Permit CITY OF T I G A R D ELECTRICAL PERMIT
• PERMIT #: ELC2000 -00244
;v'°"�in DEVELOPMENT SERVICES DATE ISSUED: 05/10/2000
'! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1 S 135BA -00102
SITE ADDRESS: 10108 SW WASHINGTON SQUARE RD's -
SUBDIVISION: OAKBURG ZONING: C -G
BLOCK: LOT : 001 JURISDICTION: TIG
Project Description: Install a first branch circuit.
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 WIO SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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 SQUARE TOO LLC ROSE CITY ELECTRIC CO INC
BY MACERICH COMPANY 4012 NE CULLY BLVD
ATTN: JANET FISHER, ASSET MGMT PORTLAND, OR 97213
SANTA MONICA, CA 90407
Phone: Phone:
287 -6164
Reg #: SUP 2127S
LIC 00003567
ELE 26 -113C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT • GEO 05/10/200C $37.50 0002061 Elect'I Final
5PCT GEO 05/10/200C $3.00 0002061
Total $40.50 ORIGINAL
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE ISSUED BY:
OWNER INSTALLATION ONL
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: k DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
f
or
CITY OF TIGARD Electrical Permit Application
Plan Check #
pp
13125 SW HALL BLVD. \v SO Rec'd By
�
TIGARD OR 97223 �S Date Rec'd
Date to P.E.
Phone (503) 639 -4171, x304 Q�t� 1 ®�-� Date to DST
Fax
Inspection
598 598-1960 9-4 Incomplete Print of Type ` 1 O �� E� 0.0 Called
# R� -69R119-
( 503 960
(503) Incomplete or illegible will not be ac ��
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) ( / j 4/(� -5 Service included: Items Cost Sum 4 '
Address /e9 / /s .5 1 I i k r A ) xv a 4a. Residential - per unit
. �J + � 7 v�� i 7 1000 sq. ft. or less $ 117.75 4
77
City/State /Zip �'.-t4 .09 i % 7 / 2 Z Each additional 500 sq. ft. or
Commercial Residential ❑ portion thereof $ 26.25 1
Limited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data bas :,p Installation, alteration, or relocation
Electrical Contractor A 200 amps or less $ 64.25 2
Addre , ,,i Z 1 - - ri 201 amps to 400 amps $ 85.50 2
401 amps to 600 amps $ 128.50 2
City IJ.. State IL Zip Z 3 601 amps to 1000 amps $ 192.50 2
Phone No. 2 7 - ta. /60(4 Over 1000 amps or volts $ 363.75 2
Job No. /V 72_ / Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 2 I 1 Exp.Date i ( - 3 1 0 4c. Temporary Services or Feeders
OR State CCB Reg. No. 3 5.0 Exp.Date I l 00 Installation, alteration, or relocation
COT Business Tax or Metro No. lb 2- Exp.Date . 3/ d/ 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n 401 amps to 600 amps $ 107.00 2
Over 600 amps to 1000 volts,
License No. l.)--`7 4 Exp.Date /OA- see "b" above.
/ 4d. Branch Circuits
Phone No. New, alteration or extension per panel
a) The fee for branch circuits _.
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 2
Address b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit / $ 37 50 3 /
Each additional branch circuit $ 5.35
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy
panel, alteration or extension $ 60.00
3. Plan Review section (if required): * Minor Labels (10) $ 107.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
descnbed in N.E.C. Chapter 5 5. Fees: �1
5a. Enter total of above fees $ 5 / • ST
* Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.05 X total fees) $
Not required for temporary construction services. Subtotal $ /y .15-.C,
5b. Enter 25% of line 5a for .
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ t10. &13°
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