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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2001 -00184 AA DEVELOPMENT SERVICES DATE ISSUED: 04/10/2001 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S126C0-01107 SITE ADDRESS: 09700 SW WASHINGTON SQUARE RD SUBDIVISION: OIABBISVGTON SQUARE ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: Installation of 6 branch circuits without service or feeder. Job #170600 - 79599. Location of work is in Fine Jewelry. 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 : 5 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: PPR WASHINGTON SQUARE LLC BROADWAY ELECTRIC - COCHRAN INC BY THE MACERICH COMPANY 626 SE MAIN 9585 SW WASHINGTON SQ. RD. PORTLAND, OR 97214 PORTLAND, OR 97223 Phone: Phone: 234 -6564 Reg #: LIC 00072942 SUP 3148S ELE 37 -546C FEES Required Inspections Type By Date Amount Receipt Elect'I Final PRMT CTR 04/10/2001 $80.10 2720010000( 5PCT CTR 04/10/2001 $6.41 2720010000( Total $86.51 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. PERMITTEE'S SIGNATURE v /J ISSUED BY: ,d / ai4thefilitm 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 639 -4175 by 7:00pm for an inspection the next business day (c ,- 0 , 6 1 .. Electrical Permit Application Date received: 1 /—/ 0- / Permit no.: / .-00/ ,thii., I City of Tigard RECEIVED Projectlappl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 9 223 Date issued: By: I Receiptno.: Phone: (503) 639 -4171 APR 1 2001 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: COMMUNITY DEVELOPMENT l TYPE OF 1'ERi\lIT ❑ 1 & 2 family dwelling or accessory ommercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction IIIr Addition/alteration /replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address: ?7O .„ ,e Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: Block: I Subdivision: Project name A/ a ,s I Description and location of work on premises: F /NE .j&-1q /,�= @' ,c /tix Estimated date of completion/inspection: d . - CONTRACTOR AI'i'LICATION i r : FEE SCIIEDL\,E , Job no: / 7 i'ce Max Business name: a ��/�Q EG�,,cL ,/G Descri lion Qty. (ea) Total no. insp New residential - single or multi - family per Address: 1pZLo , ,nF //l1 ST dwelWtg mltIncludes attached garage. City: *)O ISS tate0eI ZIP: 4372/4 Serviceinch,derk Phone: 3 z34 r 41 Fax -mail: 1000 sq. ft. or less 4 CCB no.: 7Z9 4Z I Elec. bus. lic. no: 37 - Each additional 500 sq. ft or portion thereof Limited energy, residential 2 Ci y /me lie. no.: Limited energy, non- residential 2 4/v /0ff Each manufactured home or modular dwelling Signature o s pervising electrician (required) Date Service and/or feeder 2 Sup. elect. name (print): - , v ` License no3 S Services orfeeders — Installation, alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): V v 0.4-, I 1 U(X. A O 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: ` � } (,�• � 601 amps to 1000 amps 2 City: ;�� State: �1 l I Over 1000 amps or volts 2 Phone: V Fax: IE -mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to installation , alteration, orrelocation: ORS 447, 455, 479, 670, 701. 200 amps or less 2 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 am s 2 Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: State: ZIP: B. Fee for branch circuits without purchase is Es of service or feeder fee, first branch circuit: 4/0. 4. 2 Phone: Fax: E -mail: 7.r Each additional branch circuit: 4,105 33 PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not Included): O Service over 225 amps - commercial O Health-care facility Each pump or irrigation circle 2 O Service over 320 amps -rating of I &2 O Hazardous location Each sign or outline lighting 2 family dwellings O Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over 600 volts nominal more residential units in one structure alteration, or extension' _ 2 ❑ Building over three stories ❑ Feeders, 400 amps or more *Description: O Occupant load over 99 persons O Manufactured structures or RV park Each additional Inspection over the allowable in any of the above: ❑ Egress/lighting plan ❑ Other Per inspection Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Q Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ . +� ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ lG 4 1 Expires accepted as complete. TOTAL $ ��+. �i Name of cardholder as shown on credit card $ Cardholder signature Amount 440 -4615 (6/00/COM) Electrical Permit Fees: Limited Energy Fees: I. Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total Check Type of Work Involved: Residential - per unit 1000 sq. ft or less $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq. ft. or • portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manuf d Home or Modular ❑ Garage Door Opener Dwelling Service or Feeder $90.90 2 Services or Feeders n Heating, Ventilation and Air Conditioning System' Installation, alteration, or relocation 200 amps or less $80.30 2 ❑ Vacuum Systems' 201 amps to 400 amps $106.85 2 401 amps to 600 amps $160.60 2 - . 601 amps to 1000 amps $240.60 2 ❑ Other Over 1000 amps or volts $454.65 2 • Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each sister $75.00 200 amps or less $66.85 2 (SEE OAR 918 -260 -260) • 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, ❑ see "b" above. Audio and Stereo Systems •. Branch Circuits ❑ Boiler Controls New, alteration or extension per panel ''. . a) The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. • Each branch circuit $6.65 2 ❑ Data Telecommunication Installation b) The fee for branch circuits without purchase of service S5 ❑ Fire Alarm Installation or feeder fee. First branch circuit I $46.85 H VAC Each additional branch circuit ,� $6.65 3 . ❑ Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 ❑ Intercom and Paging Systems Each sign or outline lighting $53.40 Signal circuit(s) or a limited energy ❑ , panel, alteration or extension $75.00 Landscape Irrigation Control Minor Labels (10) $125.00 ❑ Medical Each additional inspection over the allowable in any of the above El Nurse Calls Per inspection $62.50 Per hour $6 In Plant -� - $73.75 ❑ Ouidour Lai usodpc Liyl Ling* Fees: ❑ Protective Signaling Enter total of above fees $ g • 0 n Other 8% State Surcharge $ 6.41 1 Number of Systems 25% Plan Review Fee See "Plan Review" section on $ I No licenses are required. Licenses are required for all other installations front of application. Fees: / I Total Balance Due $ b 105 • Enter total of above fees $ ❑ Trust Account p 8% State Surcharge $ Total Balance Due $ • i:\dstsVbrms\elc- fees.doc 10/09/00 - CITY' OF TIGARD BUILDING INSPECTION DIVISION 4 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST BUP Date Requested 3 f AM PM BLD Location 77 S v 14/65k S1 /L9 Suite MEC Contact Person eSiewli- Ph 1.47. PLM Contractor Cdd ran_ r/,Jr, c Ph SWR BUILDING Tenant/Owner / /'o s-e CJ( At 20 4/ t Z3 ELC iu / a J Retaining Wall ELR • Footing Access Foundation a - l FPS Ftg Drain O r S t rO n4 S Crawl Drain Inspection Notes: SGN Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing 3 C! Y co IS Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final _ � PASS PART FAIL F/NQ PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final • PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final _Bliss PART FAIL — Service Rough In UG /Slab Low Voltage Fire Alarm —A AS� PART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date 6 / — C7 / Inspector c� J��� E Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.