Permit CITY OF TIGARD ELECTRICAL PERMIT
a • COMMUNITY DEVELOPMENT Permit #: ELC2010 00447
T [ G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/26/2010
Parcel: 1S126CB00500
Jurisdiction: TIGARD
Site address: 9300 SW WASHINGTON SQUARE RD 001
Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project: Macy's
Project Description: (2) branch circuits for cooling tower.
Owner: FEES
MACY'S DEPARTMENT STORES INC Quantity Description Date Amount
ATTN: TAX DEPT, 7 WEST SEVENTH ST
CINCINNATI, OH 45202 2 crt Branch Circuits 08/26/2010 $63.60
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 08/26/2010 $7.63
Electrical
Contractor:
CHERRY CITY ELECTRIC
1596 22ND ST SE
SALEM, OR 97302
PHONE: 503 - 566 -5600
FAX: 503- 540 -8147
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $71.23
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 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through R 952- 001 -0100. You ma obtain a cop of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B Permittee Signature: ....a .1....")fr
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.
08/25/2010 09:17 5035408147 CHERRY CITY ELECTRIC PAGE 02
Electrical Permit Aoplicatio
FUR t :aFl lt. l t ;r cr\i 1
Chy of Tigard Au r.) 2 5 2010 ENIMILINIIIIII=Wriffilte
i 13125 SW Hap 81vd, Tigard, OR 97223
r • Pb 5036394171 Fax 503399196p OFTIGARD
h arne . itesay BY
er taae .g 1 BUIILDING DIVISION tat` a ` See Page 7for
latectiet
11./.__VM swqemantal larormatlaa
fl? or WORK ; PLAN REVIEW
New o )Additioetl >,c deck all that apple (submit II sets of peens w /itmreS checked below):
❑ Demolition ME
Qset, Ica or fetter coo amps or mom 0 Building over three stories.
abase tt c available fault current 0 Marinas and boatyards
CATEGORY OF Ct00LS[tliet;'7rUlatt( exceeds 1 0.000 amps at 150 volts Cr ❑ p8 buildings.
❑ 1- and 2- roily dwe VI C 0 Ac Y budding
loss
mom ew etLa installations ❑ Conimrrcislyee agricultural
Q 1 - fdal�Iy Q)fr Other ❑Fira ❑7naalWiee of 73 KVA or
.fps �lE INFORMATION AND LOCATION ❑ Larger separately derived .vcstem
❑ Addition o anew motor load of ❑"A". "B ", 1- 2 ". - 1-3 1-3`.
Job no.: Job site add er: 10011F or more, occupancy.
' {1Cf31' I �' 7 R p W eaS�n t1 '1Dt♦ � ) >u Y2 (] Biz a more tmidn,Rid ,mitt. O Reeteslieoat vehicle Darks.
City/statd P:7 . (j -i 2 2 .J O Hedeb -cent facilities. 0 Supply vo>ege for more , ban
Qlraandous locations. Mtn volts nominal.
Suite/bldg./apt apt, no.: Project note: -is a Service or fonder 600 amps or more.
Cross street/directions t0 job site: Demelpme PBR SCHEDULE R'
Q, tee. Taw ,
New redaeeud althea or Steffy dwell fit.
Subdivision: Lot no.: 1,000 sr. a or Ian 168.54 4
fcg. solel 500 s q a o r paRie 33.92 1
Tax map/parcel no.:
DESCRIPTION OW WORK _( (with abase residential 75.00 2
—
• Likud teary. aredti- artily 75.00 2
At r A v'ec ct cibel:r3` xse✓ aveideg4d(w� above sq.R)
Services or feeders IrsliBattes. Merinos. and/or relocation
200 rasps ar lees 100.70 2
D PROPERTY OW ER 1 0 'MAN I' TA1 ammo to too amps 13336 2
Name: 401 amps to 600 amp 200_34 2
601 an= to 1.000 grape 301.04 2
Address: ova l,000 amp* or volts ' 552.26 2
City/Sta lee P: eTtr or Radars stiigrr. .11erm/aa * , and/or
Phone: ( ) 1 Fax: ( ) 200 B or has 59.36 1
Owner installation: This installation is being made on property that I owe which is not 201 and` t° 4 00 a 125.08 2
intended tier sok. lease. rent or exchange, according to ORS 447. 449. 670. and 74)1. 401 amps to 599 cage 16834 z
Brar*Cr creak – pew. Aker-allon. or etlretaedon. per panel
()user signature: - Date: AFL Fee for trap* and s loth
0 APFLICANT 1 0 ('•OMACT PERSON aboae wrvivo or jx+dor fee, 7.42 2
eaebheamh; tan=
Rosier flame: B. Fev for brapc6 cia.'bets rower
- - - service err feeder fee, fine ' 56.18 5<p. 2
Contact motet: Marne motif
' Fit addl hood fi costal 1 7.42 a -- 1.1-42_ 2
Address: 11QaeeRatseoaa (reennire or feeder rot included)
City /State/LIP: Ends atnafaetmed or modular 67.84 2
dvMin& swim rod/or feeds
Mlle: ( ) Fax:: ( )
Rammed only 67.84 2
E -mail: , Pa= or =sables =eh; 67.84 _ 2
Si®a re eon= fighting 67.84 2
Cn14TRA(TO)8 Sigaul eiresit(s1 (IC Waited-own • ,
Business name: r y l Dpellet pellet Aeration. Of ccteosita Page , ,
V S ^ l C am _ -cj Each asdElt i Uric over aGenntde to any of the above
Address: J • a" V �A U U Additional iospoo<i *. (1 br min) 66.25/ hr
City/Stater P: _ . • c 9 -73a. (Y he arm.) 66.25/ br
b'�ff�^ lodmt ial plant (1 Bra min) 7838/ la
Phone: ( alt Q' o I Fax: ( a40.. '6 4-7 lespcminm for whieb no fen is 90.00✓ 1a
specifically listed (' ; lo amp l
CCB laic -: GI ' ut Q s 1 Electrical Lic.:31 .6 Suprv. lac.: e, LAOS Et crinC!►L PEILMIT rim
5upty. electrician signature., regmred',. afar review (25% of
C permit fog):
Print name: V jj. Matte: O • 5- f a e 8'n ( 12% 6 o permit feet 'i . 113 ✓/ /
TOTAL PERMrr FEE: r 11 a3
Authorized Signature: U WE, vomit spgargim eapMea tr 4 Wake N eat obtained wit= 180
dap ` PiiAt =Be: ^ -r Date: after d tins beep ecceptzd a complete.
• Amster el imepe allowed per permit
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