,. USE: •
PROJECT NAME: FRED MEYER JEWELERS
DESCRIPTION: TI. Installing (21) branch circuits.
•
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: A & A ELECTRICAL CONTRACTORS INC PHONE #: 503-M9-3193
Inspection Request Scheduled For: 'Date: 7/15/2008 Pour Time:
Code # Inspection Description C•nfir-m # Contact # Message
199 Electrical final 072720 -01 503 - 949-3193 N
Corrections /Comments /Instructions:
' 4L.1.1k 2L-L__ AteVIT
RELTIR NW 417 —
• Ott.
I
•
10a. PAS' ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
IL ❑' CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: � " Date: `�'� Phone #: (503) 718 v4
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: ELC2008- 00298
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/2Q/200t$
Phone: (503) 639 -4171 y y' r�
Inspection Requests (24 Hrs.): (503) 639 -4175 IL ,
INSPECTION WORKSHEET FOR DATE: 6/30/2008 TIME: 7:00AM PAGE: 31
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: TI. Installing (21) branch circuits.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: A & A ELECTRICAL CONTRACTORS INC PHONE #: 503 949 - 3193
Inspection Request Scheduled For: Date: 6/3012008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 Ceiling cover 071976 -01 334352 -9863 N
Corrections /Comments /Instructions:
MPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
'l
Inspector: Date:0 0 e Phone #: (503) 718 -
L •
.
_ _ _ _
CITY OF TIGARD . ; N. ,.
BUILDING DIVISION PERMIT #: ELC200I3 -00298
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/28/2008
Phone: (503) 639 -4171 At • ..
Inspection Requests (24 Hrs.): (503) 639 -4175 .._. " ° ' '_L.
INSPECTION WORKSHEET FOR DATE: x26/2008 TIME: 7:00AM PAGE: 23
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: 11. Installing (21) branch circuits.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: A & A ELECTRICAL CONTRACTORS INC F F PHONE #: 503 - 949
Inspection Request Scheduled For: (Date: 6/26/2008 Pour Time:
Code # Inspection Description /Conf Contact # Message
130 Ceiling cover 071866 -01 503 - 919.3193 Y
0
Corrections /Comments /Instructions:
Q 1 i o INLL. 41 RotA F i x i mrs Aab
00b ALL 104 c c t R PASCAL 2a.
P Arkl 2s . .
o N a 046a._ ,A ti _Li I Cr-(so u
� S 4 ( 6 E .
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL !,: CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' oe L"' Date: Phone #: (503) 718- 1M6
CITY OF TIGARD G . , �,.
BUILDING DIVISION , ,-
IVISION - PERMIT #: ELC200B -00298
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ' 6/28/2008
Phone: (503) 639 -4171 / u ID l
Inspection Requests (24 Hrs.): (503) 639 -4175 ' �
INSPECTION WORKSHEET FOR DATE: 6/12/2008 TIME: 7:02AM PAGE: 61
SITE ADDRESS: 09567 SW WASHINGTON SQUARE RD 603 B CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: FRED MEYER JEWELERS
DESCRIPTION: TI. Installing (21) branch circuits.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: A & A ELECTRICAL CONTRACTORS INC PHONE #: 503-949-3193
Inspection Request Scheduled For: Date: 6/12/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Wall cover 071204 -01 503 - 949.3193 _
Corrections /Comments/ Instructions:
P -rt`V '1 j',L. i 6-)
1aa4s 1..:41,6
7 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
1 ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
G --- % 068 f
Inspector: Date: ` " �� � a Phone #: (503) 718- 2-4144
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: ELC200B-0029B
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/281200t1
Phone: (503) 639 -4171 !'�
Inspection Requests (24 Hrs.): (503) 639 -4175 s_' '
INSPECTION WORKSHEET FOR DATE: 6/512008 TIME: 7:00AM PAGE: 51
SITE ADDRESS: 09567 SW WASHINGTON SQUARE RD B03 B CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: FRED MEY JEWELERS
DESCRIPTION: TI. Installing (21) branch circuits.
OWNER: . WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: A & A ELECTRICAL CONTRACTORS INC PHONE #: € 03 - 949
•
Inspection Request Scheduled For: Date: 61512008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
105 Underground /slab cover \ 070897 -01 503.949 -3193 N
Corrections /Comments/ Instructions:
•
•
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
F L ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V V v6 Date: 66 (7% Phone #: (503) 718- Z