Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2005 -00280
{� II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/15/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09312 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Burglar alarm system. Job #083 - 18908 -0.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC ADT SECURITY SERVICES, INC
BY THE MACERICH COMPANY 2815 SW 153RD DR
9585 SW WASHINGTON SQUARE RD BEAVERTON, OR 97006
TIGARD, OR 97223
Phone: 503- 639 -8865 Phone: 503- 469 -7244
Reg #: LIC 59944
ELE 26- 209CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 9/15/2005 $75.00
[TAX] 8% State Surcharl 9/15/2005 $6.00
Total . $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952,E -0100. You may obtain copies of these rules or direct stions to OUN t 5 3- 246 -6699.
Issued By: � Permittee Signature:
J \
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DATE:
LICENSE NO:
Call 503 -639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
09/14/2005 09:55 FAX 5034697110 ADT SECURITY 0 001
- E1ei.`rical Permit Application OFFICE USE ONLY
+ �Il�
City of Tigard R eceived # _
13125 SW Hall Bivd., Tigard, OR 9722 �� DaWB . 0_5' 1 , �W
Phone: 503.639.4171 Fax: 503.5%4 /p �, ra ,• _ view
_ ✓' ,I �' I� � Plan Rev • Othcr Permit
Inspection Line: 503.639.4175 % -A4 r.•1
Internet: www.ci.tigard.or.us 4 D ata Notified/Method: y Supplemental See Page 2 for
t 1) ''\' Notified/Me
Supplemental lnfarmatloo
5 _ [� ,1, i' rL. .....---t'rjtr E''�$aul� J ` i�sddl{Oi"'r' "1 ;� ry
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. ` i • z r 'i wo Rv 1�L `+ d fir ..r. b - •
- ❑ Addi , �, ..LS._ i .. ;,.. •��. L,.. ,e.y1�.,1 91�..4hn:.,iti.Y ttt,,x �` �'�S.! ��'v�Yfi�d�!>r�,�...r�u �e� ".» a;;M, ' ; I ,
P - . . r chop `C `• a - • acement Please check all that apply:
W
❑ Demolition ❑ Othe Xt. ❑Service over 225 amps, comm'1 ❑Hazardous location
,F-4 � Fry ! a ;.-p ., ,T 41 JJ'' p �, 7^ �� n�1,�-,^ t!r �, j a; ' p �¢ i Service over amps - rating Sorkin over 10,1)00 S . ft.,
.., %�- .ems "Ri' r ., I ii R:Su.?i•Oa(1:±g.zi 1,i s 9) ii.k }' ilf' UA. tio - ' UJ, hf$ �f r1 1. F '' .�r [I,! a "f �+ ❑ g q
� Sul _- ,,�+�;. ,,�,�;_>_,,�t {,, j�&, ,,�_,j�.E�s1��1�WaE,;,,�''�� ❑S 320
', of 1• and 2- farrrily dwellings 4 or more new residential
❑ 1- and 2- family dwelling I►. omrnercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
❑ Y Other:
❑
-, r : t Mina famll I 'z Occ ant load over 99 ersons Manufactured structures or
dlIt `;iJ_'L ' `i3��lt sal �kii r 1 ❑ Master builder 3 ,, ❑ ; ll�iblei1 �u gg e -1 l iki.0 --Ta r lli E ['Occupant
tin plan persons ❑ RV park
Job no.: 1 �L fi g_ Job site address: Also y ❑Health -care facility ['Other:
i 1 Submit 2 sets of plans with any of the above.
City/State/ZIP: 3 C IA f 0 / • . a AL. i !! , The above are not applicable to temporary construction service. r.
Suite/bldg./apt no.: Project name: _ i xl i Jt. "� ar r_ T , • '" _ '
d ,i. 1 a r �I rl J_F=,.rc,....1 . � a ]f 1.: r qtr[. ?�F..
�- _ I �. .A Description Qty. Fee. Total *
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'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
:s'e� , i r 4 I �, Limited energy, non - residential 75.00 2
Ili h! t rr�ttjYF xYt Jfl ft : tiI{ 1 i I 7!i .� .' ]( r of Each manufactured or modular
•. k 1! ,,.. ,..;.. , ?r:aii 2�.L i I u ,� s� n c f
st_ vt..7. ..:d. L a,1
M J dwelling, service and/or feeder 90.90 2
�, Z �.�E Services or feeders Installation, alteration, and/or relocation
• 200 amps or less 80.30 2
{ y7 t
r f ^1 a 'r fg4j 1 dj r i I�'I rfi�d ,air I 1��� 1 , P /L } ' �� ll5d `ter ti{ � [.yI }i F 201 amps to 400 amps 106.85 2
.1. ,..,_[a-_t -.;�..,1. i _. �g . g, 1 :__ i�, , 3e:.�. U 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: ( ) Fax: ( ) relocation
200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, 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 - new, alteration, or extension, per panel
(�j iPr ;. j: �.. *' i i - J z� ,.: yal tii7� I , : . j s -I .4 :I ,u i c'l li r i -r 4 Le F Cr y '
_ _'''. --- �= , 1 ' . .'' ' a t J 01 . ", :ter.` service or A. Fee for branch feed circuits with
feeder fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
Address:
each branch circuit 46.85 2
Each add'I branch circuit 6.65 2
City/ State/ZIP: Miscellaneous (service or feeder not included)
Phone: ) q a � l � Fax : : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail
Signal circuit(s) or limited -
i r t•� [V ", � � V ` � I..t l � c�a�4 V�f � �! f L" ��r' t {t r` � ii r �v 4r T [�i t , _ „-
, • 2 y; I i 17 + r 1 I l. I[ I�[ �� f a , 4. a 1 TE_ a . '.. w, P ;,)Tif �e: L:! 'i. �i ., .._Sy- energy panel, alteration, or
ex tension . Describe I Page 2 75, tX) 2
Business name: ADT SECURITY SERVICES, INC.
Address: •,'. ' a • . Each additional inspection over allowable In any of the above
: • , I : : ta,: Per inspection 62.50
City / State/ZIP: (503) 469-7100 Investigation per hour (1 hr min) 62.50
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75 .
F .I.,; r.'�rL' }` '5II 7tl tr ! F�•+ oc�a�lt� �7 Sr/7�,P 1 J 1 r.�' '-_':=-1
CCB Lic.: r.� 14 Electrical Lic.: ,. b• C1.E uprv. Lie.; g- Subtotal - 75. as
Suprv. Electrician signature, required: - - _� Plan review (25% of permit fee)
Print name: J , ` ` Date: I ®D5 State surcharge (8% of permit fee) ID, pp
l. ` TOTAL PERMIT FEE ,f . QQ
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: + Fee methodology set by 1ti -County Building Industry Service Board
•• N of inspec per perad allowed.
i:\ Buildinracrrr {takBLC-PcnnitApp.doc 12/03 440.4615T(l0/02/COM/WBB
CITY OF TIGARD
•
BUILDING DIVISION PERMIT #: ELR200S 00280
4.
13125 SW Hall Blvd:, Tigard, OR 97223 DATE ISSUED: 9/15/2005
Phone: (503) 639 -4171 , tea '
Inspection Requests (24 Hrs.): (503) 639 -4175 �'!! IL.
INSPECTION WORKSHEET FOR DATE: 9/19/2005 TIME: 7:06AM PAGE: 31
SITE ADDRESS: 09312 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: KAY JEWELERS
DESCRIPTION: Burglar alarm system. Job #083- 18908 -0.
C. t/
OWNER: PH ONE #:
WASHINGTON LLC, 503 - 639 -8865
CONTRACTOR: ADT SECURITY SERVICES, INC PHONE #: 503 -469 -7244
Inspection Request Scheduled For: ' Date: 9/19/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 016028.01 '360-907-0718 Y
Corrections /Comments /Instructions:
I c Ata \ \Sb \P\ 11\ 1, Pw 0 w(V) o\N '
X r . z...n . „ss ❑ PARTIAL 'APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: la A_ I /.: ■ / 4' Date: 9 — / 9. Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005 -00280
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/15/2005
Phone: (503) 639 - 4171 AO r , I
Inspection Requests (24 Hrs.): (503) ..
INSPECTION WORKSHEET FOR DATE: 11/9/2005 TIME: 7:09AM PAGE: 23
SITE ADDRESS: 09312 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: KAY JEWELERS
DESCRIPTION: Burglar alarm system. Job #083- 18908 -0.
' I
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503-639 -8865
CONTRACTOR: ADT SECURITY SERVICES, INC PHONE #: 503-469-7244
Inspection Request Scheduled For: Date: 11/9/2005, Pour Time:
Code # Inspection Description • Confirm # Contact # Message
19 • Electrical final 020839-09 360 - 907 -0718 N •
Corrections /Comments /Instructions:
•
----n-lomt,c1‘1\ L. C 1 0 1 )
,s Yt PASS ❑ PARTIAL APPROVAL D CANCEL ❑ NO ACCESS
❑ FAIL, ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: !l �— Phone #: (503) 718 -
�9 y