Permit �� �� 41/.11.�!�"�
(fir .5 / �• wY dte-L .6+-9 ELECTRICAL PERMIT
A 40 r Y TIGARD C PERMIT #: ELC2004 -00028 •
4 - DEVELOPMENT SERVICES DATE ISSUED: 1/21/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 PARCEL: 1S126C0
SITE ADDRESS: 09800 SW WASHINGTON SQUARE RD
SUBDIVISION: tWeggiNGTON SQUARE ZONING. C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installing (8) branch circuits. 2/4/04, adding an additional (99) branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 106 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PPR WASHINGTON SQUARE LLC ELECTRIC HOME SERVICE
BY THE MACERICH COMPANY 9510 STONE AVE. N.
9585 SW WASHINGTON SQ. RD. SEATTLE, WA 98103
PORTLAND, OR 97223
Phone: Phone: 206 527 - 4422
Reg #: LIC 75095
ELE 37 -451C
FEES SUP 2906S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 1/21/04 $93.40
[TAX] 8% State Surcharge 1/21/04 $7 Rough -in
[ELPRMT] ELC Permit 2/4/04 $658.35 Elea! Final
(additional fees not listed here)
Total • $811.90
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 . • • : - cord ance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for mor= an 180 days. , ENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Not cation Center. Those rules are set
forth ' OAR 952 001 - 0010 ough OAR 952 001 0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246699 or
1 -8r 332 -2344. , / /
11
Is ued By: Oj 1 V. Iii � 4 / . Permit Signature: I i 44/ �l�_____
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:
CO,J RACTOR INSTALL ' ON , NLY
SIGNATURE OF SUPR. ELEC'N: / ./ .s/ t41 II %/ I DATE: i9 /'v y
LICENSE NO: 3.9 6 S /
Call 639 -4175 by 7:00pm for an inspection the next business day
I ( +
Electrical .` ;`emit •. . 17ic ��
on FOR OFFICE USE. ONLY „ Recei
City of T : - Date /B f1 Permit No.:AZ , _ t 9'
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax. 503.598.1960 AA Date /B : Other Permit.
Inspection Line: 503.639.4175 n� Date Ready/By: ions. El See Page 2 for
Internet: www.ci.tigard.or.uS.,L /A / t� �M� . Notified/Method. Supplemental Information
CCC���CCC���CCC��� TYPE OF WORK �/�/ PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: ❑Service over 225 amps, comm'l ['Hazardous location
OService over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ® CommerciaUindustrial ❑ Accessory building OSystem over 600 volts nominal units in one structure
❑Building over three stories ['Feeders, 400 amps or more
❑ Multi- family 0 Master builder 0 Other:
❑Occupant load over 99 persons ['Manufactured structures or
'JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
❑Health -care facility ['Other: Job no.: Job site address: 9800 Washington Square
Submit 2 sets of plans with any of the above.
City/State /ZIP: Tigard, OR The above are not applicable to temporary construction service.
Suite /bldg. /apt. no.: Project name: Sears Retail Store FEE* SCHEDULE
Description I Qty. I Fee. I Total I ••
Cross street/directions to job site: Washington Square Mall 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'l 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
Relocate electrical to facilate new flooring, Update display shelves, Remove older dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and /or relocation
display lighting and install more energy efficent, display lighting. • 200 amps or less 80.30 2
❑ PROPERTY OWNER ® TENANT 201 amps to 400 amps 106 85 2
401 amps to 600 amps 160.60 2
Name: Sears 601 amps to 1,000 amps 240.60 2
Address: 9800 Washington Square Mall Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State /ZIP: Tigard, Or 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
0 APPLICANT ' ❑ CONTACT PERSON _ A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: Electric Home Service (EHS Electrical Contractors) branch circuit
B. Fee for branch circuits
Contact name: Dave Rankin without service or feeder fee,
each branch circuit 46.85 2
Address: 9510 Stone Ave N
Each add'l branch circuit 6.65 2
City /State /ZIP: Seattle, WA 98103 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (206) 527- 4422(206- 926 - 9934desk) Fax: : (206) 527 -5423 Sign or outline lighting 53.40 2
E -mail: zAve5,12 , Li_ G , eO f`1 Signal circuit(s) or limited-
C ONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: EHS Electrical Contractors (EHS Electrical Contractors)
Address: 9510 Stone Ave N Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: Seattle, WA 98103 Investigation per hour (I hr min) 62.50
Phone: (206) 527- 4422(206- 926- 9934desk) Fax: (206) 527 -5423 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lie.: 7S, 5 Electrical Lice. - . 1 _ Suprv. Lie.: �16S A Subtotal 4,58.
Sup Electrician signature, required: � ipp � J /
rif l am Plan review (25% of permit fee) //
Print name: T� ge r .4 Date: State surcharge (8 % of permit fee) 5 a •t07
Y �' , _ -�� TOTAL PERMIT FEE 7 //• oa
Authorized signature: This permit application cxpires 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.
cV Building \I'crmns\ELC- PcmtitAppdoe 12/03 410.4615 r(I /02/COM /WEI
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223 RECEIVED
IMPORTANT PERMIT NOTICE FEB 0 4 2004
CY OF TIGARD
ELECTRIC HOME SERVICE BUITiLDINC OIVIS��N
9510 STONE AVE. N.
SEATTLE, WA 98103
Electrical Signature Form
Permit #: ELC2004 -00028
Date Issued: 1/21/04
Parcel: 1S126C0-01107
Site Address: 09800 SW WASHINGTON SQUARE RD SEARS
Subdivision: WASHINGTON SQUARE
Block: Lot:
Jurisdiction: TIG
Zoning: C -G
Remarks: Installing (8) branch circuits. •
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Division.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
PPR WASHINGTON SQUARE LLC ELECTRIC HOME SERVICE
BY THE MACERICH COMPANY 9510 STONE AVE. N.
9585 SW WASHINGTON SQ. RD. SEATTLE, WA 98103
PORTLAND, OR 97223
Phone #: Phone #: 206 - 527 -4422
R #: LIC 75095
ELE 37 -451C
SUP 2906S
AN INK SIGNATURE IS REQUIRED 7 HIS FORM
X _1� Io
Signature of �� pervising Electrician
If you have any questions, please call 503.718.2433.
CITY OF TIGARD
BUILDING _ n Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 1A MST i i
BUP
Received ca Date Requested fQ AM PM BUP
Location / 8 v a2,4 Suite MEC
Contact Person Ph ( ) �06) 3 g3- 30 7 (0. PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ' ,,x.1.4 4-- ELC ��
Footing Access: ELC a'� y —000 2—d
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation = `► f7 911 M 1 •
Drywall Nailing Y� V
Fire wall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fir: larm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
dlia PART FAIL
Please call for reinspection RE: I=1 Unable to inspect — no access
Fire Supply Line
ADA I A roach/Sidewalk Date `v Inspecto
PP Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL