Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 -00689
' COMMUNITY DEVELOPMENT DATE ISSUED: 12/31/2008
TIGARD 1 31 25 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S12600
SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD MGMT ZONING: MUC
SUBDIVISION: W$QNGTON SQUARE LOT : JURISDICTION: TIC
PROJECT: CLEARWIRE
Project Description: Install temporary kiosk.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
WASHINGTON SQUARE LLC COLUMBIA ELECTRIC INC
BY THE MACERICH COMPANY PO BOX 473
9585 SW WASHINGTON SQUARE RD WASHOUGAL, WA 98671 -0473
TIGARD, OR 97223
Phone: Contact #: PRI 360 - 835 - 2181
FAX 360 - 835 -3410
FEES
Description Date Amount Reg #: ELE 37 -456C
IELPRM"I'] ELC Permit 12/30/2001 $46.85 LIC 55884
FAX] 12% State 12/30/2001 $5.62 SUP 4168S
Total $52.47 REQUIRED ITEMS AND REPORTS
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 .T - • -n 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center
Those rules - e set forth + OAR 952- 001 -0010 through OAR 952 -001 -0100. You may obtain copies • hese rules or direct questions to OUNC at
503.246.6' • 9 or 1.800 33 .,
Issued _ • Permittee Signatur -• . , - 1,,��,
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: ► � C� 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.
. • 12- 1 .30/2008 16:22 360 - 835 -3410 COLUMBIA ELECTRIC #1841 P.001 /002
Electrical Permit Application FOR OFFICE l: SE ONLY
• City of Tigard Roonved - o : ,
1,1 .:,• : Permit No.: _ate: • o.. .:
• 13125 SW Hall Blvd.. Tigard, OR 97223
.. Phone: 503.639.4171 Fax. 503.598.1960 ... _ Other Permit: y •. i • 6.4, I' I (i A F: r) Inspectrom Llne: 503.639.4175 Dane Ready/BY• a See Page 2 for ERIN Interact: www.tigird-or.gov Notified/Method: Supplemental Information
. =F l, one-. J"s •"�"n..a N '.& :: frt: :rii• -2 ii'li T _ _ _ ..7n1...____.. n- .'__"57.7. X.�....-
c.J i - a.,,, : .s r; s ..icy a ✓.:..�., �!��... i .
Pr n - ++a.�r'. -_c r -'K n. � - � •c ��•. ^" �Y' �., � _i, ".i-. =: =
� r, ... �,.n '' - '. �aun, '
r.}'fT•— = -:ynh i7�Y-" fr�> '2' !`. a...�> �i'`'•�j" f,.�.i`„ � ,� -w.. _r' 1 . } ,n_ .� -T:..: -.. �.+J:J' �`:w.::.ir J:'.....'3.^,::�:ti
❑ New construction i LEI Addition/alteration /replacement Please check an that apply (submit l seta of plans w /itc ns checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Mannas did boatyards.
+ v` �' } �, s ti j ,, y m.,, ur y,` � . a".. ,t exceeds 10.000 amps at 150 wits or ❑ Floatin bmldia
__ ;. .'�'�f, Sf �`in. < � i • �ti'`- ' 1 '�rl.�_"._ ...RII?:a ;c�`_i1�:.7.:nmJU'i_•' �'>.
1 - a nd 2-family dwelling ® Comm ercilli
andustrtal } ❑ Ac cess building am m tr o or exceeds t us. ❑ c is1-0sc agricultural
Y � �' g anpc for all other installations. builditJgs
❑ Multi-family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Ins allaf of 75 KVA or
re: J�tii:_iL3''srs •� - ,XK1S[' y .: a - - ; - :� , .vi ['Emergency system. larger ly dPJ•ived gyyfern
ti �n�- :.rS:,7,ta. r, S: r te: ... - ::., ? -' : ,c ' `9 had 5$ i ❑ wddiGon of new motor load of ❑ "A", ' t• t.Z ^, - t.3 >
Job no.: Job site address: 9585 Washington Town Mgt O f c • IOORP or m o i c .
❑ Six or more residential ants. ❑ Roacafcaal vehicle parle.
City/State/Z.IP: Tigard, OR ❑ Ikatrh -care tacilitim. ❑ Supply to gr for morn than
❑ Hazardous location. 600 volts
Suite/bldg. /apt no.: I Project name: Washington Square 13 Service or feeder 600 amps or more.
Cross stxeetfdirections to job site: ription 'I Feel Total ,M1
New residential single- or mold- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. R. or less 14545 4
Tax map/parcel no.: Ea. add'! 500 sq. IL or portion 33.40 1
d id
�c ;� Limited energy, residential
7 : '?_ : err "'f; 1 q *t � r� „ 75.00 2
:
='� a z=� -�: ��� = -Ss_ ���1i1����`� .3�`ia:,t.� (with above sq. R) I
Limited energy, multi- family I
one circuit residential (with above sq. tt) 75 2
Refer to permit OUP ZI)08 00395 Services or feeders installatIoe, alttration relocation
{� 200 amps or less 80.30 l 2
`IVY. 3'tT -�, J+ t lx >`-:' {i ,y�'{� r Y_Sih.
Jk .. Z W....r i.. ; = -w i z l .. %pit i � , �f-`5; 4 ' A.M 3� k � M,..,< 1 , 201 amps to 400 amps 106 8 5 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: II
Temporary services or feede installation, alteration, and/or
relocation _
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps W 400 amps 1000 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
Sn A. Fee for branch circuits with
y i
•vie- .:,- M� `S �. , :_`+• y
- - - , � s . ,1.z- : - _ service or fe nder fx,
:;7- Oe�, ; rsxr�u_vr' ,J"c ;I..al:�i ?.°izir.:=i�t:�Jv n ii±a ;srV�'4Y_ above 6.65 2
each branch circuit 1
Business name: B. Fee for branch circuits
without service or feeder foe, 1 I 46.85
Contact name: Cheri Shaw first branch circuit 46 2
Address: Each add'l branch circuit 6.65 2
Miscellaneous (service Or feeder not included)
City/State/ZIP: Each manufactured or modular
dwelling, service and/or fender _ 90 , 2
Phone: ( ) I Fax: : ( ) Reconnect only 66.85 - 2
E -mail: columbiaelectric®a comcastnet Pump or irrigation circle 53.$0 2
�vzY•M. i .:fJ'fM.T'- >.,. '„�_ ' , f.!li9Pl�'. ->, S St J
::-.4 —wA, ` r; ,. , . i _ - aI' - a yji . }: "a, , r� ptt�' • . i Sign or outline lighting 53.0 2
.� _. •." : «RCi... �rF✓ " _ ... . Tisir..Tiic '!.9 S •. `wKA. 1.: }'a' 4
Signal circuit(s) Or limited -
Business name: Columbia Electric, Inc energy panel. alteration, or
Address: PO Box 473 extension Describe: Pa 2 2
City/ State/ZIP: Washougal, WA 98671 Each additional inspection over allowable in any of the above
Pcr inspection 62.50
Phone: (360) 835 -2181 Fax: (360) 835 -3410 investigation per hour (I hr mi.) i 62.50 _
CCB Lie.: gal 884 I Electrical Lie.: 37 -456C Suprv. Lic.: 4168S Industrial plant per hour 73.75
g q
'7- 1. o ► - (o ::, r'���•2 i!: • • x _r__ - 77.:1,; ' M- r
Suprv. Electrician signature, required: Subtotal: ! 46.85
Plan review (25% of permit fee): j
Print name: Jeff Downer Date: 12-30 -2008 State surcharge (12% of permit fee): I 5 62
Authorized signature: TOTAL PERMIT FEE: I 52.47
This permit apptianion =pins if a permit ig not obtained within 180
Print mune: ' - Date: days after it has been accepted as o i4,icte.
• Number of inspections allowed per permit.
r' \Boircrtg PamaAppdoc 051Z106 440•46IST(It &VAM/WEB 1
CITY OF TIGARD
BUILDING DIVISION
A .
PERMIT #: Fu32008,006f
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: . 12/3-10008
Phone: (503) 639-4171 11112.ilill"
Inspection Requests (24 Hrs.): (503) 639-4175 ,..., - ---
INSPECTION WORKSHEET FOR DATE: 102009 TIME: 7101A1v1 PAGE: 15
SITE ADDRESS: 09!:ititi SW WASHINGTON SQUARE RD MGMT OFFIC CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: cu.TAR
DESCRIPTION: i kompoiary kiosk..
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: COLUMBIA ELECTRIC INC PHONE #: 360-835-2 il11
Inspection Request Scheduled For: Date: 1/50009 Pour Time:
/
Code # Inspection Description Confirm # Contact # Message
195 Misc. inspection 79367-01 'Q 3S-218i N
Ictct Fi 0 AL - K it
Corrections/Comments/Instructions:
6 O. , 6. thillk
( PIA)l'iNi
-- -■iiii
\ :
c\iR)
N ...„,,
•
PASS Li PARTIAL APPROVAL 0 CANCEL , 1 I NO ACCESS
jjI AlL fl CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: '---' w6i31... Date: 1 - g / Phone #: (503) 718-