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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT A n v ~ '~ COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00103 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/29/2008 PARCEL: 1512600 -00300 SITE ADDRESS: 09619 SW WASHINGTON SQUARE RD L04 ZONING: C -G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG PROJECT: POTTERY BARN Project Description: Installing security system. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: : HVAC: PROTECTIVE SIGNAL: X INSTRUMENTATION: OTHER: : TOTAL # OF SYSTEMS: 1 Owner: Contractor: WASHINGTON SQUARE LLC ADT SECURITY SERVICES, INC BY THE MACERICH COMPANY 2815 SW 153RD DR 9585 SW WASHINGTON SQUARE RD BEAVERTON, OR 97006 TIGARD, OR 97223 Phone: Contact #: PRI 503- 469 -7212 FAX 503- 469 -7114 FEES Reg #: ELE 26- 209CLE LIC 59944 Description Date Amount SUP 389LEA [ELPRMT] ELR Permit 4/29/2008 $75.00 [TAX] 12% State Surch 4/29/2008 $9.00 REQUIRED ITEMS AND REPORTS Total $84.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. Issued By: 1 - Perm ittee Signature: „cre-P °7� 7�$�� OWNER INSTALLATION ONLY ` c� 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. Apr 28 08 0831a Stephanie Pate 503 -469 p 1 2 for Date JtAeCtrical Permit catt � � ` � Application r j , . , {l ,, City Of Tigard R 11 ,4 � . '. C9 f xetved V. IipC){ E1(.1', ',� tin ,: f) VI 1 / ,f i {! i F t o -;r t j l ` E truly 'a', 13125 SW Hall 131vd rived, at i?'� ax ,; c/B �� , [. a ., Phone: 503.639.4171 Fax. 5 1 . . ` •8.1 �� a " O:ecrPerm�t • - r; c, :1; ; I Ittepo0AOu Line. 503.639.417 �� Rcndy Mriy: hots hots H tier Page 1nt net: wwwligard � 'C` % r ® ' NonftedlMed.,t: Supplemental Information TYPE OF 4i r • - ` PLAN El New construction ` Plea= check all that apply (submit sew REVIEW ileum t Y ®Addibcat/` e` w t :' ^, tat DCIDD {IUO[1 i '1` • j p l)wj ding over stories. below) ❑ gs. ❑ Other: ! hoe a feeder aarar or more ❑ t)oilin wham the avm7abie fault mime ❑ Mamas and boatyards. CATEGORY OF CONSTRUCTION moods 10.000 amps at 150 volts or O Fleeting buhdugte Q 1 -and 2- family dwelling Commcrcial/industrial Q Ar CW,so building leas to pound, or eanomds 14,000 ❑ Cornmermal-ure a icullu al rY mg emits for all other mmall■lirxre, buildings. Q Multi- family ❑ Master builder ❑ Otb cr- Q l'iR p aw htntollauoa of 75 KVA cr O Emergency system, r tamer separately anon, JOB SITE INFORMATION AND LOCATION s- I] Addition of any motor l of system. ❑'A ^, •`g � I _Z^ •• l.�^ Job 110.; 83- r / -c,/ Job siteaddresm 9 eLtJ LU Si�S 4/ CD //i1 300JdPOrrnote. ootvpancv O �■ a awls re:sldma unier, ❑ Rocncacoml vehicle parka City/Sfatc ZIP: TIGAR)D OR t9 7,202.3 ❑ HataIW.gate facilities. 0 Supply vol am for more than ©Hate:Mous locations. 600 volts Roadtw. Suite/bldg. /apt. no.: Project name: Jer r:97---r-e /e 40 /h y ❑ Service or feedo -600 amps or more ILE Cross strcc1/dinectioas to job site: PEE 5C1IEIf ot't 1 '" Q . • I Ye I 'tYtal I • New reddenlial t . single- or multi - fatally dwelling unit Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft or less - 145.15 4 i T Map /per no.: a 0x1,'1 500 sq. R or portion 33.40 ) Lm D t ION OF WORIeWined energy, residential 75.00 2 (with above sr e.) �/ ` �t r Limited energy, multi- tainily j -,.M.4-. � _ .a,.a.e4F7 residential (arm above eq n) 75.00 J 2 /! / Services ces or feeders installation alteration, and/or relocation ❑ PROPERTY OWNER Zoo amps or less 80.30 2 ❑ "r' ANT 201 amps to 400 imps 106.85 2 401 amps to 600 amps 160.60 2 Address: 601 ampts to 1.000 amps 240.60 2 Over 1,000 amps or volts 454.65 2 City/State/ZIP; Temporary services feeders lostaUAeoa, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 altars or less 66.85 1 • Owner installation: This installation is being made on property that I own which is net 201 amps to 400 amps 10030 2 intended for sale lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 lumps 133.75 2 Ow= Signature: Brooch circuits -. new alteration or extension, .. net A- Fee for branch circuits with ❑ APPLICANT 1 CONTACT PERSON above service or feeder fee. each branch circait 6.65 2 8. Fee for branch errcerirs Contact names wtJlrotrl sett/ic or ^ !.r< lust branch circu feeder fee, 46.85 2 Address: Each addi branch circuit _ 6,65 2 City/State/ZIP Miscellaneous (service or feeder cwt included) Each manufactured or modular r Phone: (sa _ dwelling„ service and/or feeder 90.90 2 z Reconita t only 66.85 2 Pump oe irrigation circle 53.40 2 CONTRACIOR Sign or outline lighting 53,40 2 Business nine: ADT SECURITY Jtgosl cltllltt(s) or nimble d- Addres ; 2815 SW 153 ' DR extension. Despanel, alalteration, on, or 1 2 75.00 2 cribe; City/StatrlZlP: BEAVF.RTON Olt 97006 fr ach additional i aver allowable in a , of me above Phone: (5113) 469 -'7212 ) ax: (503) 469 - 7114 Pta inspection 62 50 invcstigatron per hoar (t hr min) 62-50 CCD Lie.: 58944 Electrical Lie26209 Indnaaial Omit ter hour - 73.75_ Snprv, Elea ician signature. �T11 ,6 r _ ) _ EL.1Bt�1f PER Mbt al. : �•�Y _ -� Subtotal 75.00 pi �r 0 ; Plan review (25 %of pcmut fee): Authorized Si : , State stnehsrgC (1255 of permit foe); 9.00 ~ • 4 TOTAL PERMIT FEE 84.00 Pent 11811[C_ KEN KRAl15 Date: 7 use his per application expires if a penult is net abained "Mtge III) // -- 1 . • Number of ioepeeliens allowed pet pmno;r. day. ailor It ba. hero arcepkd as complete, 1 : 1 Huildnga e etmirrl6LC- ►esrmis�lpp toe - t �/t• ��• WP• %137(I11051CgMlWflit • CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2008•00 103 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/29/2.008 Phone: (503) 639 -4171 �� A Inspection Requests (24 Hrs.): (503) 639 -4175 "_- INSPECTION WORKSHEET FOR DATE: 5/20/2008 TIME: 6:59AN1 PAGE: 29 SITE ADDRESS: 09619 SW WASHINGTON SQUARE RD L04 CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: POTTERY BARN DESCRIPTION: Installing security system. OWNER: WASHINGTON SQUARE LLC, PHONE #: CONTRACTOR: ADT SECURITY SERVICES, INC PHONE #: 6034637212 Inspection Request Scheduled For: Date: 5/20/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 070146 -01 503 - 469-7130 N SCj9 Corrections /Comments /Instructions: N 0 ‘,..-.A bi\) s j C A PASS ❑ PARTIAL APPROVAL • ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: o `+ Ve Date: a 0 v Phone #: (503) 718- 1/4