Permit CITY OF TIGARD p ELECTRICAL PERMIT
PERMIT #: ELC2006 -00295
DEVELOPMENT SERVICES DATE ISSUED: 5/25/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600 -00300
SITE ADDRESS: 09700 SW WASHINGTON SQUARE RD NORDS ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: (1) branch circuit for receptacle for at display case in men's department.
Job No. 4608
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 HILLSBORO ELECTRIC
BY THE MACERICH COMPANY 21185 NW EVERGREEN PKWY #110
9585 SW WASHINGTON SQUARE RD HILLSBORO, OR 97124
TIGARD, OR 97223
Phone: 503 - 639 -8865 Contact #: PRI 503 - 439 -9666
FAX 503 - 601 -3680
FEES
Description Date Amount Reg #: ELE 34 - 4399C
[ELPRMT] ELC Permit 5/25/2006 $46.85 LIC 134481
[TAX] 8% State Surcharge 5/25/2006 $3.75 SUP 4941 S
Total $50.60 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Speaalty 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 rf work is
suspended or-more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules a set forth in'OAR 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of thes dreslor direct questions to OU_NC at
503 -24 6699 or 1 -800- 2 -2
Issue By: �. �Q Ajii( Permittee Signat
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: L _ _ e_; _ / 6 , DATE: 6 4 4 "
LICENSE NO: h/9y/ 5
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.
05- 24 -'06 14:35 FROM- Hillsboro Electric 503 -601 -3680 T -578 P001/002 F -616
L• •16.a.aa •►.sac a .•• 4 NJ IJ a It. A astral
City of, Ti��rd - �� Received / /���
Y O � � \V `
/ l ' ; ' Date /By: 9 ,60/ o (p 4 y P erm i t No.: r�G,C.0)(' exevc
131 25 , Hallt�ivd., Tigard, i f l n Plan Review
Phone: 03.639.y171 fax 503.5 • . • .i -- hit- ,i :! Other Perrin
Inspection Line: 503.639.4175 � ^1 Date Ready/By. g See Pa Z for
Internet: www.ci.tigard.or.us �i -M .- , !1 2006 N
. Supplemental Information
TYPE OF WORK • PLAN REVIEW
-
❑ New construction �; ' )yd ttArtUa) Please check all that apply
❑ Demolition �� gl j � 7 1Tglf( M, ['Service over 225 amps, comm'I ['Hazardous location
1 f ❑Service over 320 amps - rating ❑Buildng over 10,000 sq, f.,
C�A EGORY OF CONSTRUCTION of I • and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling U'Commerctal /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
IBuilding over three stories ❑Feeders, 400 amps or more
❑ Multi family ❑Master builder ❑Other:
['Occupant _ JOB SITE INFORMATION AND LOCATION Occupant load over 99 persons ❑Manufactured structures or
DEgress/lighting plan RV park
Job no.: r,,OO r Job site address: � 700 �Sh I F P ❑Health -care facility ['Other:
'�"' J ok � �rtrr Submit 2 sets of plans with any of the above.
City /State/ZIP: i t _ r : . The above are not applicable to temporary construction service.
Suitc./bldg /apt. no.: Project name: ` f FF.E SCHEDULE
h o a r u Detcription I Qty. I Fee. I Tenth I `•
Cross street/directions to job Site New residential single- or multi- family dwelling unit
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.. Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
_
Tax map /parcel no.: Limited energy, non - residential 75 00 2
' • DESCRIPTION OF WORN • ,• : • • ' Each manufactured or modular
[�[S y� r t dwelling, service and/or feeder 90.90 2
/ / ` r e Gt f- C !j J � DS�IQ t C�,S { h Services or feeders installation, alteration, and /or relocation
Mal6 li Cpgr'4{M,CKS • 200 amps or less 80.30 2
"
❑ PROPERTY OWNER I • , ' - p o 400 . , , .. ET ' ". ; ." X01 amps t amps -
106.85 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
Reconnect only 66,85 2
City /State/ZIP: Temporary services or feeders installation, alteration, and /or
Phone: ( ) 1 Fax: ( ) relocation
200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not 20! amps to 400 amps 1 100.30 1 1 2
intended for salt, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps • 133.75 2
Owner signature: Date: Branch circuits- pew, alteration, Or extension, per panel
❑ .APPLICA 4T " . w ! °= ❑ CONTACT: PERSON " A. F /h
Fee for branch Circuits wi -
service or feeder fee, each 2
Business name: branch circuit 6.65
B. Pee for branch circuits
Contact name: wi /hour service or feeder fee.
Address: each branch circuit 46.85 ���� 2
y Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone. ( ) I Fax: : ( ) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Businessname: Hill sboro Electric L.L.C.
Address: 21185 NW Evergreen PKWY Ste #110 Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: Hillsboro , OR . 97124 Investigation per hour (I hr min) 62,50
Phone. (5 0 3) 439-9666 { Fax: (503 )6 01- 3 6 8 0 Industrial plant per hour 73.75
- ELECTRICAL PERMIT FEES *.
- CCB Lic. :13 4 4 81 Electrical Lie :34-499C Suprv. Lie.: 4941 Subtotal 16,, iS
Suprv, Electrician signature, required: I V Plan review (25% of permit fee) ••—"'"
Print name: Joey V i t a ego Date: t5--,,,w._06, State surcharge (8% of permit fee) 3 r 7.
TOTAL PERMIT FEE SD r (
Authorized signature: This permit application expires if a permit Is not obtained within 180
days after it has been accepted as complete
- Print name: I Date: • Fee methodology set by Tri- County Buildup; Industry Service Board
•• Number of inspections per permit allowed
: ta PctmnApptloc 12/0 440.46111Y1OI)2/COM/WEB
CITY OF TIGARD •
BUILDING DIVISION 111, PERMIT #: EI_C10U6 0t)2 3x7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/25/2006
Phone: (503) 639- 4171:III
Inspection Requests (24 Hrs.): (503) 639 -4175 F_
INSPECTION WORKSHEET FOR DATE: 5/30/2006 TIME: 7:'15AM PAGE: 36
SITE ADDRESS: 09700 SAN WASHINGTON SQUARE RD NORDS CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: NORDSTROMS
DESCRIPTION: (1) branch circuit for receptacle for at display case in men's depaitrnent.
Job No. 460B
OWNER: WASHINGTON SQUARE LLC, PHONE #: 50363981365
CONTRACTOR: HILLSBOROO ELECTRIC PHONE #: 503 - 4399666
Inspection Request Scheduled For: Date: 5/30/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 030745 -01 971-219-8706 N
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v A NMb Date: 301,06 Phone #: (503) 718- 144