Permit , .A... CITY OF T I G A.R D ELECTRICAL PERMIT
PERMIT #: ELC2001 -00065
0 DEVELOPMENT SERVICES DATE ISSUED: 1/29/01
" - ' I - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1 S135BA -00100
SITE ADDRESS: 10145 SW WASHINGTON SQUARE RD TGI
SUBDIVISION: OAKBURG ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Disconnect and reconnect commercial refrigeration HVAC units, (7) branch circuits. Job No. 66 -18516
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: 6 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 CHRISTENSON ELECTRIC INC
BY MACERICH COMPANY 111 SW COLUMBIA
ATTN: JANET FISHER, ASSET MGMT STE 480
SANTA MONICA, CA 90407 PORTLAND, OR 97201
Phone: Phone: 241 -4812
Reg #: LIC 000458
SUP 3289S •
PLM 2468S
ELE 26 -34C
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 1/29/01 $86.75 2720010000( Elect'l Final
5PCT CTR 1/29/01 $6.94 2720010000(
Total $93.69
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 s or direct questions to OUNC at (503)
246 - 1987. PERMITTEE'S SIGNATURE � ISSUED B X:47.(,074114d;
• 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: � 7,--- k , DATE:
LICENSE NO: 8735
Call 639 -4175 by 7:00pm for an inspection the next business day
• ElectricalPermitApplication
Date received: / — a?-o/ Permitno. : -er--
t .1 a City of Tigard Project/appl. no.: Expire date: .
Carty ogar3 L Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: - By: - I Receipt no.: ` •_
Phone: (503) 639 -4171
' " ` " Fax: (503) 598 -1960 Case file no.: - • - -- Payment type: -- _ -. - -. _ _
Land use approval: - -- - _
• COP�^�tr "7 "37. .... .- . _ . • . i
TYPE OF PI RD11T •
Cl • 1 & 2 family dwelling or accessory a O Commercial/industrial O Multi- family Cl Tenant improvement - ') ;
Cl New construction • - . „O Addition /alteration/replacement Cl Other.. _ Cl Partial
JOB SITE INFORMATION
Job address: 10145 SW WASHINGTON` SCr - RD 97223 Bldg. no.: • ` Suite'no.: 7 •-, Tax map/tax lot/accountno.: • _ -
Lot: (Block: ISubdivision:TI — t ' • - - -•- -- COMMERCIAL REFRIGERATION •HVAC UVITS
Project name:TGI FRIDAY' S I Description and location of work on premises: REFRIGERATION CIRCUITS DIN CONNE CT
' Estimated date of completion/inspection: QUESTIONS? CONTACT TIM METCALF 503 80343 AND RECONNI L I _ __
(O\I:R :■C - COR. APPIICATION .i ., A - - - FEE SCIIEDIILE - - - - ... .
- Job no: 66 -18516 - _ , • Fee Max
.- Business name:CHRISTENSON ELECTRIC, INC. ' - Description Qty. (ea.) Total no.insp
New residential - single ormaltl 1amilyper ... •
Address: 111 SW COLUMBIA, SUITE 480 dwemhgtmit .hrdudes attached garage. _
City: PORTLAND I State: OR I x:97201 -5886 S Oe aded
Phone503 2414812 'R3503241054 E-mail: moo sq. ft. orless 4
CCB no.:45 8 I c. bus. lic. no: • 26 Each additional 500 sq. ft. or portion thereof
Limited energy, residential 2
City /metro ' O.: 5 46 _ Limited energy, non-residential - 2
Each manufactured home or modular dwelling
Signa of supervisin ca required) Date 1 / 25 /01 Service and/or feeder 2
Sup. elect. ttame(print): BRIAN CHRISTOPHER License co: 873S Services or feeders — installation,
alteration or relocation: •
PROPERTY OWN ER .
200 amps or less 2
P
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: 'ZIP: Over 1000 amps or volts 2
Phone: (Fax: (E -mail: Reconnect only I
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 lasmllatioo,alteratloo , orrelocatloa:
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., 2
ENGINEER Branch circuits - new, alteration,
j or extension per panel:
Name: 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 1 46 . 8 -
Phone Fax: E - mail of service or feeder fee, first branch circuit 2
Each additional branch circuit: 6 5. 6 5 3 9.9 0
PLAN REVIEW (Please check all that apply) Misc. (Serriceor feeder not Included):
O Service over 225 amps - commercial - O Health -care facility Each pump or irrigation circle 2
O Service over 320 amps - rating of 18c2 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,
• 0 System over 600 volts nominal more residential units in one structure alteration, or extension* 2
❑ Building over three stories 0 Feeders, 400 amps or more *Description:
O 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
Not all jurisdictions cept credit cards, please call jurisdiction for more information. Notice: This permit application
Permit fee $ 86.75
ns
0 Visa O MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ 6.94 /
Expires TOTAL $ 9 3.6 9
accepted as complete.
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440.4615 (6600/COM)
OCT.2000 +FEES ON BACK OF FORM
Electrical Permit Fees: - -• • Limited Energy Fees:
• Complete Fee Schedule Below: TYPE OF W OR K INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee $75.00
- - Number of Inspections per permit allowed (FOR ALL SYSTEMS) - -•
Service Included: - -- - - Items - Cost - - --- Total ''
Check Type of Work Involved: •
Residential - per unit •••- —• - - -• --------- -•-• - • - - -. - -- ---_I !. ` ... • `
1000 lt or less $ 5.15 4 Audio and Stereo Systems
14 ❑ ms
Each additional 500 sq. ft or - -- —• -- -- • -- - r ; F ' 1
= portion . thereof . ; _. $33.40..._ _- .1 „--- •-• --,Burglar Alarm.,„.___,_„_ _ _..• . _ ..
orgy . ....: 7 1. •:- :r
Limited :yr' . �,. $ :4.�, •:, i ;;=i:�:�r =.in ' y. , Y; t :. k �k t � F.i: ` ;' r' is
f Each Manurd Home or Modular W Garage Door Opener' . - !t
f Dwelling Seivli e'or Feeder" ; r - ;+ $90.90 2 ' : • ' -- • ' ,: .:: : i:; '•.: i..� i _ _ . : :i :
i - -r,G - -. - -:
• Services or Feeders '� IJ - - - -_^ } f 0 Heating, Ventilation and Air Conditioning System' • i . t
Installation, alteration, or relocation` - • ' ' ` - - _ •
200 amps or fess • -- - - - - . - $80.30 - - 2 ! Vacuum Systems
201 amps to 400 amps: `= YE -0 "' • . - '• $106 - 2 - —
401 amps to 600 amps $160.60 2 Other •
- - 601 amps to 1000 amps` - - ---- -- -- - $240.60 -- - -- - 2 -- E3 -
-- Over 1000 amps or volts ------ --- - --- $454.65 2 - - - -
. Reconnect only - _ _ $66.85 2 -
- f. -2 .. -1-'''''''''-:;:- • - ` - -,': • - : o . : 2- -::!t : - -TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Temporary Services or Feeders r "Fee for`each system - - $75.00
1 Installation, alteration, or relocation
_ 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 ❑ Boiler Controls
New, alteration or extension per panel
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 - • • ❑ Fire Alarm Installation
or feeder fee.
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 ❑ Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal cin:rit(s) or a limited energy p -
panel, alteration or extension $75.00 ❑ Landscape Inigation Control'
Minor Labels (10) $125.00 ❑
Medical
Each additional inspection over -
the allowable In any of the above ❑ Nurse Calls
Per inspection $62.50
Per hour $62.50 El Plant $73.75 Outdoor Landscape Lighting*
Fees: ❑ Protective Signaling
Enter total of above fees $ - ❑ Other • •
8% State Surcharge $ Number of Systems
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 $
• Total Balance Due $
i :\dsts\forms\elc- fees.doc 10/09/00 - H - OVER FOR PERMIT FORM
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
!%^ BUP
Date Requested ' " 2 7 AM PM
BLD
a ( (,r1 ,L
Location � S� d" Suite MEC •
Contact Person Ph PLM
Contractor ` Phoa SWR
BUILDING Tenant/Owner L /� (L� ELC W /-6 "A
Retaining Wall ELR
Footing
Access:
Foundation FPS
Ftg Drain / c / ' SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear a a t //M7
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
•
Firewall • -
Fire Sprinkler
Fire Alarm (
Susp'd Ceiling � 1 /
Roof
Misc:
Final
PASS PART FAIL F//t14
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer -
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
CTIZ(C7�
Rough In
UG /Slab
Low Voltage
• - Alarm
S)ART FAIL
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA n�
O t he oach /Sidewalk . 2 � ��/ Inspector /' Ext
Date / ' t
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.