Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
'IA DEVELOPMENT SERVICES PERMIT #: ELR2006 -00077
+ " II 13 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/11/2006
PARCEL: 1S12600-00300
SITE ADDRESS: 09632 SW WASHINGTON SQUARE RD G -9 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Limited energy for audio /stereo.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X 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:
INSTRUMENTATION: OTHER: .
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC ADVANCED WIRING SERVICES INC
BY THE MACERICH COMPANY PO BOX 644
9585 SW WASHINGTON SQUARE RD CLACKAMAS, OR 97015
TIGARD, OR 97223
Phone: 503- 639 -8865 Contact #: PRI 503- 310 -3655
FAX 503- 698 -6372
FEES Reg #: ELE C7
LIC 162591
Description Date Amount SUP 4675S
[ELPRMT] ELR Permit 4/11/2006 $75.00
[TAX] 8% State Surchart 4/11/2006 $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
yoeOA ru
es adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 95 -101 -0010
you
952 =0 - 10 You may obtain copies of these rules or direct questions � at * • 6699.
Iss 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.
Electrical Permit Application i FOR OF IC E USI ONLY
111 ' . City of Tigard p at e c d 1 f 04 Permit No & - 2J • 40077
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
,1. ' ® Phone: 503.639.4171 Fax: 503.598.1960 Date/B Other Permit
T 1 G A It D ' Inspection Line: 503 Date Ready/By: El See Page 2 for
Internet: www.tigard- or.gov Nohfied/Method Supplemental Information
TYPE OF WORK PLAN REVIEW
New construction
Addition/alteration/replacement Please check all that apply:
Demolition ❑Other: ['Service over 225 amps, comm'I 0 Hazardous location
❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION- of 1 -and 2- family dwellings 4 or more new residential
❑ 1 - and 2 family dwelling ' Commercial/industrial ❑ Accessory building OSystem over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder ['Building over three stories ['Feeders, 400 amps or more
❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION _ ❑ Egress/lighting plan RV park
Job no.: Job site address: ge?a W W4 5q 0 Health-care facility DOther:
• Submit 2 sets of plans with any of the above.
City/State/ZIP: The above are not applicable to temporary construction service
Suite/bldg. /apt. no.: Project name: i .1 g,0 by VJO ems, FEE" SCHEDUL
n� Description I Qty. I Fee. I Total I ••
Cross street/directions to job site: �i s 14 I N6 -TD)J C-Q Nr• r.-E New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK • Each manufactured or modular
10CrAU t% 6F STI; C YST
dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
. . • PROPERTY OWNER • ❑ TENANT 201 amps to 400 amps 106.85 2
Q 401 amps to 600 amps 160.60 2
Name: too $. do 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
Phone: ( ) I F ax: ( ) relocation
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 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
❑ APPLICANT - . I ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6 65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
Address: first branch circuit
Each add'l branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax:: ( )
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited-
.. CONTRACTOR energy panel, alteration, or DO
extension. Describe: ` Page 2 76- — 2
Business name: k'IbdANC W 1)Z I N & S' b�‘1 ICES 1 ) NC •
Address: E7 0 , 1SDX 6 44 Each additional inspection over allowable in any of the above
r� Per inspection 62.50
City /State/ZIP: jACiJi 612. 6 1 - 701S Investigation per hour (I hr min) 62.50
1
Phone: (50 ) 310 — .?,,5 I Fax: coS ) bls -- (r 3 7Z Industrial plant per hour 73.75
. ELECTRICAL PERMIT FEES" ,
CCB Lic.: )t, - zr,9 ) Electrical Lic.: 7 Suprv. Lie.: 1,76 S Subtotal: ?s Oo
Suprv. Electrician signature, required: Plan review (25% of permit fee):
Print name: ‘ L dap A. Date: i) ! F-/L Q (P State surcharge (8% of permit fee):
TOTAL PERMIT FEE S . �
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tn- County Building Industry Service Board
•• Number of inspections per permit allowed.
1 \BuidmgWermits\ELC- PermitApp doc 03/23/06 440- 4615T(I I /05 /COM/WEB
Electrical Permit Application - City of Tigard , _ ,
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
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.
COMMERCIAL WORK ONLY:
Fee for each 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:
*No licenses are required. Licenses are required
for all other installations
1 \Budding\Pamits\ELC- PmgitApp doc 0323/06
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: EL 200: - 0UO /I • 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4f'l i/'213C3 ?�
Phone: (503) 639 -4171 /1 u�'��,i9 i�llt,
Inspection Requests (24 Hrs.): (503) 639 -4175 '. IL.
INSPECTION WORKSHEET FOR DATE: 4/14 /2006 TIME: 7:07AM PAGE: 69
SITE ADDRESS: 096 SW WASHINGTON SQUARE RD (3 - 9 CLASS OF WORK:
SUBDIVISION: WASI GTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: BATH + ` DY WORKS
DESCRIPTION: limited oner. for audio/stereo.
OWNER: WASHINGTON Se ARE LLC, PHONE #: 603 639 f3ti66
CONTRACTOR: ADVANCED WIRING `lERVICES INC PHONE #: 503.310.3655
Inspection Request Scheduled For: Date: 4/14/2006 Pour Time:
Code # Inspection Description • onfirm # Contact # Message
33 Low voltage 02 446-01 503- 310.3655 Y
Corrections /Comments /Instructions:
•
•
•
•
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL - ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cristo.% ' ° v ® Date: Phone #: (503) 718 - ` q,C �
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2006 -00077
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/11/2106
Phone: (503) 639 -4171 i l l
Inspection Requests (24 Hrs.): (503) 639 -4175 J.
INSPECTION WORKSHEET FOR DATE: 4/13/2006 TIME: 7:00AM PAGE: 63
SITE ADDRESS: 09;; _ SW WASHINGTON SQUARE RD ( -9 CLASS OF WORK:
SUBDIVISION: WAS ETON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: BATH + B► s )Y WORKS
DESCRIPTION: Limitedener• or audio/stereo.
OWNER: WASHINGTON SQ RE LLC, PHONE #: 503- 639 -€t665
CONTRACTOR: ADVANCED WRING ' RVICES INC PHONE #: 503-3103655
Inspection Request Scheduled For: Date: 4/13/2006 Pour Time:
Code # Inspection Description • onfirm # Contact # Message
13r) Low voltage 0 902 -01 928-301-9337 N
Corrections /Comments /Instructions:
❑ PASS ❑ PARTIAL APPROVAL XCANCE ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION DDITI AL FEES ASSESSED
Inspector: CT' _ - N • Date: J nG Phone #: (503) 718- 1114