Permit CITY OF TI GARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR2003 -00286
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 DATE ISSUED: 9/22/03
SITE ADDRESS: 09530 SW WASHINGTON SQUARE RD H -10 PARCEL: 1S126C0 -01107
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Proiect Description: Installation of limited energy for data telecommunications system. Job No. 52100
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:
PPR WASHINGTON SQUARE LLC OREGON ELECTRIC CONST /GROUP
BY THE MACERICH COMPANY 1010 SE 11TH AVE
9585 SW WASHINGTON SQ. RD. PORTLAND, OR 97214
PORTLAND, OR 97223
Phone: Phone: 503 234 - 1001
Reg #: LK/3-2342V200
SUP 4460S
ELE 26 -95C
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 9/22/03 $75.00 Elect'l Final
[TAX] 8% State Tax 9/22/03 $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 • ' ■•• 80 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
y ►. to follow rules . , • pted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 throuc
•
Issued by ;1i i d2A _ ■ .e Permittee Signature. 4 Q ,
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
, SEPI -18-03 01:03PM FROM - Oregon Electric Witiiiiii. s 5032313587 T -646 P.001 /002 F -462
I Electrical Pe ; motto - . --- ation
i ' '"�`_ OFFICE USE ONLY
City of Tigard „, ZpQ3 Date received: y /fD5 _ Permit no.fck�,y 3.p 02 fee
r 13125 SW all Blvd SE-9 1 a Project/appl. no.: Expire date:
. ,, ; J f? Phone: (503) 639 -4171, FAX (503) 598 -1960 Date issued: By: [Receipt no.:
Internet address: www.ci.tiga • • ap�F TIGARD Case file no.: Payment type:
24 - Hour Ins • ection Re • u - ;,,,
• 1&2 family dwelling or accessory l%' ”: r nercial/industrial • Multl- family ❑ Tenant improvement
O New construction O addition/alteration/replacement ❑ Other . ❑ Partial
JOB SITE INFORMATION
Job Address: : 'WashIngton Square Rd . Bldg. No.: Suite no.: Tax map/tax lot/account no.:
Lot: 9 1 30 Block: Subdivision _
Project Name: Apple Computer Store: • Description and location of work on premises: Voice/Data Cabling
•
Estimated Date of cam .letion/ins•ection:
will ou call for ins • action within 24 hours? Yes ❑ . No El Project Contact Jim eralct (503 546 -6013 Pnone
CONTRACTOR APPLICATION FIE SCI BDULE
Job No.: 52100 0wcription Qty Fee (ea.) Total unit
`ewr .1. en -zing 9 O
Business name: Oreston Electric Group multifamily per dwelling unit
Includes attached garage,
Service Included:
Address: 1010 SE 11th Ave. 1000 se. ft or less $ 145.15 $ - 4
Ev: Portland State: OR Zip: 97214 Ea Ado 500 SF OF Portion $ 33.40 $ - ,
Phone; (503) 234 -9900 FaX (503) 234 -1001 I E - Mail: Limited Energy. 15 2 Family $ 75.00 $ - 2
CCB no.: 203 Flee. bu - . lie no.: 26-95C unwise enemy. Multl. amliy $ 75.00 $ - 2
Ci /In - .; er . , ' MT
Each manufactured home or
i modulardwolling, Service
s. _ ..- . �; ,`4/18/2003 and/or feeder.
$ 90.50 a
•, Service or Feeders -
Su • . EIecG Name
=,, License n0: 44605 Installation, Alteration or
Relocation:
PROPERTY OWNER 200ampaorleas $ 50,30 $ - 2
Name (print): 201ampa- 400amps 5 106.55 $ - 2
Mailing Address: 4olarrps 600ac= $ 160,60 $ - 2
City I Tap: 601amps - 1000amps _ $ 240.60 $ - 2
Phone; Fax: 1E - mail over 1000A or Volts $ 454.65 $ - 2
Owner Installation: The installation is being made on property I Own which is Reannoa $ 66.55 $ - ,
not intended for sale, lease, rent, or exchange according to ORS 447, 455, Feeders omPOrary - I S erv i ces or
4 670, 701. F
Alteration or Relocation:
Owner's • nature: • Date: 200 am or less 5 66.x5 $ - 2
201smps • 400amps $ loom $ - 2
Name: Over 401an10$ • $00ampa $ 133.75 $ - 2
Branch Mewls - New, -
Address: Alteration or Extension Per
City: State: Zip: Panel: A. Fee ror branch
dreuite with pure nsae or service
or feeder lee. each branch
Phone: Fax: E Circuit $ 6.65 $
B. Fee for branch circuits W /Out
Purchase at Service or Feeder.
1st Branch Cad 5 45.65 $ 2
❑ Service over 225 amps ❑ Health - care facility Each additional branch circuit $ 6.65 $ -
❑ Service over 320 amps -rating of ❑ Hazardous location Miscellaneous • (service or
feeder not Included)
lea family dwellings ❑ Building over 10,000 Square feet four or East purer or inipaton clyde $ 53.40 $ - 2
❑ System over 600 volts nominal more residential unite in one structure Each Sign or Outline Lighting $ 53.40 $ - 2
❑ Building over three stories O Feeders, 400 amps or more Signal C6wit(s) or Limited Energy
Panel Alteration or Extension'
❑ Occupant load over 99 persons 0 Manufactured structures or RV park I _$ 75 -00 $ 75.00 2
❑ Egress /lighting plan ❑ Other. •Oescnpgon: voice/Date cawing
Submit 2 sets of plans with any of the above.
The above are not applicable to temporary construction service. Each AddrtionalInspection over
the Allowable In any of the
Hants: This permit application Above. Per Inspection
evokes Ira permit is not $ 6250 $ -
obalnod within tae trays tartar h tnve$toeti0n foe:
has been accepted es complete. [Ogler
Permit Fee $75.00
Plan review 25% $0.00 i
State Surcharge 8% $6.00
Total $81.00
CITY OF TIGARD • 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 . MST
�
UP
Received Date Requested if ���' AM PM BUP
Location Suite MEC
Contact Person s Ph ( ) 'I-5 -5 9r PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner a.,r 651 3 -d a J~D0
Footing
Foundation . ELC
Ftg Drain Access: - QQ O/
Crawl Drain O �P
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing .
Insulation
Drywall Nailing
Fire wall (1 k/71 Fire Sprinkler / G
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
. Final
PASS PART FAIL •
MECHANICAL
CA
Post & Beam •
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
lea —" PART FAIL
❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date A ✓. � 03 Inspector r e) Est
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL