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Permit A CITY OF F T I G A R D ELECTRICAL PERMIT PERMIT #: ELC2000 -00234 DATE ISSUED: 5/9/00 �l DEVELOPMENT SERVICES 6.-11 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1 S126C0 -01107 SITE ADDRESS: 09619 SW WASHINGTON SQUARE RD. SUBDIVISION: ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: Installation of signal circuit or limited energy panel on main floor level. Job No. 083 - 12401 -01. 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: 1 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: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 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 ADT SECURITY SERVICES, INC BY THE MACERICH COMPANY 2815 SW 153RD DR ATTN: JANET FISHER, ASSET MGNT BEAVERTON, OR 97006 SANTA MONICA, CA 90407 l\- Phone: Phone: 503469 -7100 101 \ G\" Reg #: LIC 0059944 ELE 26209CLE FEES - Required Inspections Type By Date Amount Receipt Elect'I Service PRMT DEB 5/9/00 $60.00 0002005 Elect'l Final • 5PCT DEB 5/9/00 $4.80 0002005 Total $64.80 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 -0080. You may obtain copi ese : or direct questions to OUNC at (503) 246 -1987. c/ p, PERMITTEE'S SIGNATURE /14 ISSU D BY: /..1 4 I ._ #.40(4/ 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 l 1 503 598 1960 03/17/00 FRI 12:15 FAX 503 598 1960 CITY OF TIGARD 0003 CITY OF TIGARD SW HALL BLVD. Electrical Permit Apu Plan cne.. ' tteidt Rec'dB TIGARD OR 97223 d / II `D 20 Date Recd 5 - . - !U/ Phone (503) 639 -4171, x304 Q 0D $ Date to P.E. --�� inspection (503) 639 -4175 �� EVEI�P'�ENT Date to DST Print of Typ 111 Permit # C 3 Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed N e ( name of busin -ss) �!� F il• 4 � • Service included: Items Cost Sum A W esS . • LMWL"� I • 4a. Residential - per unit City /State/Zip /� l J �` ` r ��/ 1000 sq. ft. or less $ 117.75 4 / Each additional 500 sq. ft. or Commercial © Residential ❑ - . 9.7 o. portion thereof $ 26 75 1 Limited Energy $ 60.00 Each Manufd Home or Modular 2a. Contractor installation only: Dwelling SeMce or Feeder $ 72_75 2 (Prior to permit Issuance, applicants must provide contractor license 4b. Services or Feeders Information for COT data base). Installation, alteration, or relocation Electrical Contractor ADT Security Services, Inc. 200 amps or less $ 6425 Address 2815 SW 153rd Dr . 2 201 amps to 400 amps $ 85.50 2 City Raa�rPrtpn State OR Zip 97006 401 amps to 600 amps $ 128.50 2 Phone No. a , • - 601 amps to 1000 amps $ 192.50 2 • Over 1000 a Job No. ;.� ` mpsorvolts $ 363.75 2 Elec. Cont. Lice. No. 76- 7fl9CT,R Exp.Date 10/2000 .Temp ectonly $ 5350 2 OR State CCB Reg. No. ' sgqu Exp.Date 5/7/01 installation, al Services o COT Business Tax or Metro No. Exp.Date 200 amps or less $ 53.50 2 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n �^ 401 amps to 600 amps $ 100.00 2 Over 600 amps to 1000 volts, License No. , �Sq ---- 0 Exp.Date #.3.1f/Oell see "b° above. Phone NO. 4d. Branch circuits New, alteration or extension per panel 2b. For owner installations: a ) The fee for branch circuits with purchase of service or Each Print Owner's Name branch branch circuit $ 5.35 2 Address b) The fee for branch circuits City State Zip without purchase of service p - 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 • Miscellaneous ce or arreous intended for sale, lease or rent. (Service or indcted) Each pump feeder or irrigation not ci $ 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 1 $ 60.00 $60.00 Minor Labels (10) $ 100.00 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 System over 600 volts nominal Per hour $ 50.00 In Plant $ 59.00 Classified area or structure containing special occupancy as - described in N.E.C. Chapter 5 5. Fees: * Submit 2 sets of plans with application where any Sa• Enter total of above fees $ ny of the above apply. 8% Surcharge (.08 X total fees) $ $4. R0 • Not required for temporary construction services. Subtotal $ NOTICE 6b. Enter 25% of line $a for Plan Review if required (Sec. 3) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ $64.80 IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FORA PERIOD OF 180 DAYS ❑ Trust Account # AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ $ 64 80 :Idsts\fomis \e lectric. doc CITY OF TIGARD BUILDING DIVISION MST 24 -Hour Inspection Line: 639 -4175 - Business Line: 639 -4171 j BUP Date Requested 1S " i( AM • PM BLD Location q 4 / ? 511, 4/45 4 S, Suite MEC Contact Person Ph 3,5 - 79Y - 4 PL Contractor Ph I' • V/e/. l OW -G 5-/ BUILDING Tenant/Owner ELC Zv�v -GU .7y/ Retaining Wall ' EL�i -K, 2-000 -00L3 5 Footing Access: Foundation _ FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear f� /'� �-- Framing ! O Insulation /� n Drywall Nailing L - v 4 �' - Z t -� Q Z 3 — F7' Firewall Fire Sprinkler Fire Alarm / , ( / , v Susp'd Ceiling -1 ° C, e— Q /' h- 1 — �! S "�/� � " Roof �1/ , 3� Misc: / Final �I/ PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains b , �j ✓D v CY 6n x " Q Q�/ /./2Q,�L°, Final �/ PASS PART FAIL MECHANICAL ; ' Post & Beam Rough In Gas Line Smoke Dampers / LQ ve_ G C 4u lo kJUS`s' -)-2191 Final S PASS PART FAIL ps re I Service Rough In UG /Slab Low Voltage Fire larm 1i PA AIL E Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk F Inspector ' Ext Other Date Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.