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Permit
d, CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT l n DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00095 -' '� II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/25/2006 PARCEL: 1S12600-00300 SITE ADDRESS: 09777 SW WASHINGTON SQUARE RD D9,10 ZONING: C -G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG Project Description: HVAC. 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: X PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: WASHINGTON SQUARE LLC ARROW MECHANICAL BY THE MACERICH COMPANY 10330 SW TUALATIN RD 9585 SW WASHINGTON SQUARE RD TUALATIN, OR 97062 TIGARD, OR 97223 Phone: Contact #: PRI 503- 692 -1565 FEES Reg #: ELE 34 -47CLE LIC 5193 Description Date Amount [ELPRMT] ELR Permit 4/25/2006 $75.00 [TAX] 8% State Surcha 4/25/2006 $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 direct questions to OUNC at 503 - 246 -6699. Issued By: � L Permittee Signature: �L e , 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. - Electrical Permit Appli �� I �y l FOR OFFICE USE ONLY • Received 6( l �O City of Tigard Date/B Pemut No. ( A / a 13125 SW Hall Blvd., Tigard, OR 91,231) 9 5 2005 Plan Review Phone: 503.639.4171 Fax: 503.59M00 0 Date/B . Other Permit: T I G A R D Inspection Line: 503.639.4175 ,,, ,u i '� Date Ready/By. EIVE E1 See Page 2 for Internet: www.tigard- or.gov CiT 1 O iki `- Nonfied/Method: Supplemental Information TYpEItB'�t Iv _ 't PLAN REVIEW ❑ New construction ❑ Addi /alteration/replacement Please check all that apply: ❑ Demolition ❑Other: ❑Service over 225 amps, comm'l ❑Hazardous location ['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 ❑ CommerciaUindustrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi - family ❑Master builder ❑Building over three stories ❑Feeders, 400 amps or more ❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park Job no.: Job site address: �' r Cj � � 0 Health care facility ❑Other: a , l c ( Submit 2 sets of plans with any of the above. City/State/ZIP: j (' 7 � 7 z5 d .? -'- The above are not applicable to temporary construction service Suite/bldg /apt. no.: /13 9 ( Project name: )/-7(9‘i45/:,e___ FEE• SCHEDULE l . c7/ Description FEE* Qty. I Vet' I Told I .. Cross street/directions to job site: � / . 5 mz,p Y ,cj -.G(' 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 dwelling, service and/or feeder 90.90 2 Services or feeders installation, alt tion, and/or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps ,\\ 106.85 2 401 amps to 600 amps J 160.60 2 Name: 601 amps to 1,000 amps 240.60 2 _ Address: Over 1,000 amps or volts 454 65 2 Rcconncct only 66.85 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 600 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel ❑ APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with ei .' ,� � ` branch or feeder fee, each \ 6.65 2 Business name: �:// branch circuit , B. Fee for branch circuits Contact name: 20 ��( U % i2� without service or feeder fee, 46.85 2 / D j � /� q-7,9‘2_, first branch circuit L Address: / Each add'I branch circuit 6.65 2 City / State/ZIP: ,Z --�S ©��. Miscellaneous (service or feeder not included) � �3) ‘.F2._--/_<-7,4"----- Z ^ /s� / ) C"?/-/S-P?. Sump r irrigation lig lighting 53.40 2 ` Phone: `X- Fax: : \ � J VV..�� Sign or outline lighting .Ni 40 2 E - mail: Signal circuit(s) or limited - � Ot) CONTRACTOR / energy panel, alteration, or Business name: V `/C. 0(//plr &/±4 • jv�ot `if/� extension. Describe: Paget 2 Address: /0 ../(:1-./7,1,.%‘,...,,-- 3Q gl� Yt�l ti w" Each additional inspection ove a ble in any of the above Per inspection 62.50 City /State/ZIP: 927O6 Z Investigation per hour (I hr min) 62.50 Phone: ice' 692 '-/5 CS' Fax: (053) ‘t / — ,8? ' Industrial plant per hour 73.75 l ELECTRICAL PERMIT FEES* CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal: Suprv. Electrician signature, required: Plan review (25% of permit fee). Print name: Date: State surcharge (8% of permit fee): TOTAL PERMIT FEE Authorized signatu ,��°�� This p ermi t 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\ Building\Permits\ELC- PermitApp.doc 03/23/06 440.4615T(l1/05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information ti 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 El Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* El 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 El Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical E l 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 \Building\Pmnib\ELC- PemitApp doc 03/23/06 • CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR200&- C)0095 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/25/ 2006 Phone: (503) 639- 4171 t Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/30/2006 TIME: 7.15AM PAGE: 69 • • SITE ADDRESS: 09777 SW WASHING TON SQUARE RD D9,10 CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: HOLLISTER CO. DESCRIPTION: HVAC. OWNER: WASHINGTON SQUARE LLC, PHONE #: CONTRACTOR: ARROW MECHANICAL PHONE #: 503- 692- 1565 • Inspection Request Scheduled For: Date: 5/30 /2006 Pour Time: Co• -c • = - cription Confirm # Contact # Message - Low voltage 030703 -01 072.2413.6395 N 10 F tk Co tions /Comments /Instructio• : • K PASS ❑ PARTIAL APPROVAL ❑ CANCEL , ❑ NO ACCESS ❑ FAIL gj CALL F INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: r 1 v tQl Date: t OD Phone #: (503) 718- • . CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2006-00095 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/25/2006 Phone: (503) 639 -4171 4,4 j i l Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/19/2006 TIME: 7 :05AM PAGE: 55 SITE ADDRESS: 09777 SW WASHINGTON SQUARE RD D9.10 CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: HOLUSTER CO. DES ' = •b. OWNER: WAS 111114 1.4,. SQUARE LLC, • PHONE #: CONTRACTOR: ARROW ME `ANICAL PHONE #: 503'692 -1565 • Inspection Request Scheduled For: Date: 6/19/2006 Pour Time: Code # ,Inspection Description Confirm # Contact # Message Electrical final 031881 -01 972 - 249 -6895 N Corrections /Comments /Instructions: • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION . ❑ ADDITIONAL FEES ASSESSED Inspector: N 6 b Date: 11 6) Phone #: (503) 718- 24 '