Permit _�_..�, q CITY OF TIGARD
IN
ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00367
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/19/2007
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: (1) low voltage 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 CHRISTENSON ELECTRIC, INC.
BY THE MACERICH COMPANY 111 SW COLUMBIA STREET # 480
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97201
TIGARD, OR 97223
Phone: Contact #: PRI 503 -419 -3300
FAX 503- 419 -3695
FEES Reg #: ELE 26 -34C
LIC 458
Description Date Amount SUP 1994S
[ELPRMT] ELR Permit 9/19/2007 $75.00
[TAX] 8% State Surcha 9/19/2007 $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 or direc - - estions to OUNC at 03.246.6699 or 1.800.332.2344.
Issued B #1 i2i ' // , ' / Permittee Signature: t,..., 4, ok' - lien
OWNER INSTALLATION ONLY r
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.
SEP -19 -2007 WED 12:02 PM CHRISTENSON ELECTRIC,INC FAX NO. 95034193695 P. 01
Clef,- ical Permit Application, I ()11 .. I' I I ( I . I .�' u,\ 1.
City of Tigard
RErw /1 , E D 1SW Hl Blvd, TigOR 972 CV i l P
, „ �, Other Permit.
Phone: 503.639.4171 Fax 503.598.1960 �. I Date/13 :
Inspection Line: 503.639.4175 S EP 1 9 200 4 .j -
ti ed/MA d , KIM 0 se e2 fa� armaeMa
Internet: www.ci.ligard.or.us GUY 0).-4.7,1 ''�,
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ID New construction !.1 Addition/alteratio rep ticement 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.,
�: is <n. �,wi` ''r :ir + �� Te . l�Yn Ya`= L ,-. -,.... k �i =. h' "'. .1.Vr't S'- ''''
�w 4 3' 4 ,x a; of I - and 2-family dwellings 4 or more new residential
', :€ ^x: x. '�:. '':I S :.'':,':''' ww - 41<� `dd• £% ' f # "��+l F i i > 1 Y rig
0 1- and 2- family dwelling ' Commercial/induslrial ❑ Accessory build ['System over 600 volts nominal units in one structure
❑13uilding over three stories ['Feeders, 400 amps or more
❑ Multi family ❑ Master builder ❑ Other: ['Occupant load over 99 persons ❑Manufactured structures or
x : 2' ^ m...x r # r�r T v were.. -:-.. C: w w: SW. .).4.40.7., •,,, # 3 ...£ •I PO a RV park
.,. :, F0n . 4>us is r e ;: ►, .p ` `` . $1 yr :13 414`. . :41..)W r `.. � a.?.., ❑ Egress/belting plan
.... � • , ❑ Heatth.cane facility ❑Oter' _ _
Job no.:� Op I 45 Job site address: • 5 1 (� , , ill ,. ., Submit 2 sets of plans with any of the above. ~
o Cis, /State/E,: T ,� Dt q 7 a3 The above are not applicable to temporary construction ser
1l .. ,k <. � �X4� �`av��r.� � .`.•'�'�eif•?g 4<b'' 1
$ d ./ t. no t x x 'xs� ill s, Y " "• :i S£�i 's� 1 ? 141)4 7 re '. •:
uite/bl g ap 5? D- ` I Project name( , lt°� �Rl VI� Ply n.K.tpwn i Qo• I Fee. I- Told I .
Cross street/directions to job bite:
u_Q_1�gi l5 r vve.. He new residentlal aingle or multi-family dwelling unit.
Includes attaebed_pruge. _
503- nl'o - ci 3 I 1,000 aq. IL of less 145.15 4
Subdivision: l Lot no.: Ea. add'1 500 sq. Li. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.: Limited energy, non residential 75.00 2
+ isr a . i y "' 'rt <,fY �y(�, ,w]:�4""s" 3 ' ,,: rx.e...'+. <a it ■.6 s,, A• "
.'.. .. .'" 7: . < : e; x 4,' :10 ARf,7Gk33e iW
., r$ y;K i;, x .,.5.. � � K'v'!'e Each manufactured or modular
a: dwellin • , service and/or feeder 90.90 2
dtr r i . • AA it OA.' v a • ' t r. A ' . 1 -. . _ i ■ . Services or feeders Instollatlon, alteration, and /u relocation
200 amps or less 80.30 2
• .0..,: i j i �'"O'o ; ." . , ; . °w ;c5' ;rx ;i'"Ya% . :�4.f'o'r.H.x...k . `' °eu <4 .. s +,,,,,a,..-„,.• 201 amps 10 400 amps 106.85 2
. i;•1 . 1..: i. v' ^. „...4›,.<"
.. › a : ,bF:..s'£,. ,off .. w > >i:; i�i"d w ::.%'5'- hb: xitili' *�nt : `i R7<:'a: is K:i3'fi; 401 amps to 600 amps 160.60 2
Name: K 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: ( ) I Fax: ( ) 200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not • 201 atop, 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
+
� y n " ' 'u s'� tiCOW , <'� "'°' ",' "x=' -u >' A. Fee for branch circuits with
<""«s ;`.'?:li.!.ti y "' ; •.li,,, >...i ;iit ;�0 K2.S� ,. :,o:'"�titi i 6t•.IA- ,`".$..A.."S-" ..Z :P``'.
service nr feeder fee, each
"'~ ".
,�,y9 . K' branch circuit 6.63 2
Business name: - '
. H. Fee for branch circuits
Contact name: without service of feeder fee. 46.85 2
first branch circuit ,
Address: .
Each add'I bunch circuit _ 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not Included)
Pump or irrigation circle 5140 2
Phone: ( ) ] Fax: ( ) Sign or outline lighting 53:40 2
E - mail: ' Signal circuit(s) or limited- •
,, , r l oI L . .r. . # . „.i ' t Qs .r :' .
�: :n,9,. : energy ,n, or
;„ :.;."4.444; xax;cs''>;4'4 v`..,'1�4 r Ca .. : ,.:1# « # 4,,: #. v K''.'':K'....,... +t anel alteration, extension. l Paget r 15 , 61) extension. Describe:
Business name: Christenson Electric, Inc ' CGN -
Address: 111 SW Columbia Street, Suite 480 Each additional inspection over allowable In any or the above
_ Per inspection 62.50 -
City / State/ZIP: Portland, OR 97201 Investigation per hour (t hr nun) 62.50
Fa (503) 4 19 - 3695 Industrial plant per hour 73.15 s
Phone: (503) 419 300 ( ) .4 �:. jj 1fII(A1 Fl d> , . • .
CCB Lic.: 458 I Electrical Lic.: 26-34C 15 rv. Lie.: 199 Subtotal r 7 S ' 4 0
`Vl
Suprv. Electrician signature, required: Plan review (25% of permit f>•e)
p
Stale surcharge (8% of permit fee) 6 .00
Print name: �.r�{- • Data:Ci I I 0r) TOTAL PERMIT FEE b
Authorized signature; This permit application eipires it a permit is not obtabtsd within I NO
days alter it bas been accepted as complete
Print name: Date: ' • Fee methodology set by To Building Industry Service tiaurd
air Number of empectaons per . permit allowed. �� �
,.9wldutalPermrtslEl.C pmmiGaw ddm IuO.I 440 -b I ST(Ier0VCO t/► NE° c S
CITY OF TIGARD
BUILDING DIVISION PERMIT #1,11t7..001' 003 61
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171Q+
Inspection Requests (24 Hrs.): (503) 639 -4175 4 t ..
INSPECTION WORKSHEET FOR DATE: q • tLk • O TIME: PAGE:
SITE ADDRESS: S A U, S 1 N ESN S I I
'� CLASS OF WORK:
SUBDIVISION: C. , LO$ #: TYPE OF USE:
th
PROJECT NAME: �'1° s.
DESCRIPTION: 1„p •vQl. .
OWNER: PHONE #:
I I CONTRACTOR. PHONE #:
Inspection Request Scheduled For: Dater .1,1i- Pour Time:
Code # Inspection Description Confirm # Contact # Message
otc‘ f L
Corrections /Comments /Instructions:
N ikPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cr", N 0 t• Date: 912 ' Phone #: (503) 718- �q