Permit ''CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00374
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/25/2007
PARCEL: 1512600 -00300
SITE ADDRESS: 09689 SW WASHINGTON SQUARE RD C - ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: COACH
Project Description: Telephone system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC L C SMITH COMMUNICATIONS INC
BY THE MACERICH COMPANY 3425 SW 121ST AVE
9585 SW WASHINGTON SQUARE RD BEAVERTON, OR 97005 -1716
TIGARD, OR 97223
Phone: Contact #: PRI 644 -8992
Reg #: ELE 34- 347CLE
FEES LIC 96295
Description Date Amount
[ELPRMT] ELR Permit 9/25/2007 $75.00
[TAX] 8% State Surcha 9/25/2007 $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: $.iiae i�� %til�(_i._ Permittee Signature:
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.
09/11/2007 08:35 FAX 5035981960 CITY OF TIGARD a 001
/ Electric i `grinit Agpliati90 I'o R ()FA( E USE O N L l
N . City of Tigard RECEIVED i ` ?<,�; ,
13125 Sw Hall Blvd.. Tigard. OR 97223 J i • _ i i .1� O
Phan= 503.639.4171 Fa,c 503.598.1960 7 Dray Other Permit
-- , , , i, Inspection Line: 503.639.4175 ��. ) P - i. ,' -1 4 L U U I T�eReadylBlr. 1 � la $s Pala 2 for
„1 I
Internet: www.tigard•or Noafed l�kMod 8aaptemtal lafhmeda.
OF TIGAFP
TYIB-. o • c , l .'s.;• - :.: •i ::047 •ItE �` :.:” : .c. • '.:
[] New construction . j DAdditi :.�: , 1 • - •180 I� Please dwelt ali that apply (submit 1 sets of plan, wan= climbed below
O Setvico or feeder 400 wipe or owe 0 Building over dues stories.
❑ Demolition ❑Other.
where tlee available Fault aaarem 0 Marinas and boatyards.
. • •. .. ' 1'7: -• : :' ':• • . CATEGORY..OF' C UCI70N ' ; • . : .: •
.. • exceeds 10.000 nips at 150 nib or Q Floating buildings.
Ices El 1 - and 2 family dwelling ® Commercial/industrial ❑ AccessO building arms to ground, or much 1 ne. ❑ building.
false agricultural
g amps Ibr all other installations. buildings.
0 Multi - family ❑ Master builder ❑ Other: OFire map. 0 Inualladoa 475 KVA or
. • • : • - •: . • . e,. • . - ... . dean system.
. ; • . APID • IA(.ATION}' : • . ': . :. O Aditioa o f aaaw mo tor bad of ❑ •A ". "E". "l -2 ". "I -3 ".
Jobno.: J Jobsitbaddress: 9689 Wasington Square Rd 1001 1 " m • 0°cu
_ O Sia in noon residential units. 0 Itaeroatioad vehicle parity
City/State/ZIP: Tigard, OR 97223 0 Health-see facilities 0 supply voltage for mote One
°Haarrdous Monona. 600 volts normnaL
Suite/bldgfaptno.: C - I Project name The COACH Store CI Service or tinder 600 amps or mote.
Cross street/directions to "ob site: i ''• FEE: SC i Ow.
J atrr�4tMa 1 Ow. I !sit [ Two I •
New residential single- or mul i -daily dwelling unit.
Includes attached garage. .
Subdivision: I 1,0t no.: 1,000 sq. R or less 145.15 4
Tax map/parcel no.: Es add? 500 sq. R. or portion 33.40 1
Limited energy, residential
:.:::.: . • 4 identid 75.00 2
. • •,..' L : - .... •': :. :i = ; •. :.''. ' "
Rk - ..•. : :, • y•" •.r-.. (witbabaveaq.it)
Limited energy, multifamily 75.00 2
Install Phone Syste residential (with above aq. fl)
Services or feeders installation.—alteration, and/or relocation
200 amps or less 80.30 2
.. ..';• :PPt0wea OIYI!ili •.;'.'::; . • ' . 0 ENANT -'. _. 201 amps to 400 stops 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 tamps or volts 454.65 2
City/State/ZIP: Temporary servieri or feeders installatioa, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps at less 66.85 1
Owner instillation: This installation is being made on property that 1 own which is not 201 amps m 400 amps 1 100.30 1 2
intended for salt, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: • Date: Braid shi t — new, aleeradog or won, land
F . D A. Fce for branch circuits with
0
.. • APPLICANT' : • :. . '1 _: ° .00NPAC Y SON:': • above service or feeder fee. 6.65 2 •
Business name: each branch c
9. pee for branch circuits
Contact name: witIiovr service or feeder fee
46.85 2
first branch circuit
.. Address: Each edd•1 brands circuit 6.65 2
l hedlansous (service or feeder not included)
City /Star /ZTP: Each r amRaarted or module
90.90 2
elwdliaR, service and/or feeder
Phone: ( ) I Fax: : ( ) Reconnect only w 66.85 2
E Pinup or irrigate= circle 53.40 2
. -
. .. ., • COQ.••' • .... .. Sign or outline lighting 5340 2
Business name: L.C. Smith Communications, Inc. signale ale limited-
energy paondnd, te:radal. or
Address: 3425 S W 121st Ave . tancasion. Describer 1 Pngc 2 75.0 2
Ciry/StatdZIP: Beaverton OR 97005 . Rub additiodal iapeedod over aDewNtle its cry of the above
Per inspection 62.50
PlOIIQ: ( ) 503-44-89921 Fax: ( ) 503-643-1378 lnvcstigados per hour it lr rain) 62.50
CCB Lic.:9 6 2 9 5 ? � lecvical Lie- E B 2 4 6 9 Suprv. Lic 3 4— 3 4 7 C L E � plant pa hour 73,75
� ' ELECIRICAL.PERMrr FEES (1�1.' 7
Suprv. Electrician si _ required: ' C r 7 • / • U _ subtotal: 7 5 . 0 0
Plea review (25% of permit Rx):
Print name LEROY C. SMITH n Dam9/ State surcharge (8%of permit fee): 6.00
Authorized signature: c TOTAL PERMIT FEE: A 1 • n o
Print name: LEROY C . SMITH I Date: 9 / 2 5 / 0 7 this permit entlad°a Madras If a permit ta.al obalaad whiner ISO
days Ma B has boos angled a comtdde.
�• • Number of inspection allowed per permit.
L 0! /8/06 41o4613T(t aasrooaanv is
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00374
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/25/2007
Phone: (503) 639 - 4171 i � l
Inspection Requests (24 Hrs.): (503) 639 -4175 ' F_ _..
INSPECTION WORKSHEET FOR DATE: 9/26/2007 TIME: 7 :01AM PAGE: 21
SITE ADDRESS: Q9689 SW WASHINGTON SQUARE RD C-8 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: r0 A {
DESCRIPTION: Telephone system.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR. L C SMITH COMMUNICATIONS INC PHONE #: 644 -8992
Inspection Request Scheduled For: Date: 9/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1 ow • - •e 056386 -01 503-644-8992 Y
ei
• -ctions /Comments/ nst .ctions:
4- oo N)
V
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: , v 4E 7 LE Date: Phone #: (503) 718-