Permit C•
CITY OF TIGARD ELECTRICAL PERMIT
14
COMMUNITY DEVELOPMENT Permit #: ELC2009 -00329
T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/01/2009
Parcel: 1 S 1260000300
Jurisdiction: TIG
Site address: 9585 SW WASHINGTON SQUARE RD MGMT OFFIC
Subdivision: Lot:
Project: AT & T
Project Description: (1) service & (1) feeder and (8) branch circuits.
Owner: FEES
WASHINGTON SQUARE LLC Quantity Description Date Amount
BY THE MACERICH COMPANY, 9585 SW
WASHINGTON SQUARE RD 2 ea Services or Feeders - 200 07/01/2009 $160 60
amps or less
PHONE: 8 crt Branch Circuits w /Purchase 07/01/2009 $53.20
Service or Feeder
1 ea 12% State Surcharge - 07/01/2009 $25.66
Contractor: Electrical
RED HILLS ELECTRIC & TOWER SERVICES
PO BOX 490
DUNDEE, OR 97115
PHONE: 503 -554 -8244
FAX: 503- 554 -1735
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $239.46
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law. All work will
be done ccordan ith approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ENTION Orego law = • uires u to follow the rules adopted by the Oregon Utility Notification Center Those rul are set forth in OAR
952 -00 - 0010th • ugh OAR 95 1.1-01 Yq ay obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332 C 233 � 4 .
Issu By: I ` Permittee Signature: 7L �Z v
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:
K / y / �/ r CO / N CTOR INSTALLATION ONLY
( SIGNATURE OF SUPR. ELEC' Date: '7, /(:)?
LICENSE NO.
r f !'�-
Call 503.639.4175 by 7:00 a.m. for an Inspection that business day.
This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved plans are required on the Job site at the time of each inspection.
,Eledirical Permit Application FOR OFFICE USE ONLY
11,1 R eceived r et..t^_ f � 3g
City of Tigard Received
: ?S�9 �� Permit No
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone. 503.639 4171 Fax: 503.598.1960 Date/By: Other Permit
TI G A R D � DO Inspection Line. 503.639 4175,, � _ Date Ready /By to See Page 2 for
Internet: www.tigard - gov ! ?,(Q NNotified/Method 7CO Supplemental Information
TYPE OF WORK PLAN REVIEW
New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards
CATEGORY • OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ I - and 2- family dwelling (gCommercial /industrial ❑ Accessory building amps for all other installations. buildings
• ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system.
❑ Addition of new motor load of ❑ "A "E ", "I -2 "1 -3 ",
Job no.: Job site address: C?S sit, t o r Six or or more. occupancy. p
•� ❑ Six or more residential units. ❑ Recreational vehicle parks
City/State /ZIP: A O in 7 a 2 7 ❑ Healthcare facilities ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: 4 4. 4-1— w / Ip. dL e-5.--s- ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: gbh , 4'A- a d >: -t- s- R.,-- Description I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq ) 75.00 2
ft
Limited energy, multi- family 75.00 2
•( .)e'(cJ 2 /O (4-, p - CGe' 4 FF - t,P Z `� ,',e a. i, � residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 //00. (00 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106 85 2
Name: 401 amps to 600 amps 160 60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454 65 2
City/State /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66 85 1
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, g
each branch circuit 6.65 2
Business name: B Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular 90 90 2
Phone: dwelling, service and/or feeder
( ) Fax: : ( ) Reconnect only 66 85 2
E -mail: Pump or imgation circle 53 40 2
CONTRACTOR Sign or outline lighting 53.40 2
B 1 Signal circuit(s) or limited -
Business name:
Q a. �- i Uss E- a -0....1 i e_ i , c energy panel, alteration, or •
extension. Describe. Page 2 2
Address:
-- P6 (30-X 49 6
City/State /ZIP: ap G tJD C 4 O R q7//6---- Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (gyp ? ) �- 9 – X 2 1,. )
Y y .S,5:(4 /7 7 S" Investigation per hour (1 hr min) 62 50
CCB Lic.: i�N 5S'3 Electrical Lic.:' )g7 uprv. Lic.: p Igo S Industnal plant per hour 73 75
Suprv. Electrician si required: "/ /04 /i0 ELECTRICAL PERMIT FEES (1. 0 b
Subtotal: vj�` •
Print name' :
Plan review (25% of permit fee)
�� iG Y. P12 0y State surcharge (12% of permit fee) , S' •
Authorized signature: TOTAL PERMIT FEE. .AS, , y e
This permit application expires If a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit
1 \Building\Permits\ELC- PermitApp doe 05/23/06 4404615T(I 1/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
El Landscape Irrigation Control*
❑ Medical
El Nurse Calls
El Outdoor Landscape Lighting*
El Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I \ Building\Permits\EL.C- PermitApp doc 03/23/06