Permit 11 , CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00308
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/4/2008
PARCEL: 1512600 -00300
SITE ADDRESS: 09653 SW WASHINGTON SQUARE RD MO2 A ZONING: MUC
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: SANRIO
Project Description: Low voltage for audio system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X 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:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC MUZAK LLC
BY THE MACERICH COMPANY 12449 NE MARX ST BLDG 10
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97230
TIGARD, OR 97223
Phone: Contact #: PRI 503 -554 -2594
FAX 503- 889 -3883
FEES Reg #: ELE 26- 1055CLE
LIC 142760
Description Date Amount
[ELPRMT] ELR Permit 11/4/2008 $75.00
[TAX] 12% State Surch 11/4/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 51 •' • ;00.332.2344.
Issued B —_ Permittee Signature r
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 DateB A '`fI Permit No FOR OFFICE USE ONLY
^ti City of Tigard
Ci `� Received g G� 17 9ce -z�gr
• 13125 SW Hall Blvd , Tigard, OR 9 Plan Review
Phone 503 639.4171 Fax. 503 598 1960 �
DateBy Other Permit
rr��
T I G A R D Inspection Line. 503.639.4175 \A`` (! p (,� I Date Ready /By ions 0 See Page 2 for
Internet. www tigard-or gov aI a `, �, �∎` fied/Me y Supplemental Information
TYPE OF WORD `� ` w1 V PLAN REVIEW
- New construction ❑ Addition/alterati cement Please check all that apply (submit 2 sets of plans w /items checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stories
b Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling 41 Commercial /industrial ❑ Accessory building amps for all other installations buildings
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system
Addition n
❑ Addition of new motor load of ❑ "A ", "E ", "I - ", "1 - ",
Job no.: Job site address:G %-csj,) WlL S C 't I00HP or more occupancy
❑ Six or more residential units ❑ Recreational vehicle parks
City/State/ZIP: q ^� ` ^� ❑ Health -care facilities ❑ Supply voltage for more than
CI
ty o8 �� "I � ❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: Project name: , O ❑ Service or feeder 600 amps or more
job site: Deseri tion FEE SCHEDULE
Cross street/directions to
j P I Qty. I Fee. I Total
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq ft or less 145 15 4
Tax map /parcel no.: Ea add'I 500 sq ft or portion 33.40 1
Limited energy, residential 75 00 2
DESCRIPTION OF WORK (with above sq ft )
D i r Limited energy, multi-family 75 00 2
- residential (with above sq ft )
lUt� 1 1 Services or feeders installation, alteration, and/or relocation
200 amps or less 80 30 2
❑ PROPERTY OWNER I ❑ TENANT _ 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160 60 2
601 amps to 1,000 amps 240 60 2
Address: Over 1,000 amps or volts 454 65 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 599 amps 133 75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6 65 2
- each branch circuit
Business name: B Fee for branch circuits
Contact name: without service or feeder fee, 46 85 2
first branch circuit
Address: Each add'l branch circuit 6 65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90 90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53 40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: V1 - Lk-2_44_ L'� energy panel, alteration, or
Address: (j, Y kt9 lV £ , - � / � 4 ( extension Describe. , Page 2 7 2
City/State /ZIP: ¢ Ti _ " q l-L3a Each additional inspection over allowable in any of the above
Phone: 'Z3)SSt f q Fax: ('3) y g1, ?8,3 Per Investigation 6250
l J Investigation per hour (I hr min) 62 50
CCB Lic.: I /21(00 ElectricalLic.:, doara,, Suprv.Lic.: t 2 1 2...LEA Industnal plant per hour 7375
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: _'� ` �/ Subtotal
Plan review (25% of permit fee)
Print name: I / d i, Date:' t ri dX
State surcharge (12% of permit fee) qc
Authorized signature: TOTAL PERMIT FEE Ft This
Print name: Date: T permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit
1 \Building\Permits\ELC- PermiApp doe 05/23/06 440-46I5T(1 I /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information ' �r
LIMITED ENERGY PERMIT FEES: ;=
(.RESIDENTIAL: WORE -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:
�_COMMERGIAL V�ORKON_ LY:�•. - :.: �:�: •'.: - ' _ -.: �,:= � � ,. �
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
.16 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
I \Budding\Permits\ELC- Perm0App dot 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EI R200B.00308
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/4/7008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 IL..
INSPECTION WORKSHEET FOR DATE: 11/6/2008 TIME: 7:00AM PAGE: Q1
SITE ADDRESS: 08563 SW WASHINGTON SQUARE RD MO2 A CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SANRIO
DESCRIPTION: Low voliage for audio system.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: MUZAK LLC PHONE #: 503
Inspection Request Scheduled For: Date: 11/6/2008 Pour Time:
■
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 077721 -01 803.5E4 -2587 N
Corrections/Comments/Instructions:
(
\liky'
T PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V� , VOG L Date: It. 'V Phone #: (503) 718- .1-1A2______