Permit Ail. CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00590
:44 /to DEVELOPMENT SERVICES DATE ISSUED: 9/17/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09650 SW WASHINGTON SQUARE RD
SUBDIVISION: Gtl'AgHINGTON SQUARE ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: TI, (39) 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: SIGNAUPANEL:
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: 38 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 DYNALECTRIC
BY THE MACERICH COMPANY 2904 SW FIRST AVE.
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97201
TIGARD, OR 97223
Phone: Phone: 503 - 226 - 6771
Reg #: LIC 066793
SUP 4817S
FEES ELE 26 -59C
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 9/17/2004 $299.55
[TAX] 8% State Surcharge 9/17/2004 $23.97 Rough -
Elect'I Final
Total $323.52
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: /J p / Permit Signature: 5 - ply
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
SEP 17 2004 7:36RM DYNRLECTRIC 503 226 7720 p.2
Electr Permit Application FOR OFFICE USE ONLY
City Of Tigard � ® D ' : Permit No.: �, d) y -tb S 9 0
13125 SW Hall Blvd., Tigard, OR 97223 V - Plan Review
Phone: 503.639.4171 Fax. 503.598. " r , , r. rr ( pt' ( Date/B : Other Penmt:
Inspecti Line: 503.639.4175 ! t S - _a__ 1 D a te •
ReadyBy: NE El See Page 2 for
Internet www.ci.tigard.or.us . _ v A • `' Notified/Method: Supplemental information
.�; `. a ` �`? Nr ` r • .• - \ - \ �teS ;�c `. -) ; y�S��ry1,,
' ;.':''E C- j1-7 : - j . ;'. y • :1'Jie,` :.;.5i1': ` ;:.' -' r ...',la. i',' '. SSE ',1"kA�,1i•^j.1:. ;>_ .'• ..i L"'T: '_
N ew construction ❑ Addi w V') eplacement Please check all that apply:
❑ Demolition ❑ 0th\ * ❑Service over 225 amps, comm'l ['Hazardous location
�,qq pa ti ,; , ['Service over mil amps rating ❑ or more over ore new residential
al ft.,
,1-k ga 4• -, i' g ell JQ ':r o-. Cn9 a, Ji 11 s ;i ! .r asl•TX ^r� y dwellings
y� F . �:: of 1 -and 2-family 4 or m trsidnti
`a i �' +.t 'h ,.Yr , ilit'.r�FJf.�� 4: = :'`, :r.. .�,w ^t�•'�'.f'.', . :n ' -'
❑ 1- and 2- family dwelling / Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑ Master builder ❑ Other ❑Building over three stones ❑Feeders, 400 amps or more
y ❑Occupant load over 99 persons ❑Manufactured structures or
r� ur
jfi� ' >ti:"'s : %at'er,; r e ``'y w r�r a '�s'kil {�'� . # 0011-4i tll ❑Hgressllightingplan RV park
Job no.: Job site address: QQ ❑Health-care facility ❑Other:
F�� ✓� � Sµ 4 S ' Ad Submit 2 sets of plans with any of the above.
City / State/ZIP: -T f lv 4-4. p et 7 L'L 3 The above are not applicable to temporary construction service.
Suite/bldgJapt. no.: 4.. Project name: �` r ' ' f �t r >_�"4 i *e. ea coral
l" i , L . N ' 1 � Description Qty. "•
Cross street/directions to job site: lU c hj D ? , ht 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 '1500 sq. fl or portion 33.40 l
Limited energy, residential 75.00 2
Tax map/parcel no
�1' w �: + {, } r Each manufactured or modular
: si Limited energy, non-residential 75.00 2
d 1 4 a t rim a ;y M a i t t 1 R
4fi� v,!:v�.`d "a�' , 3 - �,.�.�.i t<•a a...e E.1-k, .:,a 3'JF`- • �4•t. Y Si 21t�'t(.i d
dwelling, service and /or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
R e /red _ 200 amps or less 80.30 2
1 ,' .tNi t ' di ` pyii: 201 amps to 400 amps 106.85 2
' :u
401 amps to 600 amps l 60.60 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
E r 'h r ' t2 �Fk u t i tT �r u11, } w •1' {� r 1 ' �' rsi i sA '�� ` 1 ' circuits with
ga �.r1.rr, . t_r�at::3�..at ...o �.. �e�l,!'air A. Fee for branch c service or feeder fee, each
Business name: branch circuit 6.65 - 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit I 46.85 1.0 2
Address:
Each add branch circuit a$ 6 .65 25110 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Faz :: ( )
Sign or outline lighting 53.40 2
B -mail: Signal circuit(s) or limited-
) r-. {ri &'� a rgyE �. r I car g a A'�f'�.• h ?i en panel' alteration, or
7 i?c.`J ua :''a( ' +. '. F - �a�xi §�; extension. Describe: Page 2 2
Business name 4 _
Each additional inspection over allowable In any of the above
Address: � 4.4, _ 4 � .- / Per inspection 62.50
City/ State/ZIP: �r I ( e r r - Investigation per hour (1 tv min) 62.50
Phone: ( ,� , 77 ,� Industrial plant per hour � 73.75
' ��✓ ice � -Ian !� i / i.' :Z .^) ? l.i'rTtFi.x � -.. 7..',. -_- ', s.' ..l• t' - ! t
'
_, ,` Electrical Lic.�- Sttprv. Lic. Subtotal' 2 99 ix
Suprv. Electrician signature, required: - .. - Plan review (25% of permit fee)
Print name: 0 Date:. / State surcharge (8% of permit fee) •j
TOTAL PERMIT FEE 3 z 3 S
Z
Authorized signature: , / W This permit application expires if a permit is not obtained within ISO
40 - �. ... • .L/
days after It has been accepted as complete
W / , , �. Y —, Date: "./ . I • Pee methodology set by Tl•r•County Building Industry Service Baud
•• Number of inspections per permit allowed.
t.l Buiidina\Permita.ELC- PemaAppdoc 12/03 440.4615T(1e/02/COM/WEa