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Permit A n CITY OF TIGARD DEVELOPMENT SERVICES ELECTRICAL RESTRICTED ENERGY PERMIT .�,rl PERMIT #: ELR2006 - 00156 ' - I� 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 DATE ISSUED: 6/19/2006 PARCEL: 1S12600-00300 SITE ADDRESS: 09777 SW WASHINGTON SQUARE RD D9,10 ZONING: C - SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG Project Description: Install 2 loop system and detachers. (anti theft.) 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: ANTI THEFT X TOTAL # OF SYSTEMS: 1 Owner: Contractor: WASHINGTON SQUARE LLC BROADWAY ELECTRIC - COCHRAN INC BY THE MACERICH COMPANY 626 SE MAIN 9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97214 TIGARD, OR 97223 Phone: Contact #: FAX 503 238 - 2098 PRI 503- 234 -6564 FEES Reg #: ELE 37 -546C LIC 72942 Description Date Amount SUP 3447S [ELPRMT] ELR Permit 6/19/2006 $75.00 [TAX] 8% State Surcha 6/19/2006 $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 direc q stions to OUNC at 503 - 246 -6699. . Issued By: 61-uiL Permiftee Signature: U 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. 7 Electrical Permit Application , . FOR OFFICE USE ONLY City of Tigard —'. Y, ; a Received _. 13125 SW Hall Blvd., Tigard, OR 97223 Da Re � / / 4Ap � g Per mnitNo.: �� pn� �V / S� Plan Review ^�" Phone: 503.639.4171 Fax: 503.598.1960 _ „ • � v Permit: ���� Date/ Other Pert: Inspection Line: 503.639.4175 " . -_ .., ..• c Date Ready/By: ltulr El See Page 2 for Internet: www.ci.tigard.or.us '" Notified/Method: Supplemental Information '• F . TYPE - O ?'` =', • • . - • . - • ..- _ PLAN REVIEW New construction v r �l ❑ ❑ Addition/alteration/replacement Please check all that apply: ❑Service over 225 amps, comm'l ['Hazardous location ❑ Demolition ❑Other: ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION _ of 1 -and 2- family dwellings 4 or more new residential ❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure OBuilding over three stories ❑Feeders, 400 amps or more ❑ Multi - family 0 Master builder ❑Other: ['Occupant load over 99 persons ['Manufactured structures or JOB SITE INFORMATION AND LOCATION .: _ - ['Egress/lighting plan RV park 4306064 Job no.: f I Sto wale., Job site address : � — i I ❑ Health care facility ['Other: .� /(°J Submit 2 sets of plans with any of the above. City/ State/ZIP: l l j,� Q 177 The above are not applicable to temporary / � pp ' mPoTarY construction service Suite/bldg. /apt.no.: e i Project name: ` - FEE`_ I Q DLLE Fee. Qty. I Fee. I Total Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 • 2 • Limited energy, non - residential 75.00 2 . DESCRIPTION. OF WORK - - - , Each manufactured or modular • (n nl Ul (1 (9 1 sygfo 'X j(�(' , t l ,fig, � - dwelling, service and/or feeder 90.90 2 l v� �/ ( Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER • I ' . - 0 TENANT • - 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City/ State/ZIP: Temporary services or feeders Installation, alteration, and/or Phone: ( ) Fax: ( ) relocation 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 600 amps • . 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel ' • ❑ .APPLICANT 7 I • - ❑- CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each Business name: branch circuit 6.65 2 B. Fee for branch circuits • Contact name: without service or feeder fee, Address: each branch circuit 46.85 2 Each add'l branch circuit 6.65 2 City/ State/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax: : ( ) Pump or irrigation circle 53.40 2 Sign or outline li _ 53.40 2 E -mail: Signal circuit(s) CONTRACTOR energy panel, alte . •'.n, or extension. �< ca . ) Page 2 7S--_ Business name: '� �� w Q\1 �� c- \` ��� �7♦ 2 / Address: C" 2 Co 5 l_ �\� Each additional inspection over allowable in any of the above \ Per inspection 62.50 City/State/ZIP: ?01 --�` aid OR- ci-1 21..+ Investigation per hour (1 hr min) 62.50 Phone: o � $ Industrial plant per hour 73.75 (S 3) 23� ^� 7 Cot-{ Fax: (S�3) 2:y8 �� -2t�l - ELECTRICAL.PERMIT.PEES* _ . '- . ' - CCB Lic.: 7 2 c t 4 Z I Electrical Lic.: 31 -5 tl , c Suprv. Lic.: 3 r -KEG Subtotal Suprv. Electrician signature, required: \�\ c fit Plan review (25% of permit fee) Print name: \_ 2 ,,he. \_ ��•�+� `�J� State surcharge (8% of permit fee) (2— ` ` Date: TOTAL PERMIT FEE g J Authorized signature: This permit application expires if a permit Is not obtained within 180 days after It has been accepted as complete Print name: Date: • Fee methodology set by Tri -County Building Industry Service Board •• Number of inspections per permit allowed. i•\ BuldingWermits \ELC- PermiiApp.doe 12/03 440.4615T(10/02/COM1WEB CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2006 00Th6 AR 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/19/2006 Phone: (503) 639 -4171 qr• Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/21/2006 • TIME: 7:07AM PAGE: 53 • SITE ADDRESS: 09777 SW WASHINGTON SQUARE RD D9,10 CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: HOLUSTER CO. DESCRIPTION: Install 2 loop system and detachers. (anti theft.) OWNER: WASHINGTON SQUARE LLC, PHONE #: CONTRACTOR: BROADWAY ELECTRIC - COCHRAN INC PHONE #: 503 Inspection Request Scheduled For: Date: 6/21 /2006 Pour Time: • • 1# • Inspection Description Confirm # Contact # Message 41 Low voltage 032018-01 503-522-7351 N • Corrections/Comments/Instructions: • • • 71 PASS ❑ PARTIAL APPROVAL r� ❑ CANCEL • ❑ NO ACCESS ❑ FAIL , ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: N L Date: 6 C 4 -Ob. Phone #: (503) 718- 2_. • CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2006 -00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/19/2006 Phone: (503) 639 -4171 • I*or ' Inspection Requests (24 Hrs.): (503) 639 -4175 e L • INSPECTION WORKSHEET FOR DATE: 6/21/2006 TIME: 7 :07AM PAGE: 29 SITE ADDRESS: 09777 SW WASHINGTON SQUARE RD D9,10 CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: HOLLISTER CO. DESCRIPTION: Install 2 loop system and detachers. (anti theft.) OWNER: WASHINGTON SQUARE LLC, PHONE #: CONTRACTOR: BROADWAY ELECTRIC - COCHRAN INC PHONE #: 503.234 - 6564 Inspection Request Scheduled For: Date: 6/21/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 032062 -01 972- 249.6895 N Corrections /Comments / Instructions: • • 2 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: N Date: 0`b Phone #: (503) 718 - 2-