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Permit CITY OF TIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY lit DEVE ICES 639 -4171 DATE PERMIT ED: ELR2002-00144 30/02 SITE ADDRESS: 09714 SW WASHINGTON SQUARE RD F -4 PARCEL: 1S126C0 -01107 SUBDIVISION: WASHINGTON SQUARE ZONING: C -G BLOCK: LOT: JURISDICTION: TIG Project Description: Burglar Alarm installation. 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: INSTRUMENTATION: OTHER: : X TOTAL # OF SYSTEMS: 1 Owner: Contractor: PPR WASHINGTON SQUARE, LLC OMNI WIRE INC. BY THE MACERICH CO 16521 SE DIVISION ATTN JANET FISCHER ASSET PORTLAND, OR 97013 f SANTA MONICA, CA 90407 Phone: Phone: 503 - 261 -8789 Reg #: LAC 151222 ELE 26- 1132CLE SUP 3525JLE FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 7/30/02 $75.00 2720020000 Elect'l Final 5PCT CTR 7/30/02 $6.00 2720020000 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 -0080. You may obtain copies of these rules or dir- • - !•. ns• OU 03) 246 -1987. /� Issued by Ste , a1 _A , t 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: 6 0O DATE: LICENSE NO: Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day X 00 - l Electrical Permit Application Date received. l ca_ Permit no.a a _00 pig ., i r n n 4L i ,l f City of Tigard Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By $5 Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT 0 1 & 2 family dwelling or accessory Commercial ' .. .: al 0 Multi - family 0 Tenant improvement 0 New construction Addi '. , • • eplacement 0 Other: 0 Partial JOB SITE INFORMATION Job address: e' s 8s — 3 ( J Wcx,,1,;, v-' V. Bldg. no.: 6 it Suite no.: Tax map /tax lot/account no.: Lot: I Block: I Subdivision: (l Project name: Nob sy,ot 664 I Description and location of work on premises: (,,,,, j \c� , Estimated date of completion/inspection: $- / - 01 • CONTRACTOR APPLICATION FEE SCIIEDU.E Job no: ! Fee Max Business name: ©'171 V W , I te Q 1";,,c. Description Qty. (ea.) Total no. insp G $ � � New residential - single or multi-family per Address: � ` M '''so'� dwelling mtit . Includes attached garage. City: Po I. 1/24 Ok I State: 02 I ZIP: 9 )0i3 • Service included: Phone: S'o3.Gl" 8I°I I Fax: I E -mail: 1000 sq. ft. or less 4 CCB no,:- l 51 20,")., H/vl� Elec. bus. lic. no: 24 — i l 3 C L F Each additional 500 sq. ft. or portion thereof Limited energy, residen 2 City/ etro 1' . no.: /l /0 -o 3 Limited energy, nor- residential 2 j /42 ��� .. ?� •� Each manufactured home or m dwelling Si attire• o S upervising p trician eq uired) Date gyp_ - c, y Service and/or feeder 2 Sup. elect. name (print): C14 e;',.. I t License no: 3S f t �1vicesorfeeders— installation, alteration or relocation: • PROPERTY OWNER 200 amps or less 2 Name (print): ,A - C � c 201 amps to 400 amps 2 g r U ' � e (l ;11,Q ' 401 amps to 600 amps 2 Mailing address: p J 601 amps to 1000 amps 2 City: gq;,,0,- L,1, p e- I Sta : g do P: L_) 1 )i \ Over 1000 amps or volts 2 Phone: I Fax: I E -mail: Reconnect only Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation: 200 amps or less 2 20 ORS 447, 455, 479, 670, 701. 201 1 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 ENGINEER Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: I State: I ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit: 2 Phone: Fax: E-mail: Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc. (Service or feedernot included): O Service over 225 amps - commercial 0 Health -care facility Each pump or irrigation circle 2 O Service over 320 amps -rating of I &2 ❑ Hazardous location Each sign or outline lighting 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, O System over 600 volts nominal more residential units in one structure alteration, or extension* I 2 ❑ Building over three stories ❑ Feeders, 400 amps or more *Description: - 3" J?? : ` 0 Occupant load over 99 persons O Manufactured structures or RV park Each additional inspection over the allowable in any of the above: O Egress/lighting plan ❑ Other Per inspection I I I I Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all junsdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ -- 7�7 ❑ Visa O MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ (p '() Expires accepted as complete. TOTAL $ X51 • DO Name of cardholder as shown on credit card Cardholder signature Amount 440-4615 (6/00/COM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY p Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items - Cost Total 4, Check Type of Work Involved: Residential - per unit ❑ 1000 sq ft. or less $145.15 4 Audio and Stereo Systems' Each additional 500 sq. ft. or portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manuf'd Home or Modular ❑ Garage Door Opener' Dwelling Service or Feeder $90.90 2 Services or Feeders ❑ Heating, Ventilation and Air Conditioning System' Installation, alteration, or relocation 200 amps or less $80.30 , • • 2 ❑ 201 amps to 400 amps $106.85 2 Vacuum Systems' 401 amps to 600 amps $160.60 2 ❑ 601 amps to 1000 amps $240.60 2 Other . Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system $75.00 200 amps or less $66.85 2 (SEE OAR 918 - 260 -260) , . 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see "b" above. n Audio and Stereo Systems Branch Circuits New, alteration or extension per panel pi Boiler Controls a) The fee for branch circuits with purchase of service or n Clock Systems feeder fee. Each branch circuit $6.65 2 ❑ Data Telecommunication Installation b) The fee for branch circuits without purchase of service n Fire Alarm Installation or feeder fee. First branch circuit $46.85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 1111 Intercom and Paging Systems Each sign or outline lighting $53.40 Signal circuit(s) or a limited energy panel, alteration or extension $75.00 n Landscape Irrigation Control Minor Labels (10) $125.00 Each additional inspection over n Medical the allowable in any of the above ❑ Per inspection $62.50 Nurse Calls Per hour $62.50 In Plant $73.75 ❑ ,Outdoor Landscape Lighting` Fees: ❑ Protecti a Signaling Enter total of above fees $ t K Other (,t .L 6)/A4,.., 8% State Surcharge $ ( Number of Systems • 25% Plan Review Fee See "Plan Review" section on $ No licenses are required. Licenses are required for all other installations front of application. Fees: Total Balance Due $ - ) OG Enter total of above fees , ' $ [ C ❑ Trust Account # 8% State Surcharge ' $ i 7.O 0 Total Balance Due $ 2 / . vo All New Commercial Buildings require 2 sets of plans. i:\dsts \forms \elc- fees.doc 08/30/01 CITY OF TIGARD 24 -Hour BUILDING , C • - Inspection Line: (503) 639 -4175 4: • MST INSPECTION DIVISION Business Line: (503) 639 -4171 Q/ BUP Received Date Requested v J AM PM BUP Location 9 7P / so • g19, Suite MEC Contact Person �� �?i Ph ( ) 3 / — 4 o' PLM Contractor Ph ( ) r SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: a a _ Ftg Drain � ELR ol 7 g 7 Crawl Drain Slab Inspection Notes: • SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath/Shear Framing Insulation Drywall Nailing p Firewall V � P Z Fire Sprinkler � Fire Alarm Susp'd Ceiling I� Roof / Other: `/ Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL . MECHANICAL ' Post & Beam Rough -In Gas Line • Smoke Dampers . Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab _ mow Volteri Fir- larm - T FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. 411: ❑ Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Date g- .Z ' O 7— Inspect G(/1 -4 Ext Other: Final DO NOT REMOVE this inspection record from the jo s te. PASS PART FAIL