Permit n '
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
�I DEVELOPMENT SERVICES PERMIT #: ELR2006 -00079
" ��' II DATE ISSUED: 4/13/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09777 SW WASHINGTON SQUARE RD D9,10 ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Audio /Stereo.
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 VERSATILE CABLING, INC.
BY THE MACERICH COMPANY 12606 NE 95TH ST #C -130
9585 SW WASHINGTON SQUARE RD VANCOUVER, WA 98682
TIGARD, OR 97223
Phone: Contact #: PRI 360 -816 -1021
FEES Reg #: ELE 37- 1048CLE
LIC 161614
Description Date Amount
[ELPRMT] ELR Permit 4/13/2006 $75.00
[TAX] 8% State Surcha 4/13/2006 $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: Permittee Signature: C:Zj A • p
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.
El&trieal 0\
Permit A lication .�'
City of Tigard (� 1..0R urrlt r: t I�t: ()NIA
13125 SW Hall Blvd., Tigard, U Received _ _ •
g OR ( ®. Datc/n : i
Phone: 503.639.4171 Fax: 503.59 1 Y 13 47� Permit No.: ( , / Q
�� �„ a ,� Pla R eview �iy 7
Inspection Line 503.639.4175 � ' Date/Bv: Other Permit.
••,. _
Internet: www.ci.tigardor.u - Date Ready /ay,
0 - \ 0'IN " --. Notified/Method: se Peke 2 for
TYPE OT
t Supplemental Information
® New construction ❑ Addle).': t` replacement - l REVIEW
❑ Demolition �� �1 Please check all that apply: `
❑ Other 1 ❑Service over 225 amps, comtn'I []Hazardous location
• C A I L'rOR _ CONSTRUCTION ['Service over 320 amps — rating ['Bulldo over 10,000 sq ft •
❑ 1- and 2-family dwt llin of 1- MOM 2- family dwellings 4 or mu new rvsldenrin!
g ® Commcrciul /industrial 0 Accessory building ['System over 600 volts nominal units in one structure
❑ Other: OBuilding over three stories [Weeders, 400 .imps or more
El Multi - family ❑ Master builder
JOB SITE'r1NF01rMATfON RIND I.00A'TION ['Egress/lighting load over 99 persons °Manufactured structures or
❑Egress/IighGngPlan RV park
Job no.: Job site addres
S W Washington Square Rd Space [(Health-care facility 0O
uc/7_Tp; Tigard, OR 97223 �''- Submit 2 sets of plans with any of the above.
City /St
The above are not applicable to temporary construction service
Suite/bldg. /apt. no.: Project name: Hollister FEE* SCHEDULE_
Cross street/directions to job site: - °anl ® F ..
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: - 1,000 sq. R or less 145.15 4
I Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /ptUCCI no.: Limited energy, residential 75.00
2
DESCRIPTION. WORK Limited energy, non- residential j 75.00 7S' a> 2
Audio System Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Services or feeders Installation, alteration, and/or relocation
200 amps or less 80.30 2
0 PROPERTY OWNER 0 TENANT
201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 1 60.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454 65
2
City/State/ZIP: Reconnect only I 66 85 I 2
Temporary services or feeders installation, alteration, and/or
Phone: ( ) Fax: ( ) relocation
Owner installation: This installation is being made on property that 1 own which is not 200 amps or less � — 66.85 ' j
201 amps to 400 amps 100.30 2
intended for sale, !case, rent, or exchange, according to ORS 447, 449, 670, and 701 •
Owner Signature: 401 amps to 600 amps J 133.75 2
Date: Branch circuits- new alteration, or extension, per
®•'•APPLICANT'. • • . • ':. , :..l. 0 CONTACT PERSON • - A. Fee for branch circuits with panel
Business name: Versatile Cabling service or fader fee, each
_ branch circuit 6.65 2
Contact name. Teresa Prather — 13. Fcc for branch circuits
Address: 12606 NE 95 St without service or feeder fee,
first branch circuit 46 85 2
City /State/ZIP: Vancouver WA 98602 Each add'1 branch circuit 6.65 2
Miscellaneous (service or - feeder not included)
Phone: (360) 828 -8169 Fax: : (360) 828 -8491 Pump or irrigation circle 53.40
2
E-mail: Sign or outline light 53.ap 2
CONTRACTOR Signal circuit(s) or limited-
energy panel, alteration. or
Business name: Versatile Cabling extension. Describe: Page 2 2
Address: 12606 NE 95 St C -130 Each additional inspection over allowable in any of the above
CityCilY /Statc/%II': Vancouver WA 98682 Per inspection 62 50
Phone: (360) 828 -8169 Investigation per hour (1 hr min) 62 50
Fax 60) 828 -8491 - Industrial plant per hour 73,75
CCB Lin,: 161614 7 Electrical Lie.; / -1 ELEGTRICAL FEIN'
sup,-,. 1?Iccu•ician signature, required: 'T:://:-7-::____(___----- Subtulat
< / G Plan review (25 %nf permit 75 ��
I'rinl name: C• • - ermit f
-- _ '� f ( i Da-
3/10/06 Slate surcharge (8 % fee)
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.ri. permit application e% ire% if a
Print r1nn1C: — ._ 1 ' permit is not obtained w,Il.;,1 IRO
1e / i t� days ti ,, r p bees Iluild accepted as complete
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JqulJmv,�1'enun, +l i' Pm „ur A,, J.w• i ),nn .— •' Noollm of li mpe per pcnrot alluwc,l
440 461 n W07i OMAV1'Il
/id NlJL :60 9002 Zti 'add 16b8 8Z8 092 ON Xtld suotlnIOS 6ut jgej WO1SnO : W0e1d
CITY OF TI ,
C O CARD , . .
BUILDING DIVISION PERMIT #: ELR2006-00079
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/13/2006
Phone: (503) 639 -4171 ".1
Inspection Requests (24 Hrs.): (503) 639 -4175 .-'..W IL.
INSPECTION WORKSHEET FOR DATE: 6/16/2006 TIME: 7:00AM PAGE: 89
SITE ADDRESS: 09777 SW WASHINGTON SQUARE RD D9,10 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: HOLLISTER CO.
DESCRIPTION: Audio /Stereo.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: VERSATILE CABLING, INC. PHONE #: 360 -816 -1021
Inspection Request Scheduled For: Date: 6/16/2006 Pour Time:
C Inspection Description Confirm # Contact # Message
199 Electrical final 031796-02 972-249-6895 N
Corrections/Comments/Instructions:
r
I �1
•
i
J-eASS ❑ PARTIAL APPROVAL 111 CANCEL El NO ACCESS
�❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ‘0 66 Date: 4 . 1 4 • v to Phone #: (503) 718- 2t io
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2006-00079
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: . 4/13/2006
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 _ L.
INSPECTION WORKSHEET FOR DATE: 5119/2006 TIME: 7:01AM PAGE: 47
SITE ADDRESS: 09777 SW WASHINGTON SQUARE RD D9,10 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: HOLLISTER CO.
DESCRIPTION: Audio/Stereo.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: VERSATILE CABLING, INC. PHONE #: 360 - 816.1021
Inspection Request Scheduled For: Date: 6119/ /2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 030173.01 972 - 249.6895 N
Corrections /Comments /Instructions: ,,p
GC. Ib t') - c% GR L D.
❑ PASS • PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:~ Nte, L Date: (t 66 Phone #: (503) 718 -) J