Permit 4 " • -CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00339
TIGARD DATE ISSUED: 9/11/2007
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S12600-00300
SITE ADDRESS: 09689 SW WASHINGTON SQUARE RD C08 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: COACH
Project Description: Installation of low voltage for security alarm.
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: X
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC AMERICAN VETERANS SECURITY LLC
BY THE MACERICH COMPANY 4420 SW 110TH AVE
9585 SW WASHINGTON SQUARE RD BEAVERTON, OR 97005
TIGARD, OR 97223
Phone: Contact #: PRI 503- 808 -9010
FAX 503- 808 -9018
FEES Reg #: ELE 34- 501CLE
LIC 135086
Description Date Amount
[ELPRMT] ELR Permit 9/11/2007 $75.00
[TAX] 8% State Surchar€ 9/11/2007 $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 questi s to OUNC at
503 246 9 or 1.: 32 2 / _ _.
Issue By: , , �� at d r .A t! , Permittee Signature: "....., Or
,—
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.
A
, Permit Application
1114 . ;.. City of Tigard Received c i�0 �,,,_ -103
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
' M,: x Phone: 503.639.4171 Fax: 503.598 1960 Date/B : Other Permit"
cil u;t .` . [i' Inspection Line: 503.639.4175 Date Ready/By: la See Page 2 for
;, Internet: www.tigard- or.gov Notified/Method. Supplemental Information
TYPE OF WORK PLAN REVIEW
A New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stones.
❑ Demolition ❑ Other: where the available fault current ❑ Mannas 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 ❑ Commercial/industrial ❑ Accessory building amps for all other Installations buildings
❑ Multi- family ❑ Master builder - ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
/ J OB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system.
q
! ,o gy ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3
Job no.: Job site address: // �
(�W 9 1 e // IOOHP or more occupancy.
(J / � A 0 rN .0' " ❑ Six or more residential units. ❑ Recreational vehicle parks
City/State /ZIP: Al a j Ile 97ag3 ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: ('- g I Project name: Co Q' h ❑ Service or feeder 600 amps or more.
�. 11 FEE SCHEDULE
Cross street/directions to job site: Description I Qw. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi - family
-.....<` D - 1 Q I ✓ 1^1 residential (with above sq ft ) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PR OPERTY 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: ( ) I 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
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: 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
without service or feeder fee, 46.85 2
Contact name: first branch circuit
Address: Each add'l branch circuit 6.651 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: ( ) I 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: P i n o ,c§ n \)9k o n Q , "\' 1 , L,L.C,., en ergy panel, alteration, or 1 �r�
' 1 extension Describe: Page 2 2
Address:
City/State /ZIP) K),QA l� Cj ��5 Each additional inspection over allowable in any of the above
�� Per inspection 62.50
x)11 Phone: 4 -ems -y . 90) n I Fax. ) • Investigation per hour (1 hr min) 62.50
4I0 CCB Lic.: tssc D I Electrical ic. &. 0,1 Suprv. Lic.: 221-)LEA Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, requ' : . , N �L�i %—
Subtotal: ") S
Plan review (25% of permit fee):
Print name; lr �/ (� Dat 1 b
`� F� . State surcharge (8% of permit fee): (y
Authorized signatu - : 4 TOTAL PERMIT FEE:
���� ' - This permit application expires if a permit is not obtained within 180
Print name: i Date: O? - 1 I . 01 days after it has been accepted as complete.
• Number of inspections allowed per permit
1 \BuildingTermnstE irrit App doc 05/23/06 440-4615T(1 I /OS /CONOVER
•
, 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*
0 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 \Building\Permits\EL.C•PertmtApp doc 03/23/06
r/�
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007-00339
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/11/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 , !�+r�jll�
INSPECTION WORKSHEET FOR DATE: 10/2/2007 TIME: 7 :04AM PAGE: 93
SITE ADDRESS: 096B9 SW WASHINGTON SQUARE RD COB CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: COACH
DESCRIPTION: Installation of low voltage for security alarm.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: AMERICAN VETERANS SECURITY LLC PHONE #: 503 - 808 -9010
Inspection Request Scheduled For: Date: 10/2/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 066721 -01 503 89010 N
Corrections /Comments /Instructions:
A SS ' ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00339
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/1
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/17/2007 TIME: 7:00AM PAGE: 21
SITE ADDRESS: 09689 SW WASHINGTON SQUARE RD COB CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: COACH
DESCRIPTION: Installation of low voltage for security alarm.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: AMERICAN VETERANS SECURITY LLC PHONE #: 503
Inspection Request Scheduled For: Date: 9/17/2007 Pour Time:
Code # Inspection Description - • • Contact # Message
135 Low voltage 055804 -01 03.808 -9010 N
Corrections /Comments /Instructions: •
"1• H i s R. 0 7T 's W.A N $ f g C•T • ) Foa,
Rm vC : IN CS4%) e ll! 21 0'4 AK) NIOR,o
3 0/5‘)I s7p -L I
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
74 FAIL XCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
-Inspector: GT N boo LE"' Date: Minf 1 Phone #: (503) 718- 1-11116
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR200700339
13125' SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 911111007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 911212007 TIME: 7:01AM PAGE: 50
SITE ADDRESS: 09689 SW WASHINGTON SQUARE RD C08 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: COACH
DESCRIPTION: Installation of low voltage for security alarm.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: AMERICAN VETERANS SECURITY LLC PHONE #: 503-806-9010
Inspection Request Scheduled For: Date: 9/12/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 0555522 -01 503 -319 -4754 N
Corrections /Comments /Instructions:
/41V cry6i— 7 L4TW &2P/Fa
•
Pd PASS ❑ PARTIAL APPROVAL ❑ CANCEL • ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: `./ Date: ? a/ Phone #: (503) 718-
1,