Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
*eo DEVELOPMENT SERVICES PERMIT #: ELR2006 -00063
II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/22/2006
PARCEL: 1S12600-00300
SITE ADDRESS: 09625 SW WASHINGTON SQUARE RD FC -1 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Data /telecommunication
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 GLOBAL ELECTRIC, INC.
• BY THE MACERICH COMPANY PO BOX 162
9585 SW WASHINGTON SQUARE RD NORTH PLAINS, OR 97133
TIGARD, OR 97223
Phone: Contact #: FAX 503 647 - 5649
PRI 503- 647 -5650
FEES Reg #: LIC 15838
ELE 34 -655C
Description Date Amount SUP 3589S
[ELPRMT] ELR Permit 2/22/2006 $75.00
[TAX] 8% State Surchart 2/22/2006 $6.00 REQUIRED ITEMS AND REPORTS
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 95 01 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 -24 -6699.
Issued By: Permittee Signature: 9" - CL/Q-44-4-4.:
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 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.
(
•''' E lectricai•Permit AjIDlicaCZECEI i, , ` I•()I: ()III( I. 1 ‘,1 O\I
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City of Tigard R° �' e9.'" o(se . Pmm i txo. p90/p
13125 SW Hall Blvd., Tigard, OR 97223���
Plan Review
Phone: 503.639 4171 Fax. 503 598. 1960 FEB 21 , -. ', .;, J i Other Permit ' Line 503.639 4175 ► � 1
Internet ion Line CITY 1 ",. - Noa'fiediMatkod S Page2roe
■ �PP t*1 Information
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❑ New construction ❑ Addiuon/alteratio . r . /' - M' N Please check all that apply.
❑ Demolition rr ❑ Other � DScrvioe over 225 =Pp, scenery( ❑Hazardous location
1 °i� o'tr r �; � . Hn t I S 1 "'Ai Y. a t s a + t , f ,nnn I IR, 11',N.,.r +r ^f �tl � t 1. tt n , n lS l 1 ]�'�:•,, QServioe over 320 amps - retioi3 ❑Bw1dng over 10,000 sq ft.,
1X1 3r „' �1kkrii .1,A1,�&.1 ,.,` + 1 h II y , }I ∎'�'� t. 4 { ^ + 0 of I- and 2-family dwellings 4 or more new residential
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❑ 1- and 2- family dwelling ❑ Commercial/industnal ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories OFeeders, 400 snips or more
❑ Multi family ❑ Master builder ❑Other
w ct n + r slrn at,• tit r+wi q t r .rx ♦r , ❑Occupant load over 99 persona ❑Manufacture✓d strictures or
/ir$1 Iti}� i; f tUr A i tl } 1' {r�w. r :•tst,lla? rat 91 S.i' ,,l 1 I , yv;...3� 1"N t R i; ,,. ,,{,F',,,, Olen
:'Yl34 Y;,1tiv^1j r �'T�St +,'•�,`ali Irl,..1- ,u:'aua,..; ?ixvtt�ynuft.>F +x. 4iKYUn'�r - u. , .s, i! - r.9 , ;fnit atIAI.1 Clrc Ntuii3 y RV park
Job no 4 Job site address c...,, r',.,p,r_k_ . `c) ❑Health - care factlaiy DOther:
Submit j_ sets of plans with any of the above
City /State/Z1P' \ I 4�. i4R.0 J Q L ..i The above are not applicable to temporary construction eervice
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Suite /bldg. /apt. no. Project name: S a�,l ,i .�L\ W - -%
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Derulpttos Qh'• Pie Tdtl
Cross steel/directions to job site N Ai t .\ac; r,, t { J iN H �` t New residential 'Ingle- or multi- family dwelling unit.
1 includes attached garner.
1,000 sq ft, or less 145.15 4
Subdivision: I Lot no.: Ea. add'( 500 sq, ft, or portion 33.40
Tax map/parcel no
Limited energy, residential 75.00 1111111111111611
+it r:f 1. + wt r s r�-. r., r r ae t ' rw r r Limited energy,no . residential 75,00 2
TM1' {t rt r I g�,1 ItAIIr:•. r„1 l - -' ,t +'� u t S .`.1f ° ► 15 + ,1 4;r IV saGh tllblllllfaetllred Or modular ww�k`i.1L,t R _ e. _ ir�.•;.�,:ir�a ,., tr�r,¢nr.. >Ta+e + 1 4 +,.w.,.t, .' 1-∎:r l4l3atr 175el tE. l ie u
dwelling, service and/or feeder 90.90 2
Services or feeders hutalladon, alteration, and/or relocation
200 amps or less 80.30 2
P--`,f t t f ;; I ?f '" s iy r w -r ile ` KI. r _ , , *' r 'a;_i ] .*.PLV.: 201 amps to 400 amps 106 85 2
4 'i!i.! !a . 44.:.:Ao rr.k .wivm., lV ,p nw. 1+ . a r .a.,: . r 11'1 r I . ct
401 amps to 600 amps 160.60 2
Name- 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP'
Reconnect only 66.85 2
Temporary services or feeders Installation, alteration, and/or
Phone: ( ) Fax: ( ) relocation
200 amps or less 66.85 1 1
Owner installation: This installation is being made on property that 1 own which is not 201 amma to 400 amps I I 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133 75 2
Owner signature: Date: Branch cireaits - new, alteration, or extension, ' r pane)
3T +a I , 'e .1,�pV) G .,{` tix t'Ci its t I �� tS {{ .'S# a yy� r , ��{y},,r! lt�,� j �Ii•_tr >!•,..� wrr,• ii o,,z , ! it. A. Fee for branch circuits with
cE, `i, " ,)._ ;,,t,nn. +:., W Wloat dt i`sil FYi i �l :1 ,,,'+•'. ril (..?ir..;7:Ir1➢,,.,,.rw,F, , 4
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Foe for branch circuits
Contact name: without service or fader fee, 46,85 2
Address first branch circuit
Each add'' branch circuit 6 65 2
City/State/ZIP: Miscellaneous (service or feeder not Included)
Fax: : ) Pump or irri son circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
Mi r! ' 4'd x �;�A �uN "hvU� i R Y � R" " t , ,� h ; i z 77 -1 " i g
t�ir1„IL�,w am „Ivw,l,v ,f,•.f.mt.r n n1,t,.,. +...fl .. Et5:f[:1.!a,d�.ci7tlir��a1 w1'ti emEY Mud, alterntiml, or
extension. Describe I Page 2 K. i'� 2
Business name, ,_4_,, f3 sat--. , L LL.T 0- 1 L I C. •
address: �1 ,0� Pesch additional inspection over allowable to any of the above
Q, .� ti y, (� �—e / • ,/i9 , Pear mapecaon 62 50
City /State/ZIP' 1-1 P Li\ 1 (3 f 7 / -k Investigation par hour (1 hr min) 62.50
i r ., Industriall , hour 73 (%-,51 Phone: (S, )( e Jim: i, - . S l U I F ax: ( s J t ) '1 J 7 J / N e, L 1 MdYtt�•!'i i i.,.. o .1,,. A�i 1. �. ,� „ w. At� rn1 " -. .,.,ra 11'A�_'� .•,. - 75
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CCB Lic.: . Electrical Lic.' '3 4 __L. S G , upry Lie.: ?s--v.. w ' Subtotal
Suprv. E1ec clan l t e,/regi fired: ( , 1 Plan review (25% of permit fee)
Zf (( /0 �� ( State surcharge (8” /u of permit fee) G , V f_i
Print name: C A J t l,) J. C_ A ,`.2 ...1) Pate: Z ,— Z i —J L
TOTAL kr4t1VQ'X elf f I . J U
Authorized signature: i, „:„f Tads permit application expires ff e permit Is not obtained within 180
days alter it Yea bets, accepted se couplets
Print name' X. 4 ,i 1 e, J L -1 t! / t,. j I Date' 2 — `2...' V • Fee methodology set by Tri-C,ounty Building Industry Service Board
CITY OF TIGARD
BUILDING DIVISION PERMIT #:Q 2D0(, l�r7C63
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 /�,w
Inspection Requests (24 Hrs.): (503) 639 -4175 "'I �..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: q(
(P I``, G2v ,. CLASS OF WORK:
SUBDIVISION: <a� LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: R PHONE #:97/ —,5 76 y-7
CONTRACTOR: 00, PHONE #:
Inspection Request Scheduled For: \ Date: 3 -.2__7e.- 06 Pour Time:,
Code ; Inspection De cription C nfirm # Contact.# Mess- •
i -9 ,1-1,,A_0-fi
orrections /Comments /Instructions:
E ��`,C C..:,A m p - „ , : A At )
AM l AA AI A
At 0 11110FAMMETEriffiEWAMIE
'''Im" cOMFAINEWIPIETMTAL --
•
A
. PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: I V Ve Date: 1 4 17 Phone #: (503) 718- it. g 1