Permit � .''''CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
.rji1Ac DEVELOPMENT SERVICES PERMIT #: ELR2002 -00292
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/12/02
SITE ADDRESS: 10100 SW WASHINGTON SQUARE RD A -1 PARCEL: 1S135BA -00102
SUBDIVISION: OAKBURG ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
Project Description: Installation of audio /stereo wiring.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X 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: .
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PPR SQUARE TOO LLC AVD TECHNOLOGIES
BY MACERICH COMPANY 13600 SE 185TH PLACE
ATTN: JANET FISHER, ASSET MGMT VANCOUVER, WA 98583
SANTA MONICA, CA 90407
Phone: Phone: 360 772 - 1520
Reg #: ELE 37- 947CLE
LIC 149325
SUP 3674JLE
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 12/12/02 $75.00 Elect'I Final
[TAX] 8% State Tax 12/12/02 $6.00
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
starttg d thin 180.days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
y dto follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 throuc
sued by +.I,'1 Pam
! ir Permittee Signature re /
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:
CONT CTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DATE: /Z /Z -o -2 -
LICENSE NO: 3 7 1 / L , •
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
A - 'Electrical Permit Application
Date received: 4,frB Permit no.: ZLA, -,_, ..gyp •
_j' : 1 , City of Tigard Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued:
M Receiptno.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERM
❑ 1 & 2 family dwelling or accessory afommercial/industrial ❑ Multi- family ❑ Tenant improvement
O New construction O Addition/alteration /replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job address: /D /Of S,) S N'ils y S 4 2 Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: (Block: Subdivision:
Project name: Aet i e_ 0 6;,J I Description and location of work on premises: q,,,p; p a v )1. eo d A c A) $
Estimated date of completion/inspection: ��;, u eo vE Q [L -Zd-o . ill Z.oy - z
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: Fee Max
Business name: / Q Te�Nn 9t�6o �� GS Description Qty. (ea.) Total no. insp
Address: t 7 i 3 S , F, ,r --,- + pi/4 e.2 dwe New residential - single attached per
llinguttlt. Includes attatdted garage.
City: V,ar-JCoJVG/Z I State:w4 I ZIP: fl6,9 3 ' Servicehtcluded:
Phone3,0 -272._, sZa I Fax: I E -mail: 1000 sq. ft. or less 4
CCB no.:.y 9 3 � I Elec. bus. lic. no; 3 7 -fell c e Q Each additional 500 sq. ft. or portion thereof
Limited energy, residential 2
City /metro lie. no.: 7 Z o Limited energy, non- residential 2
/ Z./ 1-6 -Z- Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2
Sup. .4JQ, 3 L7yL Servicesorfeeders — Installation,
Su
P P C 5 N� �Ar�� Licen no: alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): 201 amps to 400 amps 2
Mailing address: 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E-mail: Reconnect only 1 .
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to Installation, alteration, or relocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am .s 2
- ENGINEER Branch circuits- new, alteration,
Name: or extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E-mail: Each additional branch circuit:
PLAN REVIEWV (Please check all that apply) Misc .(Service feeder not lncluded):
O Service over 225 amps-commercial 0 Health -care facility Each pump or irrigation circle 2
O Service over 320 amps -rating of 1 &2 0 Hazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, 1
O System over 600 volts nominal more residential units in one structure alteration, or extension* l 2
O Building over three stories 0 Feeders, 400 amps or more *Description:
0 Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lighting plan 0 Other.
Per inspection
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $ 7 Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
5 .O 0
O Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number / / within 180 days after it has been State surcharge (8 %) .... $ • c'
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card
Cardholder signature Amount 440 -4615 (6R)WCOM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Number of Inspections per permit allowed Restricted Energy E $75.00
I (FOR ALL SYSTEMS)
Service included: Items Cost Total y Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems*
Each additional 500 sq. ft. or
portion thereof $33.40 1
Limited Energy $75.00 ❑ Burglar Alarm
Each Manufd Home or Modular
Dwelling Service or Feeder $90.90 2 ❑ Garage Door Opener
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less $80.30 2
201 amps to 400 amps $106.85 2 ❑ Vacuum Systems
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 ❑ Other
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918 -260 -260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see "b" above. ❑ Audio and Stereo Systems
Branch Circuits
New, alteration or extension per panel ❑ Boiler Controls
a) The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder fee.
Each branch circuit $6.65 2 ❑
Data Telecommunication Installation
b) The fee for branch circuits
•
without purchase of service
El or feeder fee.
Alarm Installation
First branch circuit $46.85
Each additional branch circuit $6.65 ❑ HVAC
Miscellaneous
Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 ❑ Landscape Irrigation Control
Minor Labels (10) $125.00
Each additional inspection over ❑ Medical
the allowable In any of the above
Per inspection $62.50 ❑ Nurse Calls
Per hour $62.50
In Plant $73.75 ❑ Outdoor Landscape Lighting
Fees:
❑ Protective Signaling
Enter total of above fees $
Fl Other
8% State Surcharge $
Number of Systems
i
25% Plan Review Fee .
See "Plan Review" section on $ ` No licenses are required Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $
Enter total of above fees $
❑ Trust Account #
8% State Surcharge $
All New Commercial Buildings require 2 sets of plans.
Total Balance Due $
i:Vdsts forms\elc- fees.doc 08/30/01
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested g — l "3 AM PM BUP
Location ) 0160 k - - S . «0 Suite MEC
Contact Person C Ph ( 31.0 ) - 17a- a- - 15 7 - 0 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR ea . d - Z ) a - / P.--
Crawl Drain
Slab Inspection Notes:p1 , i, SIT
Post & Beam �'�t S Pk 0 k�A CP
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
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
Ur /Slab
• 'o ta. .
Fire • .
40 �" Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
140 PART FAIL
SIT 0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date — Z3 °_3 Inspect %G(i��.i� � Ext
Other:
Final DO NOT REMOVE this inspection record from the • b site.
PASS PART FAIL