Permit 1
,e'
III n CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00060
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/6/2007
PARCEL: 1S 12600 - 00300
SITE ADDRESS: 09730 SW WASHINGTON SQUARE RD F - 8 ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: LENS CRAFTERS
Project Description: Protective Signal.
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 SIMPLE SECURITY
BY THE MACERICH COMPANY 4702 SW SCHOLLS FERRY RD.
9585 SW WASHINGTON SQUARE RD #196
TIGARD, OR 97223 PORTLAND, OR 97225
Phone: Contact #: PRI 503 -574 -2254
FEES Reg #: ELE 34- 603CLE
LIC 152019
Description Date Amount
[ELPRMT] ELR Permit 3/6/2007 $75.00
[TAX] 8% State Surcha 3/6/2007 $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: 1 y...72 Permittee Signature: .---A `" 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:
CO RACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE: 6 CP I /''V' 2 b'
LICENSE NO: 11 [_i: [[[
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.
r li
+'Electrical Permit Appli - � { fc)It Oi 1 Icl uSE O�l_i'
i Received _
City of Tigard Date/B — Q •' Permit No. J J • !.-
'
C . 13125 SW Hall Blvd., Tigard, OR 97223, i..) ) U 2001 P Review
C
Phone 503.639.4171 Fax: 503.598i146O V Date/B . Other Permit
T I G A R 17 Inspection Line: 503.639.4175 j S �>
y i. ' Date Ready/By Jun B See Page 2 for
• Internet: www.tigard or.gov • i . 1 `U_I I Notified/Method Supplemental Information
..Al g
' § , + � T ,r — ' 4 - ' - - PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below)
la construction ❑ Addition /alteration/replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas 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
❑ I- 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 denved system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 , "1 -3 ",
�] ,,�M IOOHP or more. occupancy.
Job no.: Job site address:
- 9/ 0 WQ s� • S QR?4I "`' ❑ Six or more residential units ❑ Recreational vehicle parks.
❑ Health -care facilities ❑ Supply voltage for more than
City /State/ZIP: 'r /1 , 0 �. / Z Zj ❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt no.: Project name: Le K 5 C p - L.5 ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Oiv. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
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 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
n �- Limited energy, multi - family
�
V L fiy y s rc M residential (with above sq. ft.) 75.00 2
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 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
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT - 1 ❑ CONTACT PERSON ' • above service or feeder fee, 6.65 2
each branch circuit
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
I Signal circuit(s) or limited -
Business name: 5; v r `Q S 1 i QG T'
Oi t y / "...Arc C /_ energy panel, alteration, or
Address: GI 7 2_ 5.64.) - _ p se Yt (c r 4<‘y !' # 7-2 0 extension. Describe: Page 2 2
City/State/ZIP: Fey.-1- �K a (J``___ q 7 2- 'Z 5 Each additional inspection over allowable in any of the above
C0 ) Z / �1 Fax: ( ) Per inspection 62.50
Phone: (
7 3 5 7- �' �'f Investigation per hour (I hr nun) 62.50
CCB Lic.: l5Zo if Electrical Lic.: y -4 Cie Suprv. Lic.: if L 64- Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES - ,
Suprv. Electrician signature, required: Subtotal:
, Al' Plan review (25% of permit fee):
Print name: ) a Qv Date: 0(p m4 ze, ] . o
" ` State surcharge (8% of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
1. \Building\Pennits\ELC- PermitAppdoc 05/23/06 440-4615T(11/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
rRESIDENTIAI WORit ONLY . m 1
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 WOR&OONLY . • - -
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
1 \Buildmg\Pmnits\ELC- PamitApp doc 0323/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00060
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/6/2007
Phone: (503) 639 -4171 I►
Inspection Requests (24 Hrs.): (503) 639 - 4175 • IL
INSPECTION WORKSHEET FOR DATE: 3/1 TIME: 7:00AM PAGE: 53
SITE ADDRESS: 09730 SW WASHINGTON SQUARE RD F - 8 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: LENS CRAFTERS
DESCRIPTION: Protective Signal.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: SIMPLE SECURITY PHONE #: 503 - 574 - 7251
•
Inspection Request Scheduled For: Date: 3/19/2007 Pour Time:
Code # Inspection Description Confirrm • Contact # Message
199 Electrical Final 044986 -0 503574 -2254 N
Corrections /Comments /Instructions:
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL E NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cam Date: Ail (\ Phone #: (503) 718- 214
•
CITY OF TIGARD
BUILDING . DIVISION PERMIT #: ELR2007 -00060
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/6/2007
Phone: (503) 639 -4171 41
Inspection Requests (24 Hrs.): (503) 639 -4175 . ' "''L.
INSPECTION WORKSHEET FOR DATE: 3/9/2007 TIME: 7:0'IAM PAGE: '16
SITE ADDRESS: 09730 SW WASHINGTON SQUARE RD F -8 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: LENS CRAFTERS
DESCRIPTION: Protective Signal.
•
OWNER: WASHINGTON SQUARE LLC, PHONE #:
• CONTRACTOR: SIMPLE SECURITY PHONE #: 503 574224
Inspection Request Scheduled For: Date: 3/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 044 ;87 -0 503- 574 -2254 Y
Corrections /Comments/ Instructions:
ovm ALA- v vs •ED toe Lt- i c,E►u
•
S 1/4).WO L� e XI 61-)14 A 14-E W L1
1.1 o c n8 1-a bN cx11_1 N
Grft:O off. LE .
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G" • �0� Date: '� �� Phone #: (503) 718- .