Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00067
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/12/2007
PARCEL: 1512600 -00300
SITE ADDRESS: �9 WASHINGTON SQUARE RD B8 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: BOMBAY EXPRESS
Project Description: HVAC.
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: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC
BY THE MACERICH COMPANY
9585 SW WASHINGTON SQUARE RD
TIGARD, OR 97223
Phone: Contact #:
FEES Reg #:
Description Date Amount
[ELPRMT] ELR Permit 3/12/2007 $75.00
[TAX] 8% State Surcha 3/12/2007 $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 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503.246 6699 or 1.800.332.2344.
Issued By: 722 r.2 ,/d.` / Permittee Signature: 3 I rr
, tAA ,0 GPI
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.
Electrical Permit Application I U R O F l l( I - t N I: (1 \ 1.1
City of Tigard RECEWEDA Fteceived
DatetB y 7 A Permit No. ¶ .I O a
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 p Drae/B . Other Permit:
MARY 2 2007 `` ' I i D ate Re tuns: ® See Page Line: 503.639.4175 � �" _ _ � ady By. erg e t for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method. Supplemental Information
- • -1 914 L rCidilIV IPPrl. - ; • ; - _ •-. PLAN REVIEW.; '. ~ ,.. ;; te r
❑ New construction El Additio teratioreplacement Please check all that apply:
CI Demolition ❑Other: ❑Service over 225 amps, comm'l El 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 Comglerclivindustrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
1:1 Multi - family ❑ Master builder ❑ Other: ❑ Building over three stories ❑ Feeders, 400 amps or more
❑Occupant load over 99 persons OManufactured structures or
• - " ' - • ." • JOB SITE INFORMATION AM) IACATIONd7 , /7 . ❑Egress/lighting plan RV park
Job no.: 3(DJ Job site address:q &4 N Sc ied ❑Health -care facility ❑der.
Submit 2 sets of plans with any of the above.
City/State/ZIP: — T T6 J I.A'e1- n2e_Go J- C The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: 6 5 Project name: -8 i (e SS -e cr -F: o f FEE•_ CHEEDULE Fe e - �� ;; } ';: =%
� � P Descr 1 Qty. I Fen I Total I
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. R 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
Limited energy, non - residential 75.00 2
' _ , _ - = DESCRIPTION OF WORK = _ Each manufactured or modular
h ( t dwelling, service and/or feeder 90.90 2
`t � Uo ( irk-- rt-- CL 1 Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
. ,-- ❑ PROPERTY ; OWNER ' -• ; - I .- : >0) TENANT'', ` :: ' 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: f - rm le s ` 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
Phone: ( ) Fax: ( ) relocation
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' ` t I ' . CONTACT PERSON ' ' A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: 14,ti �
Q <_ branch circuit
Contact name: c,- _ T ( i � e r k J B without for service circuits
r f
` �r, wiJhour service or feeder fee, 46.85 2
Address: each branch circuit
Each add'I branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited-
= energy panel, alteration, or
extension. Describe: I Page 2 2
Business name:
1 4C- I - & -U►c�
Address: Si . s E_ _k 4i1 4..\_P LI3 Each additional inspection over allowable in any of the above
Per inspection 62.50
City/ State/ZIP: L - CUA_ILL0_, Of eA „�, ,),.L Investigation per hour (1 hr min) 62.50
Phone: ( ) l.{ coa $ a2 4x: ( t t_SC Industrial plant per hour 73.75
T ui°' lD ” ELECTRICAL- PERMIT - FEES• - _'-' 'v `
CCB Lic.: 5 Ci7 Electrical Lic. —67� C Suprv. Lic.: or n Subtotal
Suprv. Electrician signature, required: rf 7 : `/- Plan review (25% of permit fee)
Print name: 4.1., EC , ba.(2._ I Date: 3/ fa(o State surcharge (8% of permit fee)
TOTAL PERMIT FEE f , a)
Authorized signature: b - a N-■ This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name------An 1 e../It (i.e. t--o� m� c5 I Date: 3/1 O 7 • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed
i \Bwlding\Permib\E21C-PermitApp doe 12/03 440- 4615T(1oo7/COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00067
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/12/2007
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/19/2007 TIME: 7:01AM PAGE: 55
SITE ADDRESS: 09647 SW WASHINGTON SQUARE RD FC-9 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: BOMBAY EXPRESS
DESCRIPTION: HVAC.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: HVAC INC PHONE #: 503 -462 -4822
Inspection Request Scheduled For: Date: 4/19/2007 Pour Time:
Code # Inspection Description Confirm - # Contact # .Message
/
199. Electrical final ( 046748 -01 503 - 462 -4822 Y
Q
Corrections /Comments /Instructions:
BAILe
•
•
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A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
Inspector: ?'�� aNI Date: ' I Phone #: 718- 2-11