Permit r
7s „, a CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00128
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/29/2008
PARCEL: 1512600 -00400
SITE ADDRESS: 09800 SW WASHINGTON SQUARE RD SEARS ZONING:
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: SEARS
Project Description: Installing (1) low voltage CCTV 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: CCTV X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC COOK SECURITY GROUP
BY THE MACERICH COMPANY 5841 SE INTERNATIONAL WAY
9585 SW WASHINGTON SQUARE RD MILWAUKIER, OR 97222
TIGARD, OR 97223
Phone: Contact #: PRI 503- 786 -5173 •
FAX 503- 786 -3792
FEES Reg #: ELE 3- 541CCLE
LIC 151552
Description Date Amount
[ELPRMT] ELR Permit 5/29/2008 $75.00
[TAX] 12% State Surch 5/29/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 or 1.800.332.2344.
Issued By•
e Permittee Signature: k
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 � �'\I •
5 FOR OFFICE USE ONLY
Received 2
City of Tigard \: \A
�r Date/By: o G C� PermuNo. � � �� �?
13125 SW Hall Blvd , Tigard, OR ' 23 p Y Plan Review
0 Phone. 503.639 4171 Fax: 503 598 140 qr� Date/By. Other Permit.
Inspection Line: 503.639 4175 t'C Date Ready/By ions ® See Page 2 for
,�
Tlclil� . S1
Internet lie' www tigard-or.gov , t4\ '�1 Notified/Method: Supplemental Information
TYPE OF W I4 4 PLAN REVIEW
❑ New construction VI Addition/altera % (replacement Please check all that apply (submit 2 sets of plans w /items checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards
CATEGORY OF CONSTRUCTION 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 ® Commercial/industrial ❑ Accessory building amps for all other installations buildings
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: 9800 SW wAS • St. la Six or more more. R occupancy rtio
❑ Six or more residential units. ❑ Recreational vehicle parks
City/State/ZIP: n �� f' �� �� (�'i j ❑ Health -care catio tes. ❑ Supply voltage for more than
Y ` ❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt. no.: Il'roject name: S{4 AS ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Description
I Qty. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145 15 4
Ea add'I 500 sq ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq ft )
Limited energy, multi - family
e t✓ /9DQ /r/oNf residential (with above sq ft.) 75 00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ 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 1 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'I 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
/' Signal circuit(s) or limited -
Business name:
Cook 5e C Rte 6•to y 2s • energy panel, alteration, or
5 i ll s ir f Nrc'-d4,70"141 . Iv extension. Describe. I Paget 75;00 2
Address: ,�/
City/State /ZIP: )14,/ e- .02. 9 7 2Z1--- / Each additional inspection over allowable in any of the above
Phone: ( 78 4- 5 ' Fax: ( 5-63) 714 - 3772.- Per inspection 62.50
Investigation per hour (1 hr mm) 62.50
CCB Lic.: i 5 / s d s �� , . � Electrical Lic.: 3 -5 d e Suprv. Lic.: L 9� L, Industrial plant per hour 73 PERMIT 75
Suprv. Electric sig> .ture, required: ,ate . 9s/ Subtotal '75 , O0
' ' Plan review (25% permit fee):
Tort I"Avy-- I c e( o P )
Print name: Date: J 1r
0 State surcharge (12 /o of permit fee): �c X�
Authorized signature: TOTAL PERMIT FEE: (y(�
Print name: Date: This permit application expires if a permit is not obtain wwi tbln 180
days after it has been accepted as complete.
• Number of inspections allowed per permit
1 \ Building \Permits\ELC- PermiAppdoe 05/23/06 4404615T(11/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
El Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
El Other.
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
El Audio and Stereo Systems
El Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
El HVAC
❑ Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
El Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
® Other Cell/ AO 77°P J .
Total number of commercial systems: /
*No licenses are required. Licenses are required
for all other installations
I \Bwlding\Prnnite\ELC- PennttApp doc 03/23/06
CITY OF TIGARD .•
,,. A
BUILDING DIVISION '.. PERMIT #: ELR2006.00128
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/29/20013
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 1 L
INSPECTION WORKSHEET FOR DATE: 6/10/2008 TIME: 7:01AM PAGE: 41
SITE ADDRESS: 09800 SW WASHINGTON SQUARE RD SEARS CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SEARS
DESCRIPTION: Installing (1) low voltage CCTV system.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: COOK SECURITY GROUP jg ► PHONE #: 503.786 -5173
Inspection Request Scheduled For: Date: 6/10/2008 Pour Time:
Code # Inspection Description - Contact # Message
135 Low voltage 071116 -01 503. 970 -5346 Y
Ig 9 r; N,0+1/4-.
Corrections/Comments/Instructions:
•
(-,
k. U
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G.----' A. 4Q, Le Date: Al 16t Phone #: (503) 718
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