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Permit 9 {V CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT II '' COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00075 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/15/2007 PARCEL: 1512600 -00300 SITE ADDRESS: 09730 SW WASHINGTON SQUARE RD F - 8 ZONING: C - G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG PROJECT: LENS CRAFTERS Project Description: Sound system low voltage. 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- 889 -3848 FAX 503- 889 -3883 Reg #: ELE 26- I055CLE FEES LIC 142760 Description Date Amount [ELPRMT] ELR Permit 3/15/2007 $75.00 [TAX] 8% State Surcha 3/15/2007 $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: Permittee Signature: ( ,d k A .�A �� c_, _ 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. i • p rz ., rt :.:,, ‘ I r % . , Ele Permit Application. F FOR O USE ONLY City of Tigard Date/By , it 57D-) 6 Permit No.. 01 —00015 13125 SW Hall Blvd , Tigard, OR 97i 1 , ' 2001 Plan Revie ' C Phone 503 639.4171 Fax 503 598 1960 Date/By Other Permit T I G A R D Inspection Line 503 639 4175 Q � L ` u Date Ready /By ions ® See Page 2 for Internet www.tigard - gov �1 1 Ja i Notified/Method Supplemental Information 2 -•� — Tyr7Tv ' TYPE�O WORK t i PEAN °itillew 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 ❑ Marinas and boatyards :CATEGORY CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 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 JOB.,SITE INFORMATION AND 'LOCATION ❑ Emergency system larger separately derived system ❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "13 ", Job no.: Job site address: (A' �� 0 (� I x or or more R c r ea oy ❑ Six or more residential units ❑ Recreational vehicle parks City/State/ZIP: ,, �( �p ❑ Health -care facilities ❑ Supply voltage for more than Ci ty O ,� . A k) v Y` - O �t �.3 ❑ Hazardous locations 600 volts nominal Suite/bldg. /apt. no.: Project name: l_e . C. ❑ Service or feeder 600 amps or more S , 'FEE , SCHEDULE . . Cross street/directions to job site: r S(,t t — o n Description. I Qty. I Fee. I Total I • nn `` w New residential single- or multi- family dwelling unit. Iv It.. — / f Se Includes attached garage. Subdivision: Lot no.: 1,000 sq ft or less 145.15 4 Ea add'I 500 sq ft. or portion 33.40 I Tax map /parcel no.: Limited energy, residential 75 00 2 ' ' DESCRIPTION OF WORK : - (with above sq ft ) Limited energy, multi- family 75 00 2 So s 6 residential (with above sq ft ) 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 10000 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• . ❑ CONTACT PERSON, above service or feeder fee, each branch circuit 6 65 2 Business name: • B. Fee for branch circuits Contact name: without service or feeder fee, 46 85 2 first branch circuit Address: Each add'I 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: 1/ ' Ll.'2._A_k' . L1.0 energy panel; alteration, or Address: 1 nL4�� ) K extension. Describe: Page 2 2 City/State /ZIP: O R te,,,, 01 6'. q - 123 D Each additional inspection over allowable in any of the above 1 Per inspection 62.50 Phone: ()) 5 9 -3 & ({ g Fax: (3) EV1 - - ark 3 Investigation perhour (1 hr min) 62.50. CCB Lic.: 4L1 ko O Electrical Lic.. _t SC teSuprv. Lic.: ID% b LEB Industnal plant per hour 73.75 ^n �-� 1ti�- rn ELECTRICAL PERMIT FEES • - Suprv. Electrician signature, required: W.LS,Q_ez_.... Subtotal: 7•j Plan review (25% of permit fee)' Print name: W ti , 4 Date: 3 j i S I 6 o b c3 l 7 State surcharge (8/0 of permit fee)' A Authorized signature: TOTAL PERMIT FEE II Print name: Date: This 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 I \Buddmg\Permus■ELC- PermiApp doc 05/23/06 440- 4615T(1 I /05 /COM/WEB 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* ❑ 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 \ Buddmg\Permus\ELC- PermitApp.doc 03/23/06 CITY OF TIGARD . BUILDING DIVISION PERMIT #: ELR2007-00075 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/15/2007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ' °1 ' �.. INSPECTION WORKSHEET FOR DATE: 3/16/2007 TIME: 7:01AM PAGE: 75 SITE ADDRESS: 09730 SW WASHINGTON SQUARE RD F - 8 CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: LENS CRAFTERS DESCRIPTION: Sound system low voltage. OWNER: WASHINGTON SQUARE LLC, PHONE #: CONTRACTOR: MUZAK LLC PHONE #: 503 - 889 - 38‘18 Inspection Request Scheduled For: Date: 3/16/2007 Pour Time: Code # Inspection Description - Confirm # Contact # Message 135 Low voltage - 04916.0'1 803. 242 -7886 V Corrections /Comments /Instructions: \\C\ • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G-' de) Date: 3I'M i;)' . Phone #: (503) 718- 144