Permit ( CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00247
DEVELOPMENT SERVICES DATE ISSUED: 5/8/2006
°�I II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600:00300
SITE ADDRESS: 09633 SW WASHINGTON SQUARE RD FC -4 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: 15 branch circuits.
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:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 14 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
WASHINGTON SQUARE LLC RK ELECTRIC INC
BY THE MACERICH COMPANY 24495 NW OAK DR
9585 SW WASHINGTON SQUARE RD HILLSBORO, OR 97124
TIGARD, OR 97223
Phone: 503 - 639 -8865 Contact #: FAX 503 - 356 -0513
PRI 503 - 640 -1344
FEES
Description Date Amount Reg #: ELE 34 -375C
[ELPRMT] ELC Permit 5/8/2006 $139.95 LIC 94275
[TAX] 8% State Surcharge 5/8/2006 $11.20 SUP 47245
Total $151.15 REQUIRED ITEMS AND REPORTS
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: t Ce.,p _ - ,�, l
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.
May 05 2006 5: 54AM HP LASERJET 3330
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Inca' reMit AnnlicatiCii(n v \-- k orFtc -. uyE () EA'
......i of Tigard R. ived 57, ob 1. ."
p...oz... , WI of
13125 SW Hall Blvd., Tigard, OR 97223 7ViCf _ Plan Revzew Other Pe . t•
Phone: 503.639.4171 Fax: 503.598.1960 "5V4111 ';''. Date/By:
Inspection Line: 503.639.4175 I Date Ready/By. Jams Ea See Page2 far
C 110 2 " - ' ---' Notified/Method Supplemental Information
Internet: www.cltigard.or.us c■ o0 . ,
1;:: -.: iitiguotiw, . :,..:..'.::: . .::,.:',...,:::.;:::....: 7::!. ::;,;,•:;;;;..: .... ,.•;.,.,,:,:::, . ..... : - w ,..,,,,.,„,„..,,, ,,,,,., . . . ,.. .
New construction IS1 Addition/alteration/replacement Please check all that apply:
°Service over 225 amps, conmi'l ['Hazardous location
0 Demolition 0 Other: - over 320 amps -rating °Buildng over 10,000 sq. ft.,
"..'..".-;;;..';:l.:- n" ' -f . - of 1- and 2-family dwellings 4 or more new residential
--- 6" - 1in ... d '...i fatni . i e h ing '—' s' comna --- "i b--- .-- '' Ds over 600 volts nominal units in one slruuture
DBuilding over throe stories OFeeders, 400 amps or more
0 Multi-family 0 Master builder 0 Other: °Occupant load over 99 persons DManufactured structures or
biiiiiIiiiii*Vititti/kAiiii.460#;;.iii::%:::::;:;e:6,;;Z:.e,i'01;i: DEgr„siligbting plan 1W park
CI ileahh-care facility °Other:
Job no.: _I Job site address: 9633 SW Washington Square Rd. Submit 2 sets of plans with any o the above
City/State/ZIP: Tigard / OR! 97223 -flie above are not appliaible to I , porary construction service
. .
........i.l':
Suite/bldg/apt. no: i Project name: Good Dog I Bad Dog tm....40u
Cross street/directions to job site New residential single- or multi artily dwelling unit.
Includes attached garage.
Upstairs in the food court at Washington Square 1,000 sq. ft. or less
145.15 4
Subdivisioir. I Lot no.: Ea. WI 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2 I
Tax map/parcel no.: . Limited. energy, non-residential 75.00 2
;'.;Cf:':'. --- . j iyi - itiortifigkfiti' ivieliite ' :- . :.....''';'*-.'', - '''?'''''''''::' :='': Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Tenant Improvement - add, alter or extend up to 15 circuits Services or feeders installation, alteration, and/or relocation
200 amps or less 80 30 2
- • • - .. .. .. .- . - -.: --,--------- - . ::-.- . -------• - --.- ••• ..-; <t: ? ---" . - ". ..... • :s: ::-.... "- -- ,.: 201 amps to 400 snips 106 85 2
::-.: •'.:Er.i.::...*:.....T:""'5:t.f.l_fa0;1144V":02.1**.4M*,:-.::-,,:::-::.E.:1:;:i-;•:.:.:-,..,2.;:;4.,i,..;?:-4.0*)41401,f.A;i.i,...,....,.::::: ..s.p...„:„-., 160.60 2
Name: Western Roasters, Inc. 601 amps to 1,000 amps 240.60 2
Address: 1680 Willamette Falls Dr. Over 1,000 amps or volts
1- 454.65 2
Reconnect only 66.5 2
City/State/ZIP West Linn / OR / 97068 Temporary services or feeders installation, alteration, and/or
Phone: (503)805 I Fax: ( ) relocation
200 amps or less 66.85
Owner installation: This installation is being made on property that I own which is not 20% amps to 400 amps 100.30
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 600 amps 133.75
2
aims to 2
Owner signature Date. _ Branch circuits - new, Altera o. n, or e tassion, per panel
''' - . . -- ''' ' '' • - '''' - ' ' - ' - ' ' " a'''' ':'''" A Fee for branch circuits with
ce or feeder fee. eacb 6.65 2
Business name: RK Electric, Inc. branch circuit
B. Fee for branch circuits
Contact name: Ron L. Kurtz without service or feeder fee 1 46.85
each branch circuit
Address 24495 NW Oak Dr. Each addi branch circuit iii 6.65 91/0 2
City/State/ZIP: Hillsboro / OR / 97124 Miscellaneous (service or f. %. er not included)
Pump or irrigation circle 53 40 2
Phone (503) 640 1 Fax -. ( ) ' Sign or outline lighting 53.40 ,
E rkurtz@rkelectric_biz Signal circuit(s) or limited-
encrgY panel alteration, or
extension. Descnbe: Page 2
Business name: RK Electric, Inc.
Each additional inspection . er allowable in any (tithe above
Address: 24495 NW Oak Dr. Per inspection 62.50
City/State/ZIP: Hillsboro / OR! 97124 Investigation per hour ;.1 hr 1 62 50
Phone: (503) 640-1344 11 Fax: (503) 356-0513 Industrial plant per hour 73.75
K:i:5K:s:':":0$0*.40C '..0441:WAVAr*::::: :': ........... ::
CCB Lic.: 94275 1 Electncal Lic.: 34-375 C 1 Supry Lic.: 4724 S Subtotal j.3' tqc
Suprv. Electrician signature, required: t Apyi c/( Plan review (2 .% of permit fee) .4;)---
er) urcharge ( 2
O : % of permit fee) ')
i .
Print imme: ' K Vt L I Me: 5/4/06 Stale surcharge
TOT , PERMIT FEE i . L i S''''
Authorized signatare:(Zyl a e 1.(.....1---- This permit application capita Ira permit is not obtained within I St
i..) days after it has .. • n accepted as complete
Print name: ,, ,, z. K . Date 5/4/06 * Fee methodology set by Tri- .unty Building Service Board
Number of lob oar oe 't allowed
, ,
CITY OF TIGARD Cc
1
BUILDING DIVISION PERMIT #:a6jo6 eo
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 it� I�Il
Inspection Requests (24 Hrs.): (503) 639 -4175 `_..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 9 6,3.3 WI /- . SQ CLASS OF WORK:
,
SUBDIVISION: 9 LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: G....000 !bn / BO b Oa O , PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 6- / x Pour Time: /
Code # Inspection Description Confirm # Contact # Message
/ %9
/ed. 1 36,0- 6o /- 7
Corrections /Comments / Instructions:
/V o -
F
AL6O; . e\-." 2ott --s- 64213 sibs
191- E;NAL
c
•
P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: - N66 Date: 61/ 6 1 0 6 Phone #: (503) 718 - 1144
r i
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EL C2006-002‘17
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/R/2006
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ._14 .__-
INSPECTION WORKSHEET FOR DATE: 5/11/200€ + TIME: 7:00AM PAGE: !;8
SITE ADDRESS: 09633 SW WASI1INGTON`SQUARE RD FC CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: GOOD DOG BAD DOG
DESCRIPTION: 16 branch circuits. 5/10/06: ADDED LOW VOLTAGE FOR DA1 A/I EL .
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503639 -13D65
CONTRACTOR: RK ELECTRIC INC PHONE #: 503 -610- 1:x'1
Inspection Request Scheduled For: Date: 5/11/2006 Pour Time:
Code # Inapection Description Confirm # Contact # Message
126 Wall cover 029676.01 60360 -1344 N
Corrections /Comments/ Instructions:
-
•
•
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �, � i L 1? Date: sin' I c( Phone #: (503) 718- 29 6.
NommegA zingfurrse^ur 1101 S.E. 3RD AVENUE • PORTLAND, OREGON 97214 • (503) 238 -5700
IVV= V 850 CONGER • EUGENE, OREGON 97402 • (541) 683 -9333
SAFETY COMPANY 2600 AIRPORT WAY, SOUTH • SEATTLE, WASHINGTON 98134 • (206) 340 -4300
. CERTIFICATION - INSTALLATION /INSPECTION
Customer Name (1 Q i Pnia (10
Address gl!n -3 ( 7 � U 1ifac V► #vYl ic,je
s T , (ra'd f OK . } 7'
SYSTEM
Model(s) and serial numbers a I U C c I
Number of nozzles and Part No. Otk.l I t .eotAt., - k - 9
Number of detector(s) and degree rating L f? - 36c °
Energy shut -off devices — type and size 1Pt if‘CI n s cU, I 6 -.01 411 J 04
Other accessory equipment provided (pull station, electric switches, etc.) 'PL I I (4-1 t deck i(
Cu, #c1d5
COOKING /VENTILATING EQUIPMENT
Number of duct(s) and size I Q t'\Y I t(
Hood size and plenum size l-{ e I 2 x TO { I L K I ��
Cooking Appliances and size of cooking surface. (NOTE: List appliances from left to right and indicate - -
. being protected.) V
1. (r .te Q 7,-1" r (4i' 4. Z 6, r rQ ( vz.• k z 4 h1 •
2. 'C t tLi t. 5.
. -_- 3. 6f. ctP 7,1 " )-/ -4 6.
FIRE EXTINGUISHEFtINSPECTION NOTE:
❑ Kiechen ❑ Facility
= TO BE COMPLETED BY INSTALLER
lkt YES ❑ NO
The fire suppression system is installed in accordance TO BE COMPLETED BY CUSTOMER
with the manufacturer's instructions, NFPA Standard V
96 and 17 (current issue), and all applicable state and local codes. Exceptions to other provisions of NFPA 96 ❑ YES ❑ NO
that were observed are noted below. .
I understand that it is the, recommendation of •ANSUL
Exceptions: and cf the National Fire Protection Association /
Standard 96 and 17 that the fire suppression system be
inspected and maintained every 6 months to ensure r�
continued efficiency and reliability and that failure to
do so may result in failure of the system to operate
properly
CUSTOMER NAME AND TITLE
- YES ❑ NO V -
All electrical work or work provided by others to SIGNATURE
complete this system installation has been completed. DATE
INSTALLER NAM r` r 4- ` ' J
SIGNATURE & V" 1 � f
DISTRIBUTOR ` ItriJ -e( c6v\ S i t •
ADDRESS 1`o ` S 3' • '�r� I i " •
P e" - r - !G►�tr C /��d. I � ' ;
DATE 6 ft