Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00181
jib" DEVELOPMENT SERVICES DATE ISSUED: 6/6/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S12600-01107
SITE ADDRESS: 09693 SW WASHINGTON SQUARE RD
SUBDIVISION: ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Electrical tenant improvement: install a 200 AMP service /feeder, a first branch circuit and 22 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: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 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: 22 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:
PPR WASHINGTON SQUARE LLC ROSS ELECTRIC
BY MACERICH CO STEPHEN LLOYD ROSS
ATTN:JANET FISHER ASSETS 23810 SW DRAKE LN
SANTA MONICA, CA 90407 HILLSBORO, OR 97123
Phone: Phone: 642 -2800 Reg #: ELE 34 - 436C OWGINAL
LIC 001188
SUP 4232s
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Service
PRMT KJP 5/24/00 $219.45 0002424 Elect'l Final
5PCT KJP 5/24/00 $17.56 0002424
Total $237.01
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 -_ •• • the Oregon Utility Notrfication Center. Those
rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0080. You may obtain •• •ies of these r les or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE A nn ISSU D BY: L & '
OWNS I STALLATION ONL
The installation is being made on property I own which i not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTO' INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: % i<i.. i `_.∎ DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
CIpf.OeTIGARD Electrical Permit Application Plan Check #`
13125 SW HALL BLVD. Rec'd By �o
Date Rec'd 1 9- -OO
TIGARD OR 97223
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit #ELL ZGLY7 -on is1
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: in r _ 4. Complete Fee Schedule Below:
Name of Development 14(011 V (011 I n 'S61 ittir Number of Inspections per permit allowed
il
Name (or :� o• - siness) joh U - guy guy Service included: Items Cost Sum
Address : = � JV' V Y (to k i / +"'� � 6( Ra I t 4a. Residential - per unit
/ //BB h/� ff c a p 1000 sq. ft. or less $110.00 4
City /State /Zip ( ■(VL t/ 1 9 3 Each additional 500 sq. ft. or
Commercial E Residential ❑ Li portion thereof $25.00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only
(Attach copy of all current lic nses iG� 4b. Services or Feeders ..
Electrical Contractor (} Installation, alteration, orrelocation
Address .23 �6i n `ate 12-01-11,,,_ 200 amps or less 1 $so.00 2
201 amps to 400 amps $80.00 2
City f-I t L L3 # I.'I 0 State 62. Zip 77/.3-3 401 amps to 600 amps $120.00 2
Phone No. 601 amps to 1000 amps $180.00 2
Job No. , / Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No.
3` C. Exp.Date /0 - Reconnect only $50.00 2
OR State CCB Reg. No. // 8 Exp.Date // - 03 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date /0'1 Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Sur. Elec'n 201 amps to 400 am $75.00 2
g p 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. e 3 2-.5 Exp.Date see "b" above.
Phone No. 4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) TheJee-for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circuit $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit I $35.00 S■% - 42
The installation is being made on property I own which is not Each additional branch circuit 2 .L $5 �i ,+ 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
I Each sign or outline lighting $40.00 2
3. i flan Review section (if required):* Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional Inspection over
I Service and feeder 225 amps or more the allowable in any of the above
I System over 600 volts nominal Per inspection $35.00 �-- °,,,,
i Classified area or structure containing special occupancy Per hour $55.00 -%------ \
as described in N.E.C. Chapter 5 In Plant $55.00 /� � � / /
* Submit 2 sets of plans with application where any of the above apply. J5. Fees: /� (/
Not required for temporary construction services. 5a. Enter total of above fees /t" I $ (
5% Surcharge (.05 X total fees) $
NOTICE Subtotal $ /
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # �� � ` fib
Total balance'Due ` (fit)
I \DSTS \ELC96 APP Rev 9/96
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