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Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMM UNITY DEVELOPMENT PERMIT #: ELR2008 - 00058 : TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/17/2008 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: TI Installing data cable system. 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 FRAHLER ELECTRIC CO BY THE MACERICH COMPANY 11860 SW GREENBURG RD 9585 SW WASHINGTON SQUARE RD TIGARD, OR 97223 TIGARD, OR 97223 Phone: Contact #: FAX 503- 639 -4673 PRI 503- 639 -4627 Reg #: ELE 34 -13C FEES LIC 37410 Description Date Amount SUP 1816S [ELPRMT1 ELR Permit 3/17/2008 $75.00 [TAX] 12% State Surch 3/17/2008 $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: � Permittee 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. E lectrical Permit Application t: ro enr:. te USE ONLY ` City of Tigard FIECEI V vE ♦ >Na•: ' 13125 S W Hall Blvd., Tigard, OR 97223 Davy VI/d Q � �L �" �' Pia Renew Phone: 503.639.4171 Pam 503.598.1960 Other Permit: ' MAR 1 2008 Date/By. D � x.2. 7 T G n 1: D Inspection Line: 503.639.4175 Date Ready/By: tads: H See Page 2 for Internet: www.figard-or.gov .-% y of supplemental I Information l..u_� � 1ti, �Srs 1 _ - h,W -- tti; ".tr�}` :Cgx �.o : fi r;. ; �� *` �• _ � 1 ., ` ii_, :'ire- _ e -iJ•� ,,,�, . ,.,7; =7'.- ' r � (j A � ,,, - ,•=. ,, °4F,i :,FVia%� "3,i; %�'n a•�ya�r� '-x,g'. ",A•+ ;c:. i;a'7'Y+l�=" ' •t,7. �!J.'_..,,:''f;� :, !vi`x+'s+Y� '4 • F„ VISION* 40.0 ,, , o a , /,4 �`,.,; �,vffi. ux -- °' i:,l„ e,fs.,L -: , �; '!' -^ . %�`' =N ..,r �, . - , . o - . k>, i , # ! !� "N'��',,, .�, ,;1.g ;irk :�'!!,� .w..,:l":.,�'�`F',� :,.• n,r1n� *4fi3'F•`5� fiS'1 �.3�: -, h. i ^.','ie,'i5 : =, , , "! -' :;' "I" " i Please check all that ❑ New Construction 1:1 Additional -' ': o rep - emen t apply (submit a sets of plans w /items checked below) ❑ Demolition 1:1 Other ❑ Service or feeder 400 amps or more ❑ Building over three stories. where the available fault curtest ❑ Marinas and boatyards. ' ''''' -: :"�''= '-'' ' . q, „' , ''T ^Rim : , ra, - - _ �;.'' :� ` '�z,' ',,`a,�i ''. : .,per Q �j`' j� ` ' ' ' "- :" exceeds 10,000 at 150 volts or ❑ Floating buildings. ,,., -;�, -, ,. .,,H •.fi;., : 4 , ',,.,. :.•4; . V -• - less to ® Commercial/industrial ial ❑ Accessory building ll �d exceeds ens. ❑ t; dings. ❑ Multi - family ❑ Master builder l use agricultural 1- and 2- family dwelling amps for other installations. In ;taia ti ❑ ��- ❑ Fire pump. ❑ Installation of 75 KVA or © b ❑ Emmergency system larger separately derived oyster .: r< -:" 7 ' F , a : <' _ B SI7rE R1V ATIP111, 1'iND iOCAMUDN,`;T : ,''; :':',1C;,,,: ; 4 `t -ti : ❑ Amnion of new motor load of ❑ "A ", "E ", "1-2 ". "1 -3 ", lob no.: 65615 Job site address: 9619 SW WASHINGTON S UARE 100E or more. occupancy. Q ❑ Su of m ore resi r>"mial ra ❑ Remsational vehicle parks. 1 City /State/ZIP: TIGARD, OR 97223 ❑ Health-care fames' ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal Suite/bldg./apt no.: Project name: POTTERY BARN WASH SQUARE ❑ Service or feeder 600 amps or more. Cross street/directions to job site: ' z # ? = DIbL _= r a ; E �:?��' >, _, Description 1 04- I Fee. I Total I New residential single- or multi -family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. it. or less 145.15 • 4 Tax map /parcel no.: Ee add'1500 sq. R or portion 33.40 1 Limited energy, residential 75.00 2 t st;ti�;,`li :Y s + •!; ' ,.�- <- y 'Ags, w�wr ,a -s,.�:s: A .,4-,> r t a„ e S" , s '}t„�9 r c,i 1 .• al �eg ai-rz' i (with aci. $.) .. K, :,• , K�BLIODIbFWd11tC 'n4 b& with abave INSTALL DATA CABLE AT POTTERY BARN Limited (i above 75.00 2 (with above sq. ft.) Services or feeders ikon, alteration, and/or relocation �q ��1,,� 200 amps or less 8030 2 $0 �,' ' ice! 10p t -i_2:� rc Fv'S'��"��`5 ti`s t ke1-4 M,.:: ` 5+." -yt .. - n' - __ �, �,; �. �� :x��1u'?'��,�',I?Filli "�' 4 201 ampst0 106.85 2 Name: k)54 /lvf* , 5- uGtn[ liC. 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: ( ) 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 draft — new, alteration, or e panel Owner signature: Date: X011' p 5 , °.•. t �_ A. Fee for branch circuits with S'',:::; u ' m' Paz■ Z s ?+� - R C?l y, yB � 7J ?p011sfiCTt6(T� above service or feeder fee, each branch circuit 6.65 2 Business name: B. Fee for branch circuits Contact name: without service or feeder fee 46.85 2 ' first branch circuit Address: Each add'l branch circuit 6.65 2 Miscellaneous (service or feeder not included) City /State/ZIP: Each manufactured or modular 90.90 2 dwelling, service and/or feeder Phone: ( ) Fax : ( ) Reconnect only 66.85 2 E Pump or irrigation circle 53.40 2 ° '``,.��t.v a'� :L, "y'"0F.r "'t" • .�dS "�L' i' - :x.: %i ,J°„i;s; 'sV�'r: �;�., "��. rat', ��> ��,: � M�{'.:,:,.. x? a., �a :�i :�,��,G'QNT'aRA'C3'DIt; , :.. 'f °;.� :n; ,� : :;r?6 ~. "= � �. Sign or outlineligbting 53.40 2 Business name: FRAHLER ELECTRIC COMPANY energy circuit(s) or limited - anergy panel, alteration, or Address: 11860 SW GREENBURG ROAD e D T A / 1 Page 75 2 City /State/ZIP: TIGARD, OR 97223 Bach additional inspection over allowable in any of the above Per Phone: ( 5503 639 -4627 Fax ( 503) 639 -4673 inspection 62.50 Investigation a per hour (1 hr min) 62.50 CCB Lic.: 37410 r Electrical Lic.: 34— C su . Lic.: 1816S Industrial sub ce plant peT hour Supra. Electrician signature, t J' ` /' `� - ;' -;: ,.1,�, igi EI iGl C-11t: �FABIE S . Subtotal: 7 5. PR.i. F g: :'r: r tota Plan review (25% of permit fee): Print name: R . V. - FRAHLER Date: 03/13/08 State surcharge (12% of permit fee): 9.00 Authorized signature: TOTAL PERMIT FEE: 84.00 This permit application expires if a permit Is not obtained within 180 Print name. Date' days after It has been accepted as complete. Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: n 71W,,,,i'Y�WWWWW.°7'iciclai.rY�: ;°:�' `� 4' ,lE E OZ Fee for all residential systems combined........ $75.00 Check Type of Work Involved: - ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other. S CO 10,0_ GWW f ar .- �,, .� , w l'7� ;L- . .o:_'rj��sa'�.�?'�,a-.'�'i Fee for rack commercial $75.00 system (SEE. OAR 918 - 260 - 260) 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: I *No licenses are required. Licenses are required for all other installations CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2008-00058 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/17/2000 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639-4175 WORKSHEET FOR DATE: 5/19 /2008 TIME: 7:00AM PAGE: 29 SITE ADDRESS: 09619 SW WASHINGTON SQUARE RD L.04 CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: POTTERY BARN DESCRIPTION: 11. In:.tailing data cable system. OWNER: WASHINGTON SQUARE LLC, PHONE #: CONTRACTOR: FRAMER ELECTRIC CO PHONE #: 503639 - 1 1627 Inspection Request Scheduled For: Date: 5/19/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message eG iflC.�l final 070058 -01 503.639 -4627 Y Corrections /Comments /Instructions: ( � (0 -0 tAga • • • "4 PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS L ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: l?--; WJ i'7 Date: 1 O a Phone #: (503) 718- 1.04.