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Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT kr COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00026 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/31/2007 PARCEL: 1S12600-00300 SITE ADDRESS: 09757 SW WASHINGTON SQUARE RD D -4 ZONING: C -G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG Project Description: Restricted energy - 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: 0 Owner: Contractor: WASHINGTON SQUARE LLC HVAC INC BY THE MACERICH COMPANY 5188 SE INTERNATIONAL WAY 9585 SW WASHINGTON SQUARE RD MILWAUKIE, OR 97222 TIGARD, OR 97223 Phone: Contact #: PRI 503- 462 -4822 FEES Reg #: ELE 26- 571CLE LIC 50897 Description Date Amount [ELPRMT] ELR Permit 1/31/2007 $75.00 [TAX] 8% State Surcha 1/31/2007 $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, • • • k is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility ■•otification Ce :. Th•:: rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions t• • UNC - ' 03.246.6699 or 1.800.332.2344. Issu:d By: , _ f� / Permittee Signature: [AA ,. ( Z� J ,,-,- I 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 Application 1.01z (wry I•:1 s1•: oxi.) i Cl of Tigard R00C1V°d Permit No.: ' 13125 SW Hall Blvd., Tigard, OR 97223 Ran Review Phone: 503.639.4171 Fax: 503.598.1960 Date/B • Other Permit: Inspection Line: 503.639.4175 J _„ '_I J., Date Ready/By: run ® See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: e"/ /0 Supplemental Information TYPE OF W . PLAN REVIEW . ❑ New construction is /al Additiont ,- placement Please check all that apply: ID Demolition ❑Other: ❑Service over 225 amps, comm, ❑ 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 Commercia ndustrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi - family Master builder ❑Other: ❑Building over three stories ❑Feeders, 400 amps or more ❑Occupant load over 99 persons ❑Manufactured structures or • • JOB SITE INFORMATION AND LOCATION - RV . ❑Egress/lighting plan park Job no.: ! Job site address: 97 7 , (oast i41 ❑Health-care facility ❑der: Submit 2 sets of plans with any of the above. City/ State/ZIP: Tl j d / � O reQ The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: b o q Project name: ' , . 1V 4 1/"BK U • �� r Description I Qty. I Fee I Total I •• Cross street/directions to job site: U New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. R or less 145.15 4 Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 I Tax map /parcel no.: Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular Lou) UJ vc' / 0�_ el— dwelling service and/or feeder 90.90 - 2 00 �j 0A - 5 + Services or feeders installation, alteration, and/or relocation �J 200 amps or less 80.30 2 ❑ PROPERTY • OWNER I ❑ 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 relocation Phone: ( ) p er: ( ) _ - 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 service or feeder fee, each 6.65 2 Business name: branch circuit Contact name: B. Fee for branch circuits without service or feeder fee, 46.85 2 Address: each branch circuit Each add'I branch circuit 6.65 2 City/State/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) I Fes; : ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or Business name: {4I ► 4 I n +� extension. Describe: Page 2 � • �� 2 Address: 1 ( 8 - a S E _1, Each additional inspection over allowable in any of the above Per inspection 62.50 City/ State/ZIP: f` (AA.)- C1-4.1—IL © ran 1 �a� 9 -' Investigation per hour (I hr min) 62.50 Phone: ( ) 4 ( % A .3.._ A .3.._ tax: ( � t f/_ � l0 1. t _ SCS Industrial plant per hour — 73.75 _ T10 ELECTRICAL 'PERMIT FEES* CCB Lic.: 50gq 7 I Electrical Lic. 7/ I Suprv. Lic.: �J3 Subtotal 75: o0 Suprv. Electrician signature, required: ; . 71 7 0 - Plan review (25% of permit fee) Print name: 41., E -.. O b 22- Date: 1 / 3047 State surcharge (8% of permit fee) le .0 U TOTAL PERMIT FEE / , 06 Authorized signattue \ / � 614A/3 614A/ _ U This permit application expires If a permit is not obtained within 180 days after it has been accepted as complete Print name: eiYV("e_ at vii s ()4 Date: V30/01 • Fee methodology set by Tri- County Building Industry Service Board •• Number of inspections per permit allowed i .tBuilding\PcrminELC?emitAppdoc 12/03 440- 4615T(I002/COM/w® CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2007 -00026 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/31/2007 Phone: (503) 639 -4171 l I Inspection Requests (24 Hrs.): (503) 639 -4175 .J.. 1 INSPECTION WORKSHEET FOR DATE: 3/30/2007 TIME: 7:00AM PAGE: B SITE ADDRESS: 09757 SW WASHINGTON SQUARE RD D CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: NA HOKU DESCRIPTION: Restricted energy - HVAC OWNER: WASHINGTON SQUARE LLC, PHONE #: CONTRACTOR: HVAC INC PHONE #: 503 - 4614822 0k V - CS 1 Inspection Request Scheduled For: Date: 3/30/2007 Pour Time: Code : nspection Description eonfirm~# Contact # Message 195 Misc. inspe .. 0 5779 -01 . ', 360 - 601 -7929 Y i Pi-NAB Corrections /Comments /Instructions: _ -- \\ 1 „, k\ 4( - - , . \ NA \ '\ \ 1 1 r A PASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS s' El CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: • N oa 1--E Date: 110' O Phone #: (503) 718 - 24%