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Permit CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT `4I DEVELOPMENT SERVICES PERMIT #: ELR2005 -00356 .� I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/19/2005 PARCEL: 1S12600-00300 SITE ADDRESS: 09318 SW WASHINGTON SQUARE RD ZONING: C -G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG Project Description: Data /tele. 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 VERSATILE CABLING, INC. BY THE MACERICH COMPANY 12606 NE 95TH ST #C -130 9585 SW WASHINGTON SQUARE RD VANCOUVER, WA 98682 TIGARD, OR 97223 Phone: Phone: 360 - 816 - 1021 Reg #: LIC 161614 ELE 37- 1048CLE FEES Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 10/19/200°. $75.00 [TAX] 8% State Surchart 10/19/200E $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% 1 -0 0. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699. Issued By: 4111P 47 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'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. i • ���, . 'I e >r'lcal Pe d I I1 i . FoR OFFICE USE ONLY City of Tigard , n C rve C fl e . � �� : • -0o 340 13125 SW Hall Blvd., Ti Tj97i239 2005 Plan Review Phone: 503.639.4171 F�598.1960 1 /A , ri , i"rl i l' Date/By: Other Permit: . Inspection Line: 503.639.40 tY OF 1 IGAR , _, . j,. , 1J 1 _ Date Read ® See Page 2 for Internet: ` ww.ci.tig p • ut�ILDING DIVISION ..4.4.4- Notified/Method: Supplemental Information t t R z W A 'y_ 5- ` � 11" , 0'. J' y eti v 41 w7` a'. sl ti 4 r i p�,rcyp d * 'xf' i iF E ,, . ^''+, 1 LL.'S n, -i .._..J 1 o `� "T�.. X� s1... ,= 5: Rix iet4 r i New construction ❑ Addition/alteration/replacement Please check all that apply: • Demolition ❑Other: ['Service over 225 amps, comm'l ['Hazardous location ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., � ' 5 A : s [ ©® . . 7„ [t U . ...,.., _} . s � 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 ■Maser builder ❑Other; ['Building over three stories OFeeders, 400 amps or more . r � . t I � � ❑Occupant load over 99 persons ❑Manufactured structures or �4 .,s s O: I O' uPi de _ . a _ b O �( , .� '"TX ^ tr ❑E s/li tin plan RV park tooi: 9.3/ 8 S ) 60a r , ❑Healthcare facility ❑ Job no.: Job site address: n Submit 2 sets of plans with any of the above. City/ State/ZIP: 7,- t9R 99 ) i , gag 9 The above are not applicable to temporary construction service. �'" �tit?i�.�� .'. � ter" ,. �x`�' c+M'���i n z:. � Suite/bldg. /apt. no.: Project name: Ch !" Description Qty. Fee. Total Cross street/directions to job site: New residential single- or multi - family dwelling unit. _ /' Includes attached garage. W eLpV 1 I n 0 ■ --- .- 1,000 sq. ft. or less 145.15 4 Subdivision: i l Lot no.: Ea. add'1500 sq. ft. or portion 33.40 1 Tax map /parcel no.: limited energy, residential 75.00 2 u- r a�,. 7T Limited energy, non - residential 75.00 2 t; - ` : ti p ti R p o ,. a t � F Each manufactured or modular i a_ 4- - , , dwelling, service and/or feeder 90.90 2 Services or feeders installation, alteration, and/or relocation yy,y�� J fl fa 11 i 'on 200 amps or less 80.30 2 ���ay "i iii .W7 • •) ; S 1 'y .� y �„ 1 ffr- ,. }� -a , y"' F. ��'r''� �-' 1-'R ` rill 201 s to 400 s 106.85 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 Phone: ( ) I 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 `', Ae L 77,6 ,� ONE A T -, IF47 "g A. Fee for branch circuits with ?v2 +. E ac E. n..r..�_ v . :a^]r 9r -Y �M1n Sr "iJ /�, service or feeder fee each 6.65 2 Business name: c ^�, CY'- I P� branch circuit , B. Fee for branch circuits Contact name: 7 QC /(7 - without service or feeder fee, 46.85 2 Address: each branch circuit _ Each add'l branch circuit 6.65 2 City/State/ZIP: 0 Miscellaneous (service or feeder not Included) Phone: 0(0 g o / O Z / I Fax: : (.0 O lg a Q( Pump or irrigation circle 53.40 2 Si • or outl • li g h t i ng 53.40 2 E -mail: Signal circuit(s) or limited- „ d ` . (g . .e ° . '� 6t ° ,'k, s ` +' � energy panel alteration, or � J � extension. Describe: / Page 2 fl 2 V Business name: ,e/ -e G4dl. ZdC Address: /x69 0 [p 10 q I2 4-9- e c',.�3C� Each additional Inspection over allowable in any of the above /_ Per inspection 62.50 City /State/ZIP: Uo fl � (. (/e/) ,m.9 9 e1(. p 8 2. Investigation per hour (1 hr min) 62.50 Phone: ( ) Fax: Industrial plant per hour 73.75 CCB Lic.: /(1 9 Electrical Lic.: : " . V ; Supry . .: - 2�Z 4 Subtotal / s / Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: Ch /G i f ' A CC.,`•,44 Date: � (' -7/ d..r" State surcharge (8% of permit fee) ea - TOTAL PERMIT FEE S i 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 Tri -County Building Industry Service Board •• Number of inspections per permit allowed. CITII�' C'-TIGARD } • BUILDING DIVISION PERMIT#: ' €LR2005-00366 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/19/2005 • Phone: (503) 639 -4171 • Inspection Requests (24 Hrs.): (503) 639 -4175 I — INSPECTION WORKSHEET FOR DATE: 11 /3/2005 TIME: 7:06AM PAGE: 64 SITE ADDRESS: 09318 SW ' . INGTON SQUARE RD CLASS OF WORK: SUBDIVISION: WASHINGTOI .QUARE LOT #: TYPE OF USE: PROJECT NAME: CHICO'S DESCRIPTION: Dataltele. OWNER: WASHINGTON SQUAR LLC, PHONE #: CONTRACTOR: VERSATILE CABLING, IN,. PHONE #: 360 -B16 -1021 Inspection Request Scheduled For: Bate: 11/3/2005 Pour Time: Code # Inspection Description o irm • Contact # Message 135 Low voltage 12019, 01 503-449-1013 N IIt Corrections/Comments/Instructions: • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: — ' ` N 66 Li Date: It � 3 • Or Phone #: (503) 718- Z'1 U