Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
PERMIT #: ELR2005-0
Al, DEVE H B r S o RV OR 97223 DATE ISSUED: 10/114/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD MGMT ZONING: C -G
SUBDIVISION: elffiaBENGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Voice cabling Job #53121 Walker duct in corridor located near GIGI Spa
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 OREGON ELECTRIC GROUP
BY THE MACERICH COMPANY 1010 SE 11TH AVE
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97214
TIGARD, OR 97223
Phone: 503 639 - 8860 Phone: 503 - 234 - 9900
Reg #: LIC 203
SUP 44605
FEES ELE 26 -95C
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 10/14/200E $75.00 •
[TAX] 8% State Surchar.€ 10/14/200E $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: 4 , ,
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 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.
Il OCT -14 -2005 10:50AM FROM —OR ELECTRIC SERVICE 5035352763 T -279 P.001 /002 F -699
s %i " 4Na • ••••• aY.r • ""rr=7 " - -''•—
City bf Tigard F- Re. By Potosi No e/ _ / `
' � a -
13125 SW Hall Blvd., T5guni. OR 97223 Plan Rn7eiV
Phone: 503.639.4171 Fare 503.598.1960 "" `' I {' Pats B�' Other Permit
Inspection Line: 503.639.4175 14 20'••,, ' �!. DateRendrEY. - r. fa SeePaso2
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Internet: ww.citigard.or.o OCT t.• ' . Nontied/Methorl -I ( sopph.tidinfkinnntioo
TYPgIgini eiReitikeD PLAN REVIEW
❑ New construction Ei AdeithhitattiliDgiVeNnent Please check all that apply:
Demolition Other ❑Service over 225 amps, comm'I ❑ Hazardous location
❑ Service over 320 ;mops - rating ❑ Buildng over 10,000 sq. R,
CATEGORY OF CONSTRFCTION of 1- and 2- family dwellings 4 or more new residential
Q 1 and 2 family dwelling ® Commcrcial/indttstrial ❑ Accessory building Q System over 600 volts; nominal units in one structure
❑Building over three stories ['Feeders, 400 amps or more
❑ Multi family ❑ Mesta builder ❑ Other. 0Oeeupmt load over 99 persons ['Manufactured snicfures or
JOB SITE INFORMATION AND LOCATION ❑Egressnighting plan RV park
Job no.: 53121 Job site address:4396'SW WASHINGTON SQ RD. ❑nth - cane facility
['Other: -
I Submit 2 sets of plans with any of the above.
City /Stute/Z.1P: TIGARD, OR 97223 g:5
, j ..5 it, . . g The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: WASHINGTON SQUARE MALL FEE" SCHEDULE
Tea To
p� I Qty. L I I "
Cross strmt/d section to job site ...o.,¢ New residential single- or multi- family dwelling unit.
Includes attached garage- _
1,000 sq. R or less 145.15 4
Subdivision: [ Lot no.: Ea. add'I 500 sq. R or portion 33.40 1
Tax map/puaa el no.: Limited energy, residential 75.00 2
_ - Limited energy, non - residential 75.00 2
DESCRIPTION OF WORg Each manufactured or modular
VOICE CABLING (A) f dwelling. service and/or feeder 90.90 2
W t� 6 �//�� Services or feeders Installation, alteration, and/or relocation
l f I // ,s6 / � 200 amps or less 80.30 _ 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
- 401 amps to 600 amps 160.60 2
�� Name. 601 amps to 1,000 amps 240.60 2
r Address' Over 1,000 amps or volts 454.65 2
- Reconnect only 66.85 2
1 City /State/ZIP: Temporary services or feeders installation, alteration, nnd/or
intone: ( ) I Fax ( ) relocation
amps or less 66.85 1
Owner installation: This installation i3 being made on property that I own Which is not 201 amps to 400 amp 100.30 2
intended for sale. lease. rent. or exchange, according to ORS 447. 449. 670.. and 701. 401 amps to 600 Pops 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
' ❑ APPLICANT I ❑ CONTACT PERSON A. Fee for bunch circuits with
service or feeder fee, each 6.65 2
Business name: WASHINGTON SQUARE MALL branch circuit •
- a Fee for branch circuits
Contact name: without service or feeder fee,
46.85 2
Address: 9396 SW WASHINGTON SQUARE RD. each branch circuit
Each add'1 branch circuit 6.65 2
City /StatelZR': TIGARD, OR 97223 Miscellaneous (service or feeder not included)
PbOt4e: ( ) I Fax : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E Signal Circuits) or limited-
CONTRACTOR energy panel, alteration, or
- Business name: Oregon Electric Group • extension. Describe: \ Page 2 75 2
Address: 1010 SR I lth Ave Each additional lns_pection over allowable In any of the above
Per inspection 62.50
City /State/ZIP: Portland, OR 97214 Investigation per hour (1 hr min) 62.50
Phone: (503) 234-9900 Fax: (503) 535 -2763 Industrial plant per hour 73.75
_ ELECTRICAL PERMIT FEES*
CCB Lic.: 203 Electrical Lic.: 2 5 . . . • opt ic.: 44605 1 5. 0 0
Subtotal C
Suprv. Electrician signature, required: iii J Plan review (25% of permit fee) —
Print name: i' 91 , .: s surcharge (8% of permit fee) ( . d D
MA Y V. J KehtnP,1 it �J t ` /a
TOTAL PERMIT FEE g 1.00
Authorized signature: e This permit apptienfiom aspires Ifs permit is not obtained within 180
/� f days once it ms bosh accepted as complete
Punt name: t lay lG J . 144,x1 v1 e i Date: / Et) /t} ape, • F« mcehoao►op. Remus by Tri County R>ng Industry service Saul
L " Number of inspections per Permit ell awed
.0 C ot)dlt : (Sb3 5 a- 3Hi-ItA
Z'hl -1 ,FafYls: <5o St4q- 543,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005.00349
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10114/2005
Phone: (503) 639 -4171
Inspection Requests (24 s.): (503) 639-4175 "14#('
39 -4175 I �..
INSPECTION WORKSHEET FO' DATE: 11/23/2005 TIME: 7:00AM PAGE: 73
SITE ADDRESS: 09586 SW WA INGTON SQUARE RD MGMT CLASS OF WORK:
SUBDIVISION: WASHINGTON ' OUARE __ LOT #: TYPE OF USE:
PROJECT NAME: t ASH Tt- IBS* Ali E EXPANSI ---
DESCRIPTION: Voice c:abiing Job .•3121 Walker duc it cn orridar located near GIGI Spa
OWNER: WASHINGTON SQUAR•' LLC, PHONE #: 503 - 639 -8860
CONTRACTOR: OREGON ELECTRIC GR `UP PHONE #: 603-234-9900
Inspection Request Scheduled For: Date: 11/23/2005 Pour Time:
Code # Inspection Description C. firm # Contact # Message
135 Low volts. 022• .4 -01 503 - 572-3444 (
1°1 °1 F ;144\)_.,
Corrections /Comments /In actions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 0 Phone #: (503) 718\
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