Permit *r CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00582
.4111- DEVELOPMENT SERVICES DATE ISSUED: 11/4/02
„�-1 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1 S126C0 -01107
SITE ADDRESS: 09635 SW WASHINGTON SQUARE RD ZONING: C-G
SUBDIVISION: FC -5
BLOCK: LOT : JURISDICTION: TIG
Project Description: Job No. 9556
Tenant Improvement
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: 10 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:
PPR WASHINGTON SQUARE LLC AMP ELECTRIC
BY THE MACERICH COMPANY 12209 NE FOURTH PLAIN #U
9585 SW WASHINGTON SQ. RD. VANCOUVER, WA 98682
PORTLAND, OR 97223
Phone: Phone: 360 - 892 -4499
Reg #: ELE 37-561C
FEES
Description Date Amount
Required Inspections
[TAX] 8% State Tax 11/4/02 $9.07
[ELPRMT] ELC Permit 11/4/02 $113.35 Wall Cover
Elect'I Final
Total $122.42
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: Permit Signature: 4 164 i' i -4
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 639 -4175 by 7:00pm for an inspection the next business day
2002 - 22.26 3608927761 AMPELECTRIC PAGE 01/02
4,,,6 ,,
A Electrical Permit Application
Date received: Permit
era 102 -oo 5g,.,
. l,j.` -'1 i!. City of Tig Projcct/appl. nu.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171
Date issued: By: l Receipt no.:
Fax: (503) 598 -1960 Case file no,: Payment type:
Land use approval:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory O Commercial/industrial 0 Multi- family ( Tenant improvement
New construction ' 0 Addition /alteration/replacement 0 Other.. O Partial
.1011 SITE INI'ORMATION
Job address: '
e✓ .,; . Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: Subdivision:
Project name: S' (N S , Descri tion and location of work on premises: y At,
Cv!/i2.r
Estimated date of tom •letion/ins. - don: 2 - 0 Z ---
CONTRACTOR APPLICATION _- "`:'
FEE SCHEDULE
Job Ho: 9 g ' e Foe
Business name: n I?+ p , , � c Des on Qty. ea.) Total no. Inv_
Address: New nnidendal - single ormahi- fem;ly per
k �� dweitinguntt.Indudes attached garage.
City: 4,u State• ZIP:
,� 1 serviceirtemaea:
Phone16 -) /d . °SAS Fax: i 2 - ,,,M E -mail: 1000 sq, ft. or less 4
CCB no.: ^ 787s. Z Elec. bus, liC. no: Each Eac a on4'onu al 500 sq. ft or2ottton thereof —
5 f C. Limited energy, residential 2
City /metro lie. n o.: 2,2. Limited energy, non- res 2
�r�L% �, .„ .�2_ Each manufactured home or modular dwelling
i�:, atur .fsu.•isingelectriclansequired) bate Service and/or feeder 2
Sup. elect. name (print): 1-E, A � , f„ • Set�ices orfeedeYt- ihsladlation,
�• " • ' License no: alteration or relocation:
PROPER I l' OWNER 200 amps or less 2
Napo,e (print): 201 amps to 400s 2
Mailing address: 401 amps to 600 amps 2
604 taupe iv 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: J Fax: I E -mail: Reconnect only 1 - Owner installation: The installation is being made on property I own Temporary services orfeeders -
which is not intended for sale, lease, rent, or exchange according to Insiailatloa, alteration, orrelocation:
ORS 447, 455, 479, 670, 701 • 200 stops or tea, 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
- Address: service or feeder fee, each branch circuit 2
City: State: ZIP: B. Fee for branch circuits without purchase
Phone Fax: Erman: of service of feeder fee, first branch circuit: / far Wry' 2
Each additional branch circuit: (tri ■,,C0
PLAN REVIEW (Please cheek all that apply) Mac. (Service or feeder not included):
❑ Service over 225 amps- commercial ❑ Eeelth -care facility Each pump or irrigation circle 2
O Service over 320 amps- rating of 1 St2 0 Hazardous location Bacb sign of outline l ighting 2
family dwellings O Building over 10.000 square feet four or Signal circuit(a) or a limited energy panel, •
O System over 600 volts nominal more residential units in one structure _ alteration, or exteosion* 2
0 Building over three stories 0 Feeders. 400 amps or more, "'Description:
❑ Occupant load over 99 persons O Manufactured structures or RN/ park Each additional inspection over the allowable in any of the above:
O Egress/lighting plan ❑ Other: Per ins ection
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
'No: mill jwied"icaom jurisdiction accept credit cards, please call jtion for more information. Notice: This permit application Permit fee $ I / 3S
visa o MasterCard expires if a permit is not obtained review (at _ %) $
Credit card number. ap f M /q f r t) I P S within 180 days after it has been State surcharge (8%) .... $ 9 t1
r`e'd" (4- kat , y c 1, --, EV •7 Sties accepted as complete. TOTAL $ (2- L '( l
Name of [_holder as shown c cedit card
V22 it
■
ardhatder signature Amount 440 -4615 (6eo/COM)
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 - 4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested // -` $ AM PM BUP
Location 6 Ce/G S `L 5 7 few Suite MEC
Contact Person • Su 6 wa c el" Ph ( ) , �� ff /o -5 PLM
Contractor Ph ( ) SWR -
BUILDING Tenant/Owner ELC Ze Z —GL' CI' 2-
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
, Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole 1
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
L_CTRICAt
Service
Rough -In
UG/Slab
Low Voltage
F: larm
S PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
❑ Please call for reinspection RE: ❑ Unable to inspect — no access -
Fire Supply Line
ADA
Approach/Sidewalk Date 1 r / �!� Inspector - J .rte Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL