Permit a CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00707
krtk DEVELOPMENT SERVICES DATE ISSUED: 10/28/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600 -00300
SITE ADDRESS: 09315 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: T.I. Limited energy systems are: Data, Fire Alarm & HVAC.
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: 1 W /SERVICE OR FEEDER: ,! 2.b . PER INSPECTION:
201 - 400 amp: 1 1st W/O SRVC OR FDR: 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 ELECTRICAL DIMENSIONS INC
BY THE MACERICH COMPANY PO BOX 12146
9585 SW WASHINGTON SQUARE RD 3961 N WILLAMS AVE
TIGARD, OR 97223 PORTLAND, OR 97212
Phone: 503 - 639 -8865 Phone: 503 - 282 -7255
FEES Reg #: LIC 44008
SUP 2964S
Description Date Amount ELE 26 - 432c
[ELPRMT] ELC Permit 10/21/200' $320.15
[TAX] 8% State Surcharge 10/21/200' $25.61 REQUIRED ITEMS AND REPORTS
Total $345.76
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 or 1 -800 32 -2 4.
Issued By: id , f 4 ,4 , <4, 6/) Permittee Signature: ( O, ,t
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 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.
metrical Permit Appli tion _. '',. ' <; FOR OFFICE <t SF O\L.a
City o f Tigard EC E Rte° / %� Permit Na . ESC 2005- 0010'i
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax. 503.598.1960 a "^ e; fr Date/By Other Permit
Inspection Line: 503.639.4175 OCT 9 g �: 137 : it
Date Ready/By. h� ® See Page 2 for
Internet: www.ci.tigard.or.us • 1 J I I Notified/Method Supplemental Information
❑ � '4 ��"�iC� , PLAN REVIEW
( ew construction M P.17���er1 Please check all that apply: •
❑ Demolition ❑ Other: J SION ❑Service over 225 amps, comm'1 ['Hazardous location
['Service over 320 amps - rating ['Bulldog over 10,000 sq. ft.,
. CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder ❑ Other: ❑Building over three stories ['Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: r� --(5' 7 1 Job site addres 5$5 5 e J V,- . so , RD Submit" sets of plans with any of the above
City/State/ZIP: `�X ) / O� 9 2-2.-3 The above are not applicable to temporary construction service.
Suite/bldg/apt. no.: T ®33 Project name: "T64 J e cho 4. '/ •FEE * - SCHEDULE
Desaiptios I Qt7• I Fa.. I Tom 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: c JiN SQ. /'rq-LL Lot no.: Ea add'1500 sq. ft or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
-r / �∎ �]�_ /� A- �/ dwelling, service and/or feeder _ 90.90 2
`/ FOR 1 1 ' Services or feeders installation, alteration, and/or relocation
200 amps or less 10[1.1! 80.30 [f' ✓ sem
❑ PROPERTY OWNER I ❑ TENANT
201 amps to 400 amps I 106.85 01.45 2
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
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 arrgns to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 an to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT I ❑ CONTACT PERSON k Fee for branch circuits with
service or feeder fee, each 6.65 j 3 3
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, •
each branch circuit 46.85 2
Address:
Each add'1 branch circuit 6.6 2
City/ State/ZIP: Miscellaneous (service or feeder not induded)C
Phone: ( ) I Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
6•G Tr (�T , ,r 1'1 T.- extension. Describe: Page 2 2
Business name: - L_ i- �- � 1 r 1 /v•,' .T.-AX...
Address: 37 CO , id , ( .4J y LL % 5 T� , ( Each additional inspection over allowable in any of the above
` ' '-' Per inspection 62.50
City / State/ZIP: R)R L j )O / C) ff' Q ...2_2._:- Investigation per hour (I hr min) 62.50
Phone: () - -j55 Fax: ( 'pj) 2,20- / / 9 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 414 no Electrical Lic.: 6 -t-132 Suprv. Lic.: aq6 4 5 32o.15- Subtotal r 3./P11'a
Suprv. Electrician signature, required: , . Ai Plan review (25% of permit fee) - 1
Print name: > - _ Date: / j ( �S Z5,61 State surcharge (8% of permit fee) . �
3151 L (O[C) TOTAL PERMIT FEE 4 ,
Authorized signature: This permit application expires • permit is not o
days after it has been accepted as compre pki ,r1L7
Print name: Date: • Fee methodology set by Tri- County Building Industry ``�� ��
• • Number of inspections per permit lowed.
C 6, jtp 1(" l
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005.00707
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/28/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 `''�
INSPECTION WORKSHEET FOR DATE: 11/212005 TIME: 7:04AM PAGE: 66
SITE ADDRESS: 09315 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: TEAVANA
DESCRIPTION: TI
OWNER: WASHINGTON SQUARE LLC. PHONE #: 503 - 639.8866
CONTRACTOR: ELECTRICAL DIMENSIONS INC • - PHONE #: 503 - 282 -7255
Inspection Request Scheduled For: Date: 11/2/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 Ceiling cover 020096-01 603 -282 -7255 N
•
Corrections /Comments / Instructions:
1\\to sod - oK�
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: cT vs NUI Date: a ` • Z' Phone #: (503) 718- 2 A t k�
U
•
CITtOf TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00707 rr
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/28/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175. . ' 41 l 1...
INSPECTION WORKSHEET FOR DATE: 11/4/2005 TIME: 7:08AM PAGE: 52
SITE ADDRESS: 09315 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: TEAVANA
DESCRIPTION: TI
OWNER: WASHINGTON SQUARE LLC. PHONE #: 503 - 639.8865
CONTRACTOR: ELECTRICAL DIMENSIONS INC PHONE #: 503- 282 -7255
Inspection Request Scheduled For: Date: 11/4/2006 Pour Time:
Code # Ins ection Description Confirm # Contact # Message
125 Wall cover - 020372 -01 503 - 282 -7255 N
Corrections /Comments /Instructions:
•
•
•
o(I PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: - N 1 L Date: 11' Qr Phone #: (503) 718- 2iL14
• •
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00707
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/2812005
Phone: (503) 639 -4171 il
Inspection Requests (24 Hrs.): (503) 639 - 4175±+
INSPECTION WORKSHEET FOR DATE: 11/8/2005 TIME: 7:00AM PAGE: 111
SITE ADDRESS: 09315 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: TEAVANA
DESCRIPTION: TI
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 -639 -8865
CONTRACTOR: ELECTRICAL DIMENSIONS INC PHONE #: 503 - 282 -7255
Inspection Request Scheduled For: Date: 11/8/2005 Pour Time:
• Code # Inspection Description Conf •• Contact # Message
115 Electrical service 020542 -01 5503-282 -7255 N
Corrections /Comments /Instructions:
~ 4 oN ect.V rUkN c c oN t` . Mg 26b - 3(
(60 ND Arty • 1L5(t3I6 0
c iV 1 L o ck ctR,, V Mkt A�5 • -
® Pan vi Fv s t3 ® PA b'► 5 co rotor'
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 8 Phone #: (503) 718 -
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200S -00707
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/28/2005
At: Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/9/2006 TIME: 7:09AM PAGE: 62
SITE ADDRESS: 09315 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: TEAVANA
•
DESCRIPTION: TI
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503. 639 -8865
CONTRACTOR: ELECTRICAL DIMENSIONS INC PHONE #: 503-282 -7255
Inspection Request Scheduled For: Date: 11/9/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 020705 -01 - 503 -282 -7255 Y
Corrections/Comments/Instructions:
6-0.11111 gZ4 . oN l
•
•
•
❑ PASS ' PARTIAL APPROVAL 0 CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: e. 8 Date: I I ( I Phone #: (503) 718 111 (OS
I
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00707
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/28/2005
Phone: (503) 639 -4171 ���",��� I
Inspection Requests (24 rs.): (503) 639 -4175 `'I_L.
INSPECTION WORKSHEET SR DATE: 11/18/2005 TIME: 7:17AM PAGE: 87
SITE ADDRESS: 09315 SW SHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTO SQUARE LOT #: TYPE OF USE:
PROJECT NAME: TEAVANA
DESCRIPTION: TI
OWNER: WASHINGTON SQUARE LLC. PHONE #: 503 - 639-8865
CONTRACTOR: ELECTRICAL DIMENSI+` S INC PHONE #: 503 - 282 -7255
Inspection Request Scheduled For: Date: 11/18/2005 Pour Time:
Code # Inspection Description , onfirm # Contact # Message
199 Electrical final 0 ' 833 -01 5 503-282 -7255 N
Corrections /Comments /Instructions:
5 thiti- NAY IQ MO V Ki ' .•
) se 1 w ‘INur. cl %Kg.* •Itia-z
t l't..• ix\ coN) ovi u 45 ftet■e. (:s. 4
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED .
•
Inspector:
CT 1 ° Q8 Date: 1 1 I Phone #: (503) 718- 2 -4 14 •