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Permit CITY OF TIGARD ELECTRICAL PERMIT 2:- COMMUNITY DEVELOPMENT Permit #: ELC2009-00119 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/12/2009 Parcel: 151260000300 Jurisdiction: Site address: 9631 SW WASHINGTON SQUARE RD FCO3 Subdivision: Lot: 0 Project: RUBY THAI KITCHEN Project Description: TI. Owner: FEES WASHINGTON SQUARE LLC Quantity Description Date Amount BY THE MACERICH COMPANY, 9585 SW WASHINGTON SQUARE RD 1 ea Sign or Outline Lighting 03/11/2009 $53 40 PHONE. 1 ea 12% State Surcharge - 03/11/2009 $6.41 Electrical Contractor: JERRY M YOUNGER 840 NE SQUIRE AVE GRESHAM, OR 97030 PHONE 503 - 618 -7826 FAX 503 - 253 -9407 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $59 81 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law 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 the 180 days ATTENTION. Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952- 001 -0010 through R g-0 95520 - 011000 You may obtain a copy of the rules or direct questions to OUNC by calling 50�r 1 800 332 2344 1 Issued By: IX t (L ' `1C . ` ta/A Permittee Signature: ��,1 (Vll I v 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' 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 �4� @Ct1C"1tCR1 .� @rM1f!• Ap �C��SIGIi RECEIVE ): , , , , lo.,,,c rt 1 F, „.. 1 .,i (ii i 5 _ ,r W ' City o Ti Heil) a a 97223 MAR 1 4 r. _, o`z 46 l�anttttrlo...� It✓ r ' . C ' _O 1 _ 0 2009 an Ntw _ ` l __1 .1, . Amur. 5036394171 Fax 505,598.1'960 1 DOWRY, OtherPennit 4 p�c . t S } 1 . y in t,•ine: 501 63? 41 75 �r�r Dane kaadyByr lam a Pap far Trtarner wwev,rigerd- or.goy CITY OF 11G �rrl��lcd1e'd• 11 C. . ,. SuEremenrarreftnoxnoe TVS OF wiiiiiLDINO DIVISION I PLAN REVIEW © Now Construction Addit.On /alt ct max• eh•v n I M apply (auErtft Z ante of pi= whites ahecoad1 i1nw� Sarin( or t••da• 4CO nova rtr more 0 9nildeas over three ;wise Dem itto ©Other: I where t h e serileble f•u1t current ❑ Ma roes and boatyards, CATEGORY OR CONSTRUCTION ( ascends 10,0(O mop: at 150 veils er El Flondaa brtitdmgo. t I Ins. to Ord, CO eacoodr 14."00 ❑ Cemmcreict -ire •pricnlnnnl [ 1- and 2-family dwelling 0 Commercial /industrial ❑ AccvsBOry blinding amps far all ctl^a irrcllnnvrs lnuldrrgr Kadti- family 0 Mast Builder ther: i Cl Eire pump G Inamllotion of 75 KVA Cr •apn ataly derived syxtc�n am SITE 1NFORMATrON AND LOCATIQN ©Prragene}' ,yctem hvFcr I Clned4lce new motor lead of 0 "q' L 1 2•. - Job no.. Job site address: 96 / c ',„ t~/� I I0a11r m moR acvupency. �LIeL - f"" '°! ❑ Stz as more realden;tnl units. ID . exrcecori l voh:olt pada. Ctr}" /Statc/ZIP. - I r' 0 e1' -1z2 3 --- He ttl-eare ratillr,et ❑ 8oapiy volmart Pot Wrote Aim l ' C1 In H0 7 ..aceouv ∎Oo lints. FOC veils nominal. Sui:e/bldg. /ep'. no.. Project name: iD Service or feeder enO amps at more, FEE SC ARDULL L Cross strcet'directior tojob Site: ..Otewibtnn Total I / New residential single• or mold dwelling unit. .84 " - , 1 . ■ri [i ^ / / I inelodt:vmrtaebed garage. 505Clivis ion: 1',01 n0.: j L000 K. ft. or toss i l e5.15 1 _ 4 I Ea add'1500 so ft. crportion 33.40 I 1 Tax map /peroclno.: Cimitc rebidentistl i DESCRIPTION WORD xtth aoova_aq R} 75,00 2 DIESC "' I Limited energy, multi - family - r _.. -.- 1R J�ta. dla e tifil/L/ . { residential (wit.abava rq. A.) 75 00 1 2 Services orfeeders Insnl(tion, ;Mere tion, and /or retneetion 20D am or less 60.30 2 ICJ PROPERTY OW1�'ER - 0 TE'NAN'T L 20l s amps tr: 400 amps - 106,35 I _ 2 Nan 1'c: 1 �N- np�, I 401 amps le 600 amps 160 60 2 C p r ' � . ' •' 60 1 amps to 1,000 4111 1)5 240,60 I 2 Address: j ,'i. d I A) c. ^ , . J, tai. P I b Orel 1,000 amps tsr vain 454.5S 2 City/State/ZI , P; r • 1 Temporary services or feelers Instaliattlon, alteration, and /nr Pd i relocation Phone: ( ) I Fax: ( ) r 205 amps or less I 66 B5 1 Owlter installati0nt This utstallalion is bei made or. r '---' 201 Mpg IC 400 amps . - *ta property that , own which is not 1 100.30 2 :mended for sole, lease, rent or evchanga, According t0 ORS 447, 449, 670. and 701. 401 amps ec 599 amp, t i 33.75 2 Branch elrenm — new. alteration, or extenslon. er panel Owner signature; _ _ D A. lee for branch circuits wall D. APPLICANT I jg CON TAC_'J: PERSON above sen'lrc or feeder fee, Bu9z•1c3s name. ppJ,� each brand circuit 6 FS 2 1' ]tT K r 1'(',f i .. J K,..- .7tilY .,, 13 Pea for bras'e i circuits Contact n¢m o��� 1 � D D ivtrhosr service or feeder Z. 46.85 2 eJ rk l first branch circuit Adesy: C ' o 2e• Each ride'! branch circuit 6 65 _ 2 City/Stara/ZIP: dt — Miscellaneous (sorvIce or feeder not included) „g,la . en # r , Each taanu 5ivt dormoduiar 90,90 2 — dwellingg, service and/ot feeder Phone: ( c; •24 _ q A. ° I Fast:: 1 Reconneel only 66.85 2 E-mail: : Pump or irngation circle 58.40 2 I —.,. CONTRACTOR Sipsor outline lighting i 53.40 tA ,/0 2 Business name. •-• + Signal ci cwt(s) or limited- � ^ ...ff../ . a . _. s 1 • ... .d.- , cncrey panel, alteration or Address: C� `i / I J j s ' eak ,. cxrcr;sion. Deacribc, Pau 2 2 City /Stsie/Z((' v` pp f Each additional impeetlnn Aver allowable in ■n nfthe above t'4 1+ 7.1!!, /X 4 4.+ t t)-4, �'1 G C y Per insration I 6150 i Phone: (CDi WO O - 77(f' 115• t •a 4I L ` 2 83 q c{C) 7 _., TsIvesti59tion per hour (, hr sun) J 62.50 CCB Lic,: 1 P.1ect•tcal r 7 t1p5N. L(c.. :24:794 I Induatrist plam per hour f 73.75 _ I Al 9uprv. L� signatrre. - equired' /� _ /' ef I' 7. I• tl eG - / 5 t '-- ELECTRICAL PERMIT FEES �---_ .. _ ,,, J Sub7ltal: I 5'5 • L 0 Print Entire: , ' , e _ �, Plan review 45% of permit fee): -- 9- -- h -�-- I State surcharge (l 2'YG ofpern,it fccti (p . if Authorized GIgABtt 1e: ir TOTAL PP.12MTT Poe; I 4t . 3 �y Print tame: J f Q Q r / Dt Soya eAgr:e Fee I Ti, la■tioa wira n obtelned wl a 1 p' been accepted a• complete , ndlarlrrrna4,r1c.rret wp r p Inc avn ? roc ' Number a` nofCCdohs allawrt pm pnrml rm� / i i / - o Sr:1I [NAVES I 'M& GI Ed Wd9T : E0 600E 60 •- eN 90176 2SE 20S : '0N 9NOHd sus t S 'g uoaN al 1 l 03 t 1.-rd : WOdd s