Permit (t CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
•; COMMUNITY DEVELOPMENT Permit #: ELR2010 -00032
T j AR b 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/16/2010
Parcel: 1S 126CC00100
Jurisdiction: TIG
Site address: 9700 SW WASHINGTON SQUARE RD
Subdivision: Lot:
Project: NORDSTROM
Project Description: Voice and data cabling for entire store.
FEES
Owner:
WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY, 9585 SW Restricted Energy Permit 02/16/2010 $67.84
WASHINGTON SQUARE RD 12% State Surcharge - Electrical 02/16/2010 $8.14
PHONE:
Contractor:
DYNALECTRIC
5711 SW HOOD AVE
PORTLAND, OR 97239
PHONE: 503 - 226 -6771
FAX: 503 - 226 -7720
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: Y Fire Alarm: N
HVAC: N Instrumentation: N Total $75.98
Intercom /Paging: N Landscape /Irrigation: N
Required Items and Reports (Conditions)
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N
Other Desc:
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 i - • i - n : , • - •proved 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. • TENTION: Oregon la r- • -' . you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -r 01 -0010 through OAR 952 -0' L 100. •u obtain a copy of t e rules or direct questions to OUN • • ;.:•99 or 1.800.332.2344.
Is - ed By: . _ ! , 4:1i / Permittee Sig - ii
/ 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.
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.
2010, FEE, 18, TLUE 07:41 DY SALEM FAX No, 503 391 - 2817 P. 001
RECEIVED
Electrical Permit Application FOR OFFICE: USE ONLY
Received n Q .
City of Tigard FEB 16 2010 Date/13y: Z ,tU io / Permit No.: £' pcGl��O�✓
° 13125 SW Hall Blvd„ Tigard, OR 97223 Plan Review , �, pig —�a4s
• i Other Permit: K
: • Phone: 503. Fax: 503.598/ OF TIGARD Date /By:
T i G ARD Inspection Line: 503.639 Dale Ready /By; tuns: Si See Page 2 for
Internet: www.tigard- or.gov BUILDING D IVISION N otified /Method; 1 Supplemental Information
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❑ New construction Addition /alteration /repiacernent Please check all that apply (submit 2 Sets of atans w /items checked below):
❑ Service or feeder400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: `; where the available &tilt current ['Marinas and boatyards.
1;44,g j 1}ltrl5�1�ri vi� k .i Y VCSA/fidrot vo� i,'iti141'i�l7ll @!W 1+'a ,1t :1 i� ;1 1 lit l exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
...
..,,.r?k.A�t lr „�,. .4..y.4t7 w ,. . , - d:. J a.s,7 5,...,. less to ground, or exceeds 14,000 ❑Commercial -use agricultural
❑ 1- and 2- family dwelling c ommercial /industrial El Accessory building amps for all outer installations. buildings.
❑ Multi family ❑ Master builder 0 Other: ❑ Fire pump. ❑ Installation of 75 KVA or
P'.'” e V r E t " i ,, nt ency system, larger separately derived system.
i 1ft T 3 i r 7 Y+ � 4,, i} �
,. ❑ Emerg
R +.�,1�; ' rp ■T. Ild'!i�1, a " , W' ''';� W i� i SfoliMAT y 1 �'A 1? yL OCL'E�'pVik '" 1 „w1 �'', rtti I .. - r . ❑A of new motor load o ❑ : :n• ••E : •'1.3
iD � T grco 3 . 'n � /„! ) f) � • , f f 00HP or more. occupancy.
Job no.: 1 C� Job site address: e
7 / (,t- �{ f r0 �(
O ❑ Six or more residential units. ❑ Recreational vehicle parks.
CI /State /ZIP; /� �7 ❑ Health car facilities.
❑ Supply voltage for more titan
ty �Q� }r� i t��- I /,� 600 volts nominal
J " - ❑ Hazardous locations
Suite/bldg. /apt. no.: Project name: Ai
)rdS1 ❑ Service or feeder 600 amps or more
is j;l + r } u r 3 €' , i . 'y (E E „S f)! L 4
Cross street/directions to job site: Description I Qtv 1 Pee. j Tani j
' New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 scLft. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 1
Tax map/parcel no (� t '�� �y n Limited energy, residential
i i , 4 htf l +Pd �� . �(a 10i ' d� .OtTiOi3 1 -# 147 %11p �a 1 .4�+ I a� t 1Yk Pv`'F ti i iil i S +iy ( 0.
jj� a Y � u y W t with above s ftJ 67.84 2
r.. �_ �f :i9� ^it:Y.da_. � .Y.,M,,(,,,,�..,+ i Y. . +N :.It;y, v c,...«,.,,.,,aS.:.,; --
Vol �D � residential (with above sq. ft.)
d . J � � Limited energy, multi-family 2
t.
Services or feeders installation and /or relocation
LA-A- 200 amps or less 100.70 2
ii,' a t L r ,,y�'y' v llt.l «1
' x n t 1. ""' . $ � + 4 Y' S t i t' +r5 {d
V,0 t l1i 11 r e!r rlh.i:'l+ii�ie5;t�b)` g„ l , {• Y e ),,.'Rt �i i' ' u FP 201 amps to 133.56 2
Name: 401 amps to 600 amps 200.34 I 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 I 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 1 59.36 I
Owner installation: This installation is being made on property that 1 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
Branch circuits - new, alteration, or extension, per panel
Omer signature: Date: A. Fee for branch circuits with
feeder fee.
n �igg �'f a� t 1 ,+ t 1"1� iu �i al�tY t l. � 'e r4 if §" �'^A', 1'g above service '
M 9 i } �l k ( A��f`LLZ7ANTti, � 4CCt CT F,RS �Tt > t or
;1 /, 18r 5,1 ?, %' hru.ti yi�4s _...aae , .1. . Alai, „1 7.42 2
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee,
56.18 2
Contact name; first branch circuit
Address: Each add'I branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City /State(Z1P: Each manufactured or modular 67.84 2
dwelling, service and /or feeder
Phone: ( ) Fax: : ( ) Reconnect only _ 67.84 2
E Pump or irrigation circle 67.84 2
r ", A . � �:.!!; ,n1��1� ,.:i 1 t ji.rir `f gi 1 :. , , �I (Ot�l,' 00, `YE
t ll + it r "������ r�9`,°rl dit 't rs, tRw Sign or outline lighting 67.84 2
b�r r
g u .n4 �� f� � . � I�� �3'.�irzz
Business name. C g tlal uit {s) or limited-
(' _ /} / enSier pane alteration, or f 9
Address: 57� s I D rd extension. Describe: J Pagel lD 2
City /State/ZIP: poY4- lam p c! lz39 Each additional inspection over allowable in any of the above
Per inspection 66.25
Phone: (5,63)2.16_(47 ) Fax ( • )1_24 .7 y ) Investigation per hour (1 hr min) 66.25
( 2( 5�C p Industrial plant per hour 78.18
CCB Lie.. Electrical Lic.: Su rv. Lie..
' + {, ,.qFl+Pi,1 LECTRIok1l, PERMIT:)F1JLS , #r
Suprv. Electrician signature, required: SkaNd■ - ; Subtotal: ( sq./
Print name: �� � �4 �,� {�� ( S i� Dal': i� - Q Plan review (25% of permit fee):
� - � � =a '� .� — "+ � State surcharge (1: of permit fee): F. (LC
Authorized signature:e Ae / - TOTAL PERMIT FEE: 75 9y
This permit application expires if a permit is not obtained within iSO
Print name: �� Date: 7fj lO days after it has been accepted its complete.
'r Number of inspections allowed per pennit.
1:\ 9u11d141Permba\Et.C- PennitAi') doe 10/01/00 440- 4615T(11Po5 /CO.WWEB
2011 FEB. 10 TUE 07 :41 DYNALECTRIC SALEM FAX No. 503 - 3991 - 2817 E. 002
aje— Electrical Permit Application - City of Tigard 2v/
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
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Pee for all residential systems combined $67.84
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ B urglar Alum
n G arage Door Opener*
Li Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
MYS11 IE. i, /lVAU.„ONT_4.Y50,7411 6 C��: ?,l RE ,;,TM
Fee for each commercial $67.84
system
(SEE OAR. 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
l❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instiumentation
❑
I ntercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
•
❑ Other
Total number of commercial systems:
No licenses are required. Licenses are required
for all other installations
1:16 u i ld i ng\Permi te1E LC -Perm I tApp.000 10/01/09