Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
°. COMMUNITY DEVELOPMENT Permit #: ELR2010 -00029
Date Issued: 02/09/2010
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.639.4171 Parcel: 1S126CC00100
Jurisdiction: TIG
Site address: 9700 SW WASHINGTON SQUARE RD
Subdivision: Lot:
Project: NORDSTROM
Project Description: Low voltage for audio /visual & intrusion alarm.
FEES
Owner:
WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY, 9585 SW Restricted Energy Permit 02/09/2010 $135 68
WASHINGTON SQUARE RD 12% State Surcharge - Electrical 02/09/2010 $16.28
PHONE:
Contractor:
STONER ELECTRIC
1904 SE OCHOCO
MILWAUKIE, OR 97222
PHONE: 503 - 462 -6500
FAX: 503- 659 -4968
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 2
Audio & Stereo: Y Boiler Controls: N
CCTV N Clock Systems: N
Data & Telecommunications Y Fire Alarm: N
HVAC: N Instrumentation: N Total $151.96
Intercom/Paging N Landscape/Irrigation: N
Landscape Lighting: N Medical: N Required Items and Reports (Conditions)
Nurse Calls N Protective Signal: N
Security Alarm: N Other: N
Other Desc:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All work will
be done in a approved plans This permit will expire If work Is not started within 180 days of issuance, or if work is suspended for more the 180
days. A NTION Oregon la . • -s you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0 -0010 through OAR 952 -1 % '' 00. o may obtain a copy of the rules or direct questions to OUNC by ca 503 24. 6699 or 1 800 332 2344
•
Iss ed By: �- \ . - Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an Inspection that business day.
This permit card shall be kept in a conspicuous place on the Job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Feb. 9. 2010 6:48AM No. 1346 P. 1
Electrical Permit Application I (/1,! (WI ICI. 1 51.: t►\ 1.1
City of Tigard �� Dal .: -'
a 13125 SW Blvd„ Ti: tgi 17 � �.` �� + a� ••
ev 114 0 Morns: 503.639.4171 Fa , ;N 98.1960 o1Q Dag ; Otherpe,mit: - u o?008 eV 4 •
i. t1,.1141y Inspection Line: 503.639.4173 9 Date Ready/By. hair El see Page for
Internet www. ligard•or.gov <�8 � Ndifiod/Method Supplemental Information
TYPE OF rr W � S1O� PLAN REVIEW
❑tlewconstruction ($AdditiotQq�ldr E epi bment Please check all ttnt apply (submit awn of plans wTaems checked below):
1L VN ❑ Service ce feeder400empeormore ❑Bwlding over three stones.
❑Demolition ❑Other / where the evailable fault current ❑IM(arites and boatyad&
CATEGORY OF- CONSTRUCTION exceeds 10,000 amps st ISO volts or ❑ Floating buildings,
leas to ground, or exceed 14,000 ❑ CammereilLuse egrieulorsi
❑ 1- and 2- family dwelling riq,CommorciaUndustrial ❑ Accessory building amps for all other installations. buildiiga.
❑ Multi- family ❑ Master builder ❑ Other. ❑File pimp. ❑ lealalation of 75 KVA or
JOB SITE INFORMATION AND LOCATION D Em' aency system larger separately derivedsyslem
pMdarli:R enew motorloadof 0 - A - ,18'•,1 - 2', -3
V. / 10013P or morn occupancy.
31,d lob no.: #450 v Job site address: 9 7po J
�� /N mu CC /�
❑Sixormaereaidrraislunits. ❑Reaeationalvrhiclepadre.
City/State/ZIP: /176 a ( 974Z-- ❑ Health-owe faeilitica ['Supply voltage to mote than
❑ Hazardous locations 600 volts mmmimt
Suite/bldg./apt.no.: I Project name: 1j »7 El Scvice feeder 600 maps a more
Cross street/direotions to job site: De FEE SCHEDULE
I Qtr. I Pee. ( raw I •
New realdenllal single- or multi- family dwelling unit.
Includes attached prate. •
Subdivision: I Lot no.: 1,000 aq. R. or leas 168.54 4
Ea add'/ 500 eq. ft. or portion _ 33.92 1
Tax map/parcel no.: Limited emergy, residential
DESCRIPTION OF WORK (with above eq. IL) 67.84 2
A C�D/D� ✓!Se/14Lr Limited energy, multi-family 67.84 2
J+vVPI- /u) 4 4,,Qp7 residential (with above sq. ft)
— Services or feeders Inslallatlon and /or relocation
200 amps or lees 100.70 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 R 2
Name: 401 amps to 600 amps 20034 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or voila 552.26 2
City/Stet /ZIP. Temporary services or feed era Installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 5936 1 1
Owner installation: This installation is being mado on property that I own which is not 201 amps to 400 amps 123.08 2
intended for sole, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch dreulte new, alteration, or extension, per panel
A. Pee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 7.42 2
Business name: B. Fee for branch circuits
Contaotnatne: wlthouteervice 36.18 2
first branch circuit
Address: Each add'/ branch circuit 7.42 2
Miscell aneous (service or feeder not Included)
City /State/ZIP. Each manufactured or modular
67.84 2
dwelling, service and/or feeder
Phone:
( ) I Pax: • ( ) Reconnect only 67.84 2
E -mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: Signal pane (a) or limited- 0. 8µ �`��
STONER ELE CTRIC, INC. enorgypane /�
Address: 1904 SE OCHOCO extension. Describe: 2, Page 2 2
City /StawzIP: MILWAUKIE, OREGON 97222 Each additional inspection over allowable In any of the above
Per inspection 66.25
Phone: ( 503) 462 -6500 Pax' (503)659-4968 Investigation per hour (I hr min) 66.25
CCB Lie.: 44823 I Electrical Lie.: 26 - 122C Suprv. Lie.: 3496S Industrial plant per hour , 78.18
A ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: m Subtotal: 73.61 4$
Print name: MICHAEL FALCONER I Date: 2 g,fib Plan review (23% of permit fee): a
State surcharge (12% of permit fee): A, i Z
Authorized signature' I TOTAL PERMIT FEE: /57, qolo
Print panto' I Date: Thla psrmlt application expires Ira permit Is not obtained within 180
11 days after it has been accepted as tempter.
• Number of inspections allowed per permit.
I: 1& dldirg\Permital.C•Pem,itepp.doc Lab1A9 410 -16Iyr l t C3/OOMlwE6
- }Feb. 9. 2010 6:49AM No. 1346 P. 2
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY
Fee for A. residential systems combined... $67.84
Check Type of Work Involved
0 Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
i COMMERCIAL WORK ONLY;
Fee for each commercial $67.84
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved;
jR...
Au ....
dio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
VL I2ata Telecommunication Installation
❑ )?ire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems: 2—
'No licenses are required. Licenses are required
for all other installations
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