Permit AA, CITY O F T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00222
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/15/2006
PARCEL: 1S12600-00300
SITE ADDRESS: 09700 SW WASHINGTON SQUARE RD NORDS ZONING: C -
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Voice & Data
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC REIGN COM INC
BY THE MACERICH COMPANY 11954 NE GLISAN STE. 232
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97220
TIGARD, OR 97223
Phone: Contact #: FAX 503- 256 -7813
PRI 503- 262 -9335
FEES Reg #: ELE 26- 1009CLE
LIC 129318
Description Date Amount
[ELPRMT] ELR Permit 9/15/2006 $75.00
[TAX] 8% State Surcha 9/15/2006 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
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 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 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: , Permittee Signature: orth Ot
OWNER INSTALLATION ONLY i/
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 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.
FROM :h *-igncom Inc FAX NO. :503 256 7813 Sep. 14 2006 12:59PM P1
•• ' -- (I 1 (r b � ii \V 1 IL k�
Electrical Permit Application 4, n i r)i: i )i• i lc: is i is o\1.1
City of Tigard R v ! l3 6 � - • • —• .
13125 SW Hall Blvd., Tigard, OR 97223 �+
SEP 14 :1
Phone: 503.639.4171 Fax: 503.598.1960 :x ' I X Other Permit
Inspection Line: 503.639.4175 ,r 14- J I.. ' Date Ready/By: tma El See Page 2 for
Internet: www.citigard.or.us itied/Mstho�
�i 1 Y 'a3 L bYJ I"La�lL Supplemental Information
1, au%.••, 4,�,i4rack;.;;}+ CI`cs^ mo r n , 'r•w M wi t ems•• a
k+fin, a `9, .uF. "' G } i f " �.ti....x -.�Y] ;�yi2c�i~'� „ ��¢�7� '''1''' ' +, wrrc � :• ••,�,� �^'+ � K _ �;: ` . ,u°�:''i0`2 >;\;t ; :r1•, � �
❑ New construction
t ; . ' "
<_ Addition/alteration/replacement Please check all that apply:
0 Demolition 0 Other: ❑Service over 225 amps, comm'I ❑Hazardous location 1
�wk "`ic+ ��'fi�a ' ,. a °: 4....‘ a „ `? �':� �`�; ?„ ❑Setvicc over 320 amps - rating ❑Bnildng over 10.000 sq. IL,
• a • = F�f �"•,.� -t1 .: %X:: ,,, is , ?! ti , te . ' of 1 -and 2- family dwellings 4 or more new residential
Q 1- and 2- family dwelling !_ Commercial/mdustrial ❑ Accessory building ❑System ova 600 volts nominal units in one structure
❑Building over three stories []Feeders, 400 amps or more
❑ Multi - family ❑ Master builder [] Off:
x '�� + � : : y: x' ,'a {: ti,, r ,..`�:r r••R
x , ❑Occupant load over 99 parsons ❑Manufactured structures or
: "ribi• ,,` .�.w�:y:..., a � �
`"`- ' ^ �''`A•: ,'�
;. �:' ❑Egretsa/lightingplan • RV Perk
Job no.: Job site address: 92&o S4) L 6 , 6,p R o ❑ Health -core facility ❑ Cnh er:
Submit 2 sets of plans with any of the above.
City/State/ZIP: c20 0,1a ) ')2 3 ,,-,� p,'� The above are not applicable to temporary construction service.
Suite/bldg./apt no.: L P Project name: r rtl' w'r �� .. ,• ,� 4,C ;:
�aiP� ` 1 Qty. I Pee Total
Cross street/directions to job site: New residential single- or multi- family dweuing unit.
Lrl4 / k m i �cw4� Ov9 n � � AA C 1,000 sq. fattached r less garage.
Ie v r r 4� .. 1,000 sq. tt or ls 145.15 4
Subdivision: "Lot no.: _ Ea. add'! 500 sq. ft. or portion • 33.40 1
Tax map/par no.: Limited energy, residential 75.00 2
t �`,,��'' = z.f ti q �r Limited energy, non - residential 75.00 2
i; � (: d ;' 2fi r . ; G' , c ,'•�q -� `:`1 :`•:w� a'' Each mannfactlred or modular
ll'Dl 4 Okik /�T yu dwelling. service and/or fender - 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
201 amps to 400 amps 106
441, •'� ;. 4Ar e, ' •�; 47 , .�� f , + r�z, �t,� . • -r s, -,,,, 7 , r, .85 2
y �Eti .: is J._ . •� x: ,. , . , ' b,' Mil:, f•, ''; �M•e[ �� ''s -; a= � � • ,Y.0 � r, =�
401 amps to 600 amps 160.60 2
Name: 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: ( ) I Fax: ( .) relocation
200 amps or less 66.85 1
Owner installation: This installation is bcing made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rcpt, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date:
Branch circuits _ new, alteration, or extension. per panel
.',., : ,.e'Y y. S # ^` C.,1:. _ i '; . c 1 a, ; am i a t " .v A Fee for branch circuits wir/r
service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: wirhour service or foedcr foe,
Address: "
/ 3/ / each branch circuit
Each 46.85 2
ch add'1 branch circuit 6.65 2
City /State/ZIP: a IRV g 'Pt) x Miscellaneous (service or feeder not included) -
Phone: Pump or irrigation circle _ 53.40 2
( ) ,, I Fax:: ( ) �� v Sign or outline lighting 53.40 2
E- mail: _. L • L Signal circuits) or limited-
p• . .n7. ? k . r .• . •.r, n •.. c. U 7.. '' :- c ', ; : 1+d \'.`� energy Panel. alteration, or
Business name: 6A,) �, L = _,.,?0C_ extension. Describe: r Page 2 2
r Address: //95:4 A/a. 6446470 cScar a. 23 Z Each additional inspection over allowable in any of the above
brmin) 62
Per inspection Investigation per hour 6250
\�City/State/L1P: �/� ) c Q 9i7 . , ,�/ '71110 (1 30
Phone: (, 3 ) 2 _ C P 3 Fax: ( P 2t o - / g plant per hour 73.75
L ; ? :V � '' ' n lil�ie •1 �3�r, ,' "�? i � ;
A•
CCB Lie.: J� 31 g E lec tr ical Lic.: al Su Lie .: 3/0144 Subtotal ac e
r
• Suprv. Electrician signature, rrqui - ` Plan review (25 %of permit fcc)
Print name: �. p e State surcharge (8% of permit fee) 1v G-2-- �ILGf/Q . ii i / /CCi - , / �'d 06 TOTAL PERMIT FEE gi, t�
Authorised signature 'Mb permit application expires if a permit is not obtained within 180
days after it has biro accepted as complete
Print name gatet1446 A. riiputcH I Date: 9//d / 4, • he methodology set by TA-Coolly Dumas Industry Service Board
f � •• Numterofiaspecdons per permit allowed.
l:\aull.iaBWt tiisNar-PvmaApp.dae 12/03 4404615T(1002/COM/Wpn
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELR2006-00222
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9/15/2006
Phone: (503) 639 -4171 ' �
Inspection Requests (24 Hrs.): (503) 639 -4175 - I �..
INSPECTION WORKSHEET FOR DATE: 9/ ?2006 TIME: 7 :02AM PAGE: 43
SITE ADDRESS: 09700 SW WASHINGTON SQUARE RD WORDS CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: NORDSTROM SUNGLASS SHOP
DESCRIPTION: Voice & Data
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: REIGN COM INC PHONE #: 503 -762 -9335
Inspection Request Scheduled For: Date: 9/22/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 037026 -01 971 - 235 -4667 N
Corrections /Comments /Instructions:
4 )\ .,,,_
IA PASS . ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: "''' J ` Y (18 L Date: ci 2 01, Phone #: (503) 718 -''A