Permit 1
ELECTRICAL PERMIT -
CITY OF T I G A R D AP* RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR2004 -00136
13125 SW Hall Blvd.. Tigard, OR 97223 (5031639 -4171 DATE ISSUED: 5/26/2004
SITE ADDRESS: 10246 SW WASHINGTON SQUARE RD C -16 PARCEL: 1S135BA-00102
SUBDIVISION: OAKBURG ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
Project Description: Low voltage: telephone cabling.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
• Owner: Contractor:
BY THE MACERICH COMPANY LIBERTY COMMUNICATIONS
9585 SW WASHINGTON SQUARE RD 2191 NE LIBERTY AVE.
TIGARD, OR 97223 GRESHAM, OR 97030
Phone: Phone: 503 674 - 4922
Reg #: LIC 101807
ELE 26- 1035CLE
SUP 3990LEA
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 5/26/2004 $75.00 Elect'I Final
[TAX] 8% State Surcharl 5/26/2004 $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
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.
Issued by � Permittee Signature 6--77 a cL yy.1
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
't 11 .
• 05/24/21 4:17 FAX 5095981900 CITY OF TIGARD [1001
Electrical permit ApplicatioR I,10 FOR OFFICE USE ONt_1
City of Tigard MOOR
W 6 6 (o
d o • Pamir lie.: _ •
i - p0/3
13175 $ W Hall Hall Blvd.. Tigard, OIL G sort Rainey/ Other Other $east
Phone: 503.630 "4171 Fax 503. 1, �! , • 1 • '1111 p gY
NceWad1Mathod:
Inspection
on Liar 503.639.4175 onus
Internet wvw_dtigaed.or.aa �` � GP - . •." E .. .
E�^'-,= "�''a !''�uc'�.:2i:.L� -w °9lma$ nm �..�me/'. :mr=. ,. w:
0 New construction _s Addi. .' : i ' }`r „Igccnt Please check all that apply:
❑ Demaitlon ❑ Otis 0 ❑Service eve 225 omps, contm'l DHarerdaus location
74 al
>m T •- ,=-� -.r•!. r r:,-'.-- c ,- 7 5 '
❑Service over 320 arms - rating OBuildng over 10,000 sq. it.,
I , r " 2-tinnily Myelin 1 w : � =..: -- C . r ' ir' ._., t , � 4 n..,t1 ! _ , .tl t ;T_. <? i- awdI-familydwellfi.ga 4orIIieio new [e8idential
❑ I - and 2- Ti Myelin r ❑ Accessory building Dyes= over 600 volts nominal units in one etrocaue
o i a1>ta_ ,,, ❑ Afasxr builder n Other
over tutee straits OFeeders, 400 amps or more
_ -f1 -r '.1 4 1 3 .x.. 1 -.
❑Ooeupant load aver 99 persons ElMartlr£actared structures or
gr ` - = . , - ; ' s 1 - = >c .":a t t u ' L . , 1 L `" 7 Q figre Bht616 pl RV petit
: Job site address / 40,1 4 / iJ W Z Cis . T • ' Submit „L sets Duality n nether nether Job no
M.) '� • Snbrtdt �, sets of pleas with any of the above.
/S� �� The a bove are not app li cabl e to temporary construction ct service.
y , D ie . �� 3 t.�'.'. r., - _ .
t V, r:' ��,., � 4" �i�. :ir
l el ... lJ ir '.:.. ,N ■ '.i
Suitelbld$/apt no.: Proieern ,Br�/Va_ 49041 =- _ ;�, a ,) _...:,
b en a,wn ev• Fm Tow "•
Cress Streer/dfracdans to job site: New residential single- or multi- family dwelling unit.
Includes attached garage. _
1,000 sq. B. or less 145.15 4
Subdlvfslott: Lot no.: Be.. add'1500 sq. ft. or portion _ 33.40 1
I3toited energy. residential 75.00 2
Tax niap /parcel no.: Limited energy, eon- residential 1 ' 75.00 16 : • 2
-- -311 --222_,'- - - ; = 77 yvr G � 1, .. ,r.._L.s11_--- L :" _ ,,J ' �.I! W Bub nsinufentured or modular
dwelling, service and/or feeder 90.90 , 2
Services or feeder Installation, alteration, and/or reloeatima
200 amps or less 8030 ' 2
r . . , r, `. : ':. t '.'!'-'.7.:-77,' � , l . , � n•-„ ; z. :� 9§- r L r� 201 amps to 400 ammps 106.85 2
� _�_
, � _,. • ��_.- _s,,, .L 1, .7
: ._.:�,cn�:a+� `� 401 amps 600 amps 160.60 �
.,_
Name 601 amps to 1,000 amps 240.60 2
Addrt:elt: • Over 1,000 snips or volts 454.65 2
Reconnect only 66.85 2
City /State/ZIP ' Temporary services or feeders Installation, alteradoe, and/or
Phone: ( ) Fact. ( ) roe
200 amps or leas 66.85 1 _
Owner lamination: ion: This installation is being made on property that I own which is not m Iowa amps 40Iowa 1003 ' 0
intmtded for sale, lease, rent, or exchange, according to ORS 447, 449, 670. and 701. ' '
401 atolls to 600 snips 133.75 2
Owner algnatluv _ Date: Stanek tirades-new, alteration, or ezteaalon. per panel
;, t r : 1 - _ - = ` . - A Fro OR breach circuits with •
., . _ • . -- - ,. *- -_ _ -, - _ . ..,.._ _ - .._ _ •. - -W aavioe feeder fee. each
Business nano branch circuit 6.65 2
B. Fee fbrbrincb circuits
Qin= nu= wlfAmrtsemice orfb:derfee. 46.85 2
each branch circuit
'4ddtt st Each addl branch circuit 6.65 2
City/Sr:ere/ : _ Miscellaneous (service or feeder net included)
Phone: ( ) Fsrz:: ( ) Pump or irrigation circle 53.40 2
Sign oroutlinelighting 5340 2
E - nat1 ' _ _ Signal cfrct►il(e) or Hated. - -
1F5-T �- r '• i t ti< r is t Fes• wi t;a1`'' at ';• „i i' tat Panel. et •
_._,__: '.! 7 .. I _,-.. _ .,: J.�� ' ^i �Qtll6i en. be9Wlse: Paige2 2
Business zanier . AI /// i 1 - J a f -/l --
Jt / r Each additional inspection over a llowable In any of tto above
Adchrss ! Ira "e • Pa inspection 62-50
(.ar.. - OR 9703 Investigation per hour (1 gale) - 62.50
de Ploac: 69 3) (0 7q - '-f 22 ( Fax: 603) La 74 — Li a & 4-.)- Indscreiel , rant per hour _ 73.75
A A �� ``' tt,, iii. i dik i tli ie '' 1 1'14-3 "�- . 1
{ F" .4`•' � r_;� ` '`''�. 7l'. tsl�
�J
Cal Lk.' it i ��- � EleCtllcal la '" lietg up". Loa :- "� r 5 K1 .:.� ` �, Subtotal ,
Suprv_ Electrician signature, required: lie- Q - —7B °! -05 Plan review (25% of parfait fee)
Printnoun: , ,. -r- Date:s, —oL1 _ 1 ;t atemlreitm u(8 %ofperatotfeo) !;
TOTAL PERMIT FEE i 5 ee
Authorized signer Thb permit application expires tf a permit not obtained within 110
days after It has b® aaowtcd as aomplate
Print run= Dates • Fes , etedmdobay set by' rti - Counb Banding rndeayservioeBowl
•• Number climamtiam per permit anowne.
BovnelegkicraidELOPanenvneoc 1740 4a046urntse IWSNw83
I'd 2E6i, - tPG9 -EOS 3WI 'WW03 r112i3BI1 dEb. :21 trD SZ ReW