Permit q CITY OF TIGARD ELECTRICAL PERMIT
E°1 3 COMMUNITY DEVELOPMENT Permit#: ELC2014-00721
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/17/2014
Parcel: 1S126CB00500
Jurisdiction: Tigard
Site address: 9300 SW WASHINGTON SQUARE RD
Project: Macy's Subdivision: FAIRVIEW PLACE CONDO Lot: 20
Project Description: Connect gas furnace and low voltage for HVAC.
Contractor: MACY'S NW INC Owner: MACY'S DEPARTMENT STORES INC
12100 SE 82ND AVE ATTN: TAX DEPARTMENT
HAPPY VALLEY,OR 97086 7 WEST SEVENTH ST
CINCINNATI, OH 45202
PHONE: 971-563-6932 PHONE:
FAX:
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo/Purchase 12/17/2014 $63.60
Specifics: Service or Feeder
1 ea Signal circuit or Limited 12/17/2014 $75.00
Type of Use: COM Energy Panel
Class of Work: ALT 1 ea 12%State Surcharge- 12/17/2014 $16.63
Electrical
Type of Const:
Occupancy Grp:
Total $155.23
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 . • •- __ ,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. •TTENTION: Oregon aw re• 'es you to follow the rules adopted by the Oregon Utility Notification Center. Those ules are set forth in OAR
95 101-0010 through OAR 952-1 1090. Yo ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1. . 32.234
I sued By: 10 / Permittee Signature:
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' . Date:
LICENSE NO. 3 Z / /S
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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.
Electrical Permit ApplicaRi EIEIVED FOR OFFICI. t'SF ONLY
City of Tigard Received D a t l vv: /, inffl Permit No.: 'j2 '' -j702/
13125 SW Hall Blvd.,'Tigard,OR Plan Review
' a Phone: 503.718.2439 Fax 503.�96� 7 2014 Date.B•: Other Permit:
T t GA R D Inspection Line: 503.639.4175 Date Ready/By: tuns. H See Page 2 for
Internet: www.tigard-or.gov CITY OFTIGARD Notified-Method. Supplemental Information
TYOUILINW DIVISION 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
❑ 1-and 2-family dwelling ®Commerciatindustrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family 0 Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORbiAT'ION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A" "E" "l-2>-"l-z",
Job no.: Job site address:9300 SW Washington Square RD 10011P or more. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard OR 97223 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name:Macys ❑Service or feeder 600 amps or more,
FEE SCHEDULE
Cross street/directions to job site: Description j Qty. l Fee. I Total
New residential single-or multi-family dwelling unit.
Washington Square Mall,North.Macy's Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft or less 168.54 4
Ea.add')500 sq.ft.or portion 33.92 1
fax map/parcel no.: Limited energy,residential
DESCRIPTION OF WORK (with above sq.ft) 75.()0 2
Limited energy,multi-family 75.00 `
Connect new gas furnace 120V and control voltage(4t/R' residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1.000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation
200 amps or less 59.36 I
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: _.._......_ .................._____..._.Date:......._.._....._.......................................____ Branch circuits—new,alteration,or extension,per panel
❑ APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder tee, 7.43 2
Business name: each branch circuit
B.Fee for branch circuits without
Contact name: service or feeder fee,first 1 56 18
branch circuit 56.18
Address: Each add'I branch circuit 1 7.42 7.//7- 2
City/States ZIP:
Miscellaneous(service or feeder not included)
Each manufactured or modular 67 84 2
Phone:( ) Fax: :( ) dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name:Macy's Signal circuit(s)or limited-energy i See
panel,alteration,or extension. f Pane 2 75• 2
Address: 12100 SE 82ND Avenue Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:Happy Valley OR 97086 Investigation(1 hr min) 66.25/hr
Phone:(971)563 6032 Fax:( v Industrial plant(1 hr min) 78.18/hr
`t \\� Inspections for which no fee is 90,00'hr
CCB Lic.: Electrical Lie.: C 172 ut Suprv. Lie.: 3241S ‘ specifically listed(1 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:
Subtotal: j y 40
-
Print name: Donald Edgley Date: 12/17/2014 an review(25°0 of permit fee):
State surcharge(12%of permit fee): /e,.6 3
Authorized signature: TOTAL PERMIT FEE: /cc.a.3
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.
t:'Building'•PermitstELC_Permit4pp_ELR_ERE.doc Rev 0521i2013 440-4615T(11105iCOM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined ... $75.00 Description I Qty. I Fee I Thiel
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems*
15.01 to 25 kva 200.34 2
❑ Burglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
El Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance with 552.26 2
El Heating. Ventilation and Air Conditioning OAR 918-309-0040)
* Solar generation systems in excess of 25 kva:
System
Each additional kva over 25 7.42 3
El Vacuum Systems* >100 kva—no additional charge 0.0 3
ElOther: additional inspection over allowable in any of the above:
Other: Each additional inspection is 66.25%hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 9000/hr
specifically listed(Y2 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMTI' FEES
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan review,if required(25%of pennit fee):
State surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL.PERMIT FEE:
This permit application expires if a permit is not obtained within 181)
❑ Audio and Stereo Systems days after it has been accepted as complete.
• Number of inspections allowed per permit.
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
El Fire Alarm Installation
HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
El Outdoor Landscape Lighting*
n Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:`•.Building'il'ermits\ELC_t'ermitApp_ELt_ERE.doe Rev 05/21/2013
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9300 SW WASHINGTON SQUARE RD, TIGARD,
OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00721
Jeff Grove
Violation Summary:
Inspector Contractor