Permit CITY OF TIGARD. ELECTRICALPERMIT -
RESTRICTED ENERGY
I� DEVELOPMENT H BMENT r SERVICES 639 -4171 DATE ISSUED: E2 23/2004
SITE ADDRESS: 10230 SW WASHINGTON SQUARE RD C -12 PARCEL: 1S135BA -00102
SUBDIVISION: OAKBURG ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
Project Description: Voice & Data.
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:
WASHINGTON SQUARE LLC RICHARDSON COMMUNICATIONS
BY THE MACERICH COMPANY 15875 SE 114TH
9585 SW WASHINGTON SQUARE RD CLACKAMAS, OR 97015
TIGARD, OR 97223
Phone: Phone: 503 - 617 - 9800
Reg #: LIC 137396
ELE 3- 390CLE
SUP 2956LEA
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 12/23/2004 $75.00 Elect'I Final
[TAX] 8% State Surchart 12/23/2004 $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 . e-e_ 0 \ 7
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
Electrical PermittApplic
A r�+� Datereceived: - 7 "% j Permit no. { of--40 3 e y
, �1,i City of f Tigard , ,D �1�appl•no.: /UZ - pi1'tdate:
Ciry pfTigard Address: 13125 SW Hall R Date issued: Receipt no.:
Phone: (503) 639 -4171 •
Fax: (503) 598 -1960 Case file no.: Payment type:
DEC 3 2004
Land use approval: CITY v fIGARD •
7' ?5' : () PLRM1ITI .
O 1 & 2 family dwelling or accessory ,Comtnerelal/industrial 0 Mull- family 0 Tenant improvement
"New construction ❑ Addition /alteration/replacement 0 Other: ❑ Partial
•
J013 SITE INFORMATION
Job address: r� Bid . no.: Suite no.: Tax map/tax lot/account no,:
Lot: Block: Subdivision:
Project name: rj[ MK tit, !Description and location of work on premises: l)(),C `s• 'Oleo L& (Ot bl Anee--
Estimated date of completion/inspection:
CONTRACTOR APPLICATION I FEE SCHEDULE
3usinessname: tr \ C9 .- r( % .6• (C11\ FMB Mae
Dm:11 Q (ca.) Total net trip
address: 0 1 VCD lie ' blewr tmt-enskarraatu ranalr
dr enitincladesAIMehedgeraiti
�iry/State/ZIP: T � -- )D 0 S�aMm .
l` 1000 61 or less • 4
e : 7 (CO) 1/4:7 `�) re."` ( )X17 9s,-9 � -- Each eddtiona1 soo se_ R or portion thereof
Lie. no.: 3 - 7-7 0 C L6 CCB lic. no.: / S 7- 31 C Lit nitedencrgy.residataal 2
Supervising electriciaiC 7 [.imithadenergy,noa�sidcmid
itgnature, required: j . . / Z c1 s G L( S maalfaetorr� ttdfor feeder Aerncor modulo 4wodwelling 2
Printnane: ��,., (it " o / 02 c",...,__ 1 Date: /2 /2 . ) /el y Services or feeders -iosballatiots,
alter*ttonorrelocation:
PROPERTY OwNTR 200 amps or less 2
201 amps to 400 amps `—
Name WO*: - 401 amps to 600 amps 2
Marling address: - 601 amps to 1000 amps 2
City State: RD: Overt 000 amps or volts 2
Phone: [Fax: 1 l? -mafl: Reconnect only 1 ,
Owner (nsallation: The installation is being made on property I own temporally sorter ar'teedeo. �—
which is not intended for sale, lease, rent. or exchange according to 0° ' ati0n Ow
200 ORS 447, 455, 479, 670, 701. 201 amps to 4 x 2
400 2 unps to coo amps 2
OWpehr stgmantre: Date: 401 to 600 mops , 2
ranch a,ts - eovr, ariwn4my
or extension per pan&
NUM: • A. Foefor branch circuits with purchase of
Address: sarvicc or feeder fee, eacb branch circuit 2 .
City: [Staate• . 1�p: B. Fee for br4aab cheeks withoutpurchase
Phone: Fax: l E - mail: of senico or War fee. flea branch circuit: 2
Each addifcoml branch cirrait
' PLAN REVIEW (Plra5e clicclt all that apply) Mow (ScrvIoeorfeedernetiaeladed):
O 9ervl.& ovor22S amps.ro warm al U Health.care Each pump orinigation circle 2
O service over 320 amps-rating of 1&2 CI Hsztudouslocetion Each sign or outline lighting 2
family dwellings O Building over 10,000 saguaro feet four or Simnel eircuit (e)ore limited energy panel.
USystemover600 volts nominal more hesidenaal units inone structure eltaarion,oroxtnsion - • . _ 2
O Building over threestoties es Fenders, 400 snaps or mom •Dascnptioa: •
O Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over Ilse allowable in any cattle above
0 Egtessalghdngpian O Other. Par impaction I I 1 1
Submit _ sets of plans rNth any of the above. tnvmtigmioa fee _
The above are not applicable to temporary construction su-vicc. Other •
Tta otl wines aooeph c.�u w�, a cell is.acsae rot mete ;e N o t ice: Thi permit application Permit fee _.... $
O Vim O Mastercard expires if permit is not obtained Plan review (qt _ %) $
erttnt cal ;wea t: I I within 180 days after it has been Stare surcharge (8%) .... $ _ •
Expires accepted as complete. TOTAL .. $
Name Of eloikbadee d abode ea emu cad
S
Candhotdct atg.aAUe Amount - amya6'S (noncom)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: ' (503) 639 -4171 MST
BUP
� �
Received Date Requested _ a AM PM BUP
Location / v - 2_ -2 ,6 4" S Q, Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) 0 (4- SWR
BUILDING Tenant/Owner RC) ' ELC
Footing ELC
Foundation
Ftg Drain Acees ETTL t� ELR t26() t26() 3
Ov�
Crawl Drain _
Slab Inspection Notes:047 a b SIT
Post & Beam
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
MECHANICAL FAIL ` tm\( ks C , \ V C\ M) � t 1 (e _ I
�` 1` � � b o
Post & Beam 10 d\ 0
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage N at
Fire Alarm
AC O L PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspecti • n RE: 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the b site.
PASS PART FAIL