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Permit CI TY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00359 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/17/2007 PARCEL: 1512600 -00300 SITE ADDRESS: 09779 SW WASHINGTON SQUARE RD D -11 ZONING: C -G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG PROJECT: CHAMPS Project Description: Installation of limited energy of r security system. 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: SECURITY. X TOTAL # OF SYSTEMS: 1 Owner: Contractor: WASHINGTON SQUARE LLC CHECKPOINT SECURITY SYSTEMS GROUP BY THE MACERICH COMPANY 8180 UPLAND CIRCLE 9585 SW WASHINGTON SQUARE RD CHANHASSEN, MN 55317 TIGARD, OR 97223 Phone: Contact #: PRI 971 -570 -0530 FAX 503- 772 -1070 Reg #: ELE 37- 1024CLE FEES LIC 130739 Description Date Amount SUP 558LEA [ELPRMT] ELR Permit 9/17/2007 $75.00 [TAX] 8% State Surcha 9/17/2007 $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 irect ques s to • NC at 503.246 6699 or 1.800.332.2344. Iss ed By: I _ � � � � Permiftee Signature: 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. cical Permit Application FOR O USE O N t� O N LY Received I /7 7 E4 w 9.0 City of Tigard Reeve Pe rmit No `�K/ III 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review C Phone: 503.639.4171 Fax 503 598 1960 Date/By Other Permit T I G A R D Inspection Line 503.639 4175 Dale Ready/By: tuns RI See Page 2 for Internet www tigard-or.gov Notified/Method Supplemental Information ,,..,( TYPE OF WORK PLAN REVIEW /,�J Please check all that apply (submit 2 sets of plans w /items checked below) New construction ❑ Addition/alteration / replacement `� ❑ Service or feeder 400 amps or more ❑ Building over three stories ❑ Demolition ❑ Other: where the available fault current ❑ Mannas and boatyards C ATEGORY OF CONSTR ' _ exceeds 10,000 amps at 150 volts or ❑ Floating buildings . less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1 - and 2- family dwelling ;#2 Commercial /industrial ❑ Accessory building amps for all other installations buildings ❑ lti- family ❑ Master builder 0 Other: ❑ Fire pump. ❑Installation of 75 KVA or ❑Emergency system larger separately derived system 7.7 y JOB SITE - INFORMATION, AND' LOCATION 0 Addition of new motor load of ❑ "A ", "E ", "1 - ", "I - ", / ���� /lI/��� Q� Six or or more Recreational Job no.: Job site address: on ....../ /'�(/ may ''J ,` ❑Six or more residential units ❑ Recreational vehicle parks City/State /ZIP: ,Q �) , /g7, /� ❑ ❑ Health -care facilities ❑ Supply voltage for more than /'/ f / /f Hazardous locations 600 volts nominal Suite/bldg. /apt. no.: / v7( Prt ct name: � ❑ Service or feeder 600 amps or more. �,� � FEE SCHEDULE Cross street/directions to job site: i j/ Z�� �Q ��/ - ri0 i /�� Description I Qty. I Fee. I Total I • New residential single- or multi- family dwelling unit. 7 #,// i 'd� y- f We 4 ? Includes attached garage. Subdivision: Lot no.: 1,000 sq ft or less 145 15 4 Ea add] 500 sq. ft. or portion 33 40 1 Tax map /parcel no.: Limited energy, residential 75 00 2 DESCRIPTION OF WORK (with above sq R ) -4 /IV Zr) //��� Limited energy, multi-family 75 00 2 C' residential (with abb a sq sq ft ) Services or feeders installation, alteration, and/or relocation 200 amps or less 80 30 2 ❑ PROPERTY OWNER ❑ 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 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT I ❑ 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] 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 Business namea�,�'� ©��," -7), , f � ; energy panel, a) e r limited- t or energy panel, alteration, or Address: f_/„*�`" l y�,1t' extension Describe ) Page 2 2 2 . 64/thqt Cit /ZIP: ey,d/ . /. „ A ig-27/ ✓,/7-1 " ` 5 ` Each additional inspection over allowable in any of the above \ Y-fl /� Per inspection 62 50 Phone: ( 5/) 3`, „ D� 'C t Fax: ( � 2 ,7Z, 61,6 Investigation per hour (1 hr min) 62 50 (� 1 CCB Lic.: 1:1 yir Electrical Lic.: 3 a ,�j Suprv. Lic.: a7 — /ttpyr(,, Industnal plant per hour 73 75 �1 4 f 'ELECTRICAL PERMIT FEES v, Suprv. Electrician signature, required: �� �1J -��t�g Subtotal / Print name: /j�G.k'� Date: l Wig/ Plan review (25% of permit fee). State surcharge (8% of permit fee). a ,g, f� i Authorized signature: TOTAL PERMIT FEE J �� T his 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 I \Building \Permits \ELC-Permit App doc 05/23/06 440- 4615T(II/05 /COM/WEB Electrical Permit Application - City of Tigard f -- -- Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: [JRESIDENT.IAL WORKONLY: . ' . • 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: COMMERCIAI:. WORK ONLY: , - - 1 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* IA Protective Signaling , n Other Total number of commercial systems: / *No licenses are required. Licenses are required for all other installations I \Buildmg\Permns\ELC- PermitApp doc 03/23/06 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2007- 00359 • 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/1 ?00 Phone: (503) 639 -4171 Vfit Inspection Requests (24 Hrs.): (503) 639 -4175 • INSPECTION WORKSHEET FOR DATE: 9121/2007 TIME: 7:00AM PAGE: 2 SITE ADDRESS: 09779 SW WASHINGTON SQUARE RD D CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: CHAMPS DESCRIPTION: Installation of limited energy of r security system. OWNER: WASHINGTON SQUARE LLC, PHONE #: CONTRACTOR: CHECKPOINT SECURITY,SYSTEMS GROUP PHONE #: 971 -570 -0530 Inspection Request Scheduled For: Date: 9/21/2007 Pour Time: Code # Inspection Description Confirm -# Contact # Message 13 5 Low voltage 056119-01 971 - 570.0530 N Co,ecti s /Come ts ructions: A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: . Q 1‘1 Date: 'RI O Phone #: (503) 718-