Permit • • 4.
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
i� DEVELOPMENT SERVICES
PERMIT #: ELR2006 -00085
�''1 'I-- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/18/2006
PARCEL: 1S12600-00300
SITE ADDRESS: 09641 SW WASHINGTON SQUARE RD FC - 7 ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: LOW VOLTAGE CCTV SYTEM
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: 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: CC TV X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC VISION SECURITY SERVICE
BY THE MACERICH COMPANY 10874 SW ROLAND CT
9585 SW WASHINGTON SQUARE RD WILSONVILLE, OR 97070
TIGARD, OR 97223
Phone: 503- 639 -8865 Contact #: PRI 503- 682 -6713
FAX 503 -582 -1133
FEES Reg #: ELE 3- 544CLE
LIC 152497
Description Date Amount
[ELPRMT] ELR Permit 4/18/2006 $75.00
[TAX] 8% State Surcha 4/18/2006 $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 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 -0110. You r : • •tai opies of these
rules or direct questions to OUNC at 503 - 246 -6699. /
Issued By: P ermittee Signature: _ 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.
r !�.�
Elec Permit ADDli b": Q FOR (I)I Icy: 1151 O l Y.
City of Tigard Received q rirmairm Pernut No 0 , 1
13125 SW Hall Blvd., Tigard, OR 2006 Plan Review
Phone: 503.639.4171 Fax: 503.5 8.l 60 U Date/B . Other Permit
T I G A Rid Inspection Line: 503.639.4175, 1 r Date Ready/By. ions El See Page 2 for
Internet: www.tigard -or gov,,,���� _ . _k J f b Notified/Method T Supplemental Information
TWO O V O - a t `- / tNiI01\ PLAN REVIEW , .
❑ New construction /1?'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 l- and 2- family dwellings 4 or more new residential
❑ i - and 2- family dwelling 'Commercial/industrial ❑ Accessory building ❑System 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.: J Job site address: q(d.-1 1 s i Wd$)4. sei -j ❑Health -care facility ['Other:
11 Submit 2 sets of plans with any of the above.
City /State/ZIP: I 1 c=3 ( DP_. (i a 33 The above are not applicable to temporary construction service
Suite/bldg. /apt. no.: Project name � : b �'�/���� � FEE* SCHEDULE
�y'""�"' Description I Qty. I Fee. I Tad I ••
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
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
,
DESCRIPTION OF WORK Ea Limited ch manufactured energy or modular non - residential 75.00 2
( 4- 1 / S �. r .n , dwelling, service and/or feeder 90.90 2
�/ f7W Services or feeders installation, alteration, and/or relocation
200 snips or less 80.30 2
❑PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: 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
relocation
Phone: ( ) Fax: ( )
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
�) 5 )OAS S rC I I n • r � S � v iC branch circuit or feeder fee, each
Business name: 6.65 2
�l.V tai branch
Contact name: L�t3 {,7r_�No B. Fee for service circuits
without service or feeder fee, 46.85 2
Address: ' O /" SIJO ,i OUD OT- first branch circuit
Each add'I branch circuit 6.65 2
City/State/ZIP: VV) IS Vl)\Q I 02._ O')) ooplo. Miscellaneous (service or feeder not included)
Phone: (69., bga.. c,7) 5 Fax: : ) 3D. r33 Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
' . - CONTRACTOR energy panel, alteration, or
extension. Describe Page 2 2
Business name: rt 0 a
Address: Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: Investigation per hour (1 hr min) 62.50
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES* . -. . '
CCB Lic.: 1, Electrical Lic.:3 eta. Suprv. Lic.:3 Subtotal:
Suprv. Electrician signature, required: Plan review (25% of permit fee):
Print name: I\4, W (fi '- t'ji'fe_
Date: Lk) U Dark) State surcharge (8% of permit fee):
TOTAL PERMIT FEE O i.
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 \Building\Permits\ELC- PermnApp doe 03/23/06 44046I5T(11 /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
IABuilding\Pemits'ELC- PemitApp doe 0323106
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR 00f;.0 I085
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/18000:3
Phone: (503) 639 -4171 I C I
Inspection Requests (24 Hrs.): (503) 639 -4175 '
INSPECTION WORKSHEET FOR DATE: 513/2006 TIME: 7:00AM PAGE: 72
SITE ADDRESS: 0%41 SW WASHINGTON SQUARE RD FC -7 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: PANDA EXPRESS
DESCRIPTION: LOW VOLTAGE CCTV SYTEM
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639-10066
CONTRACTOR: VISION SECURE IY SERVICE PHONE #: 503-682-6713
Inspection Request Scheduled For: Date: 5/312006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
M voltage 029153 01 503 - 682.6713 N
Correc ions /Comments /Instructions:
y
G
- �
PASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Ni 6 Z Date: ✓ 66 Phone #: (503) 718- IV