Permit k''Y. I 1 Y OF IGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00931
�i DEVELOPMENT SERVICES DATE ISSUED: 1/31/2006
�=--' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600-00300
SITE ADDRESS: 09632 SW WASHINGTON SQUARE RD G -9 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: TI
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: -2-- -9' W /SERVICE OR FEEDER: —62' (O ( PER INSPECTION:
201 - 400 amp: 1 1st W/O SRVC OR FDR: I 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: X CLASS AREA/SPEC OCC:
Owner: Contractor:
WASHINGTON SQUARE LLC ADVANCED WRING SERVICES INC
BY THE MACERICH COMPANY PO BOX 644
9585 SW WASHINGTON SQUARE RD CLACKAMAS, OR 97015
TIGARD, OR 97223
Phone: Contact #: PRI 503 - 310 -3655
FEES
Description Date Amount Reg #: ELE C7
[ELPRMT] ELC Permit 1/31/2006 $754.70 LIC 162591
[ELPLCK] ELC Pin Rev 1/31/2006 $188.68 SUP 46755
[TAX] 8% State Surcharge 1/31/2006 $60.38
REQUIRED ITEMS AND REPORTS
Total $1,003.76
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 otification Center Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or s' • . ions to at
503 - 246 -6699 or 1- 800,32.3344.
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.
4913 w
Ele t>�-i�al Per I pp I�a -tl an - - ,, -, - 1 - FOR OFFICE USE ONLY
� •�
City of Tigard �+ Received ,
= DateBy 60 Permit . ,EL La'(}Q5 —" Gbf3 ('
13125 SW Hall Blvd , Tigard, OR 97223 r. ■ Plan Review
Phone 503.639.4171 Fax 503 598.1960
( - ' � Date/By. Other Permit
Inspection Line 503.639.4175 e• I Date Ready/By ions El See Page 2 for
Internet: www.ci.tigard.or.us CFI Y OF TI GARD Notifiied/Method. r 6 Supplemental Information
3i " sr _ II1, -, i V
PE
' TY O PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply.
❑ Demolition ❑Other:
E Service over 225 amps, comm'l ❑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 ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi- family ❑Master builder ❑ Other:
❑Occupant load over 99 persons ❑Manufactured structures or / 1 1
JOB SITE INFORMATION AND LOCATION ®Egress /lighting plan RV park
Job no.: Job site address 7 SW WASHINGTON SQUARE ❑Health -care facility ❑Other:
�
j Submit 2 sets of plans with any of the above.
7
City/State /ZIP: TIGARD, OR 97223 119 32-. The above are not applicable to temporary constriction service
Suite/bldg. /apt. no.: G-09 Project name: BATH & BODY WORKS FEE* SCHEDULE !
_ Description I Qty. I Fee. I Total
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq ft or less 145 15 4 i
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 i5
DESCRIPTION OF WORK Each manufactured or modular i(}�t
INTERIOR REMODEL OF RETAIL SPACE IN MALL FOR EXISTING dwelling, service and/or feeder 90 90 2
Services or feeders installation, alteration, and/or relocation
TENANT "BATH & BODY WORKS" 200 amps or less 2 ✓ 80 30 146•1315 2
• 201 amps to 400 amps l 106 $5 106.10 2
❑ PROPERTY OWNER I ® TENANT
401 amps to 600 amps 160 60 2
Name: BATH & BODY WORKS 601 amps to 1,000 amps 240 60 2
t Address: THREE LIMITED PARKWAY Over 1,000 amps or volts 454 65 2
Reconnect only 66.$5 2
City/State /ZIP: COLUMBUS, OH 43420 Temporary services or feeders installation, alteration, and/or
Phone: (614)415 -7000 I Fax: (614)415 -7349 relocation
200 amps or less 66.85 I
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
Co 2. 6 65 11236 2
Business name: BATH & BODY WORKS branch circuit
B. Fee for branch circuits
Contact name: TIM SCHENK without service or feeder fee, 46 85 2
Address: 1120 EAST 80 STREET -SUITE 211 each branch circuit
Each add'I branch circuit 6 65 2
City/State /ZIP: BLOOMINGTON, MN 55420 Miscellaneous (service or feeder not included)
Phone: (800) 541 -0821 Fax: : (952) 854 -4909 Pump or irrigation circle 53 40 2
Sign or outline lighting 53 40 2
E -mail: tims @elderjones.com Signal circuit(s) or limited- �f�
CONTRACTOR ` energy panel, alteration, or
Business name extension Describe . Page 2 2
g(JL' 'it 1&/ /Z /m fti?li /itf
�Q (� Each additional inspection over allowable in any of the above
Address:
fp ' I O d9/ Per inspection 62 50
City/State /ZIP: e/ / n mr 970/ j Investigation per hour (1 hr min) 62 50
Industnal plant per hour 73 75
Phone: ( S03 ) 833 ....,2 9g Fax ( ) ELECTRICAL PERMIT FEES*
CCB Lic.: /(2g -q/ Electrical Lic.: 2 : prv. Lic.: 4 753/ lb Subtotal
Suprv. Electrician signature, required: / Z in ‘y Plan review (25% of permit fee) _2„431;43 ; 43
Print name: i � Date: / -. �� rcharge (8% of permit fee) �/
L)D3 -A TAL PERMIT FEE
Authorized signature: / This permit appli on e if a permit is not obta ed within 180
, tem y s after it has been accep as complete Print name: Srifiv Date: / _ 3/-0‘ * Fee methodology set by Tn- County Building Industry Service Board
/ ** Number of inspections per permit allowed
i uddingWermns\ELC- PermiApp doc 12/03 4 40- 4615T(10 /02 /COM/WEB
Building Division
I
Request for Permit Action or Refund
City of Tigard
TO: CITY OF TIGARD
Permit System Administrator
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard - or.gov
FROM: ❑ Owner ❑ Applicant
(check one) Contractor ❑City Staff
Name: I #
(Business or Individual) ,4kVA! CE) W i N6 S�� i V G .
Mailing Address: P.O. goX &9.1
City /State /Zip: c L ACKA -MA 02 . 17015
Phone No.: 'O3 - I ( - ZLSG
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
❑ CANCEL PERMIT APPLICATION.
REFUND PERMIT FEES.
❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit).
Permit #: LIL ZDo5 - Do9
Site Address or Parcel #: pei (, 3Z S. h3 _ W J- IN6-T6 N 54. 2 - (,.. -
Project Name: jAV-i d ciy 1400KS
Subdivision Name: Lot #:
EXPLANATION:
ra VAMIC eteA. i/DD a4.-7 pl.ev
eifrcvhi 7 W p lr✓i c,Q Gt z/ 44,66;40,;c � Gl /Gl�i —
Signature: Date: 4Z/0// ZOD‘
Print Name: �� �' e
Refund Policy
I The Building Official may authorize the refund of
a) any fee which was erroneously paid or collected. -
b) not more than 80 percent of the permit fee for issued permits prior in any inspection requests.
c) not more than 80 percent of plan review fee when an application is canceled before any plan review effort has been expended.
2. Refunds will be returned to the original Payer in the same method in which payment was received.
FOR OFFIC US I: 0)L.1
Rte to S Admin: Dat _ Do B , Rte to BId: Admin: Date ? G 06
Refund Processed: Date B Invoice Processed: Date B
Permit Canceled: „Terimm B Parcel Ta: Added: Date B
Recei st #4t -, - .' 'Date ../1:706 Method C Amount $
l \ Building \Forms\RegPermnAction- Bl.g.doc 01/20/06 u �
CITY OF TIGARD
BUILDING DIVISION PERMIT #:G�-S'� � b 93
13125 SW Hall Blvd., Tigard, OR 97223 I DATE ISSUED:
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ° __
INSPECTION WORKSHEET FOR DATE: TI ; 4.7i1 > PAGE:
SITE ADDRESS: Cj � / C�'�'9 CLASS OF WORK:
SUBDIVISION: ` LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #: - 9.73' - 25 go
CONTRACTOR: S c PHONE #:
Inspection Request Scheduled For: Date: ti — c° Pour Time:
••e # Inspection Description Confirm # Contact # Message
4 =- • Comments /Instructions:
•
t • ct W p awl .♦ `. (2lbA'•
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: i\W)1/4.,)de Date: / n 4, Phone #: (503) 718-14410
CITY OF TIGARD ELC " _ J
BUILDING DIVISION '' PERMIT #: °� OO � DO FS r
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 , - ,,,,ir 1 4,
Inspection R equests (24 Hrs.): (503) 639 -4175 ' ..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 9(0 3. ' SO - CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: y PHONE #:
Inspection Request Scheduled For: Date: 3 - .., F- 0 Pour Time:
Code # Inspection De :rn Confirm # Contact # Message
L3 c 30 Cam 3'° - 33, ss
Corrections /Comments /Instructions:
Z I4 )'P SP L i Cp-E 4 Pal +)a Boo )&tt
i.,16 ,ou is- 7-6(b4L.„
•
Z Y "7 o c,c1 1. • L
L1ii- F-06- AGE,e
PASS 1KARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (.1 V0.) Date: 3 W Phone #: (503) 718- V'
CITY OF TIGARD , r= �-c-
BUILDING DIVISION PERMIT 4005 ov 7 3/
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171�°i I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE:. TIME: PAGE:
SITE ADDRESS: C ? Co 3 Z W ` S Q . . CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 ` 8- oee Pour Time: r
Code # nspection Des '•n Confirm # Contact # Message
1 . 30 qz ,?- 30/ - q 3 3 7
Corrections /Co - • . ctions:
"PeOCN e a tirt4c ,act 6G
13e`7 (Gorr.
•
•
•
L14SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
F' IL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CC/M1 Date: c\L Phone #: (503) 718 - x
V p' `��
E LC 60
CITY OF TIGARD
BUILDING DIVISION PERM #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 p,
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/ � /d 6 TIME: PAGE:
SITE ADDRESS: £ �p 1— � �S` � �. CLASS OF WORK:
SUBDIVISION: l LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
•
Code # Inspection Description Confirm # Contact # Message
1 L J�` • v .
o re ions /Comme ts/Insuction
tMb
❑ PASS P ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: lv Pi?) LE Date: 3( I fib Phone #: (503) 718- 1341
CITY OF TIGARD
BUILDING DIVISION PERMIT #: rI F 005 L,lies31
13125 SW Hall Blvd., Tigard, OR 97223 - DATE ISSUED: F ,-;
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 .71
INSPECTION WORKSHEET FOR DATE: 2117/2I 06 TIME: 7.06Alvk PAGE c;
SITE ADDRESS: 09632 SW WASHING TON SQUARE PD G-9 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: •
PROJECT NAME: BA1-FI + t3ODY WORKS
- DESCRIPTION: TI
OWNER:, WA SQUARE LLC, PHONE #:
CONTRACTOR: ADVANCED WIRING SERVICES INC , PHONE #: 603.,310,?t�;,;'tj
. Inspection Request Scheduled For: Date 2117/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
10 &o Un&.igroundislab cover 027121 - 01 803- 310 - 3655 N
Corrections /Comments/ Instructions:
•
•
•
•
•
•
*PASS " PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1V Gp L1E. Date:, 6 Phone #: (503) 718 - _-