Permit CITY OF TIG/^6R® ELECTRICAL PERMIT
PERMIT #: ELC2005 -00423
i ++ DEVELOPMENT SERVICES DATE ISSUED: 8/16/2005
• • 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: Electrical TI, low voltage systems on plans are to be done under separate permit by others. Job No. FS312
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: 0
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 2 W /SERVICE OR FEEDER: 67 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 FIVE STAR ELECTRIC, INC.
BY THE MACERICH COMPANY PO BOX 555
9585 SW WASHINGTON SQUARE RD BANKS, OR 97106
TIGARD, OR 97223
Phone: Phone: 503 - 324 - 0948
FEES Reg #: ELE 34 -665C
Description Date Amount LIP 158231
p SUP 4622S
[ELPRMT] ELC Permit 8/16/2005 $713.00
[ELPLCK] ELC Pln Rev 8/16/2005 $178.25 REQUIRED ITEMS AND REPORTS
[TAX] 8% State Surcharge 8/16/2005 $57.04
Total $948.29
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws
All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are se 1 AR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions'to OUNC at
503 -246- 99 or 1 -80 - 2 ,
Issued y: ., Permittee Signatur, . .de ' 1 N .nd� _
y ��
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
- . TRACTOR INSTALLATION ONLY
-.11111
SIGNATURE OF SUPR. ELEC'N _ : _.�-. = 40 DATE:
LICENSE NO: 1
-
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Per It E J WI6 li FOR OhFI(.l•. USE ONLY
■ y / 1
- 'City of Tigard A+ t� Date/By � 05 n Permit No s.�(
13125 SW Hall Blvd , Tigard, 04 2005 Plan Revie
Phone. 503 639 4171 Farr(-'� ,59$ ,1960_ " m Received
ra /1 4ii( ' f ,1 Date /By Other Permit
Inspection Line 503 639 41 TS i V f (IuH�u ^'' I Date Ready /By i/ El See Page 2 for
Internet• www ci ugard orliMLDINQ. DIVISION Notified/Method ^•' i Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction Addition /alteration /replacement Please check all that apply
❑ Demolition ❑Other: ['Service over 225 amps, comm'l ❑Hazardous location
• EService over 320 amps — rating ❑ Buildng over 10,000 sq ft ,
CATEGORY OF CONSTRUCTION of I- 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
❑Building over three stories ❑Feeders. 400 amps or more
El Multi- family 0 Master builder 0 Other:
['Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
Job no.: F12_. Job site address: i 29 W04.3k l • ❑Health -care facility ['Other
4 --.. . W • Submit 2 sets of plans with any of the above
't /I City /State /ZIP: a /d D 4113 #7-7 The above are not applicable to temporary construction service
Suite/bldg. /apt. no.: Project name: FEE* SCHEDULE
Description I Qty. I 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 I
Limited energy, residential 75 00 2
Tax map /parcel no.:
Limited energy, non - residential 75 00 2
Q�Q
DESCRIPTION OF WORK Each manufactured or modular
'(� `- .. 1 ' ` ct dwelling, service and/or feeder 90 90 2
Y • Services or feeders installation, alteration, and /or relocation
200 amps or less Z,. 80 30 lik leo 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 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
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 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
❑ APPLICANT ❑ CONTACT PERSON A Fee for branch circuits with
service feeder fee, each o. ( J . ( 2
Business name: branch anch circuit (VI r (7 6 65 g l
B Fee for branch circuits
Contact name• without service or feeder fee,
each branch circuit 46 85 2
Address: Each add'l branch circuit 6 65 2
City/State /7_I P: Miscellaneous (service or feeder not included)
Phone: ( ) 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
extension Describe Page 2 2
Business name: Five Star Electric, Inc.
Address: PO Box 555 • Each additional inspection over allowable in any of the above
Per inspection 62 50
City/State /ZIP: Banks, OR 97106 Investigation per hour (I hr min) 62.50
Phone: (503) 324 -0948 Fax: (503) 324 -0973 Industrial plant per hour 73 75
ELECTRICAL PERMIT FEES*
CCB Lie.: 158231 Electrical Lic : 34 -665C Suprv. Lie.: 4622C Subtotal e 19
Suprv. Electrician signature, required: � / / Plan review (25% of permit fee)
Print name: le� (,, t),,,1 E sip„ t / J Date: f3 (o / nC State surcharge (8% of permit fee) q51,)
ffr" 1 ((( tv TOTAL PERMIT FEE .(05
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 Tn -Counry Building Industry Service Board
•• Number of inspections per permit allowed
1 \Buildmg\Pernuts\Ei.C- PermnApp doc 12/07 440 -4615T( 10 /02/COM/WEB
CITIrOF TIGARD
BUILDING DIVISION PERMIT #: ELC2005.00423
13125 SW Hall Blvd.,Tigard, OR 97223 - DATE ISSUED: 8/16/2005
Phone: (503) 639 -4171 i l l
Inspection Requests (24 Hrs.: (503) 639 -4175 ,„,
INSPECTION WORKSHEET FOR DATE: 10/27/2005 TIME: 4:11P PAGE: 74
•
SITE ADDRESS: 09329 SW SHINGTON SQUARE RD • CLASS OF WORK:
SUBDIVISION: WASHINGTO SQUARE LOT #: TYPE' OF USE:
PROJECT NAME: SEPHORA
DESCRIPTION: Electrical TI, low Itage systems on plans are to be done under separate permit by others. Job No. .
FS312
OWNER: WASHINGTON SO RE LLC, PHONE #:
CONTRACTOR: FIVE STAR ELECTRI INC. PHONE #: 503 324 - 0948
Inspection Request Scheduled For: Date: 10/28/2005 Pour Time:
Code # Inspection Description (:nnfirm # Contact # Message
199 Electrical final '. 531 -01 503 324 -0948 N
4 1k
Corrections /Comments /Instr ions:
� OTE F;NA s
- sTicr -) Q AC
nog( c_.- A u o
?Awe - b N'TA >
vi
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L R Q �. ALArt.t^l\ E 00
fiNAL 4t,
P 16�
PASS ❑ ,PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N O8 Date: /b1 2 - Phone #: (503) 718- 244-
-
•
� 1
CITY OF TIGARD
igilbiLNG DIVISION PERMIT #: ELC2005 -00423
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/16/2005
Phone: (503) 639 -4171 p 1 r'
Inspection Requests (24 Hrs.): (503) 639 -4175 ,_.11
F'I
INSPECTION WORKSHEET FOR DATE: 10/11/2005 TIME: 7:08AM PAGE: 65
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SEPHORA
DESCRIPTION: Electrical TI, low voltage systems on plans are to be done under separate permit by others. Job No.
FS312
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR. FIVE STAR ELECTRIC, INC. PHONE #: 503 - 324 -0948
Inspection Request Scheduled For: Date: 10/11/2005 Pour Time:
Code # Ins e n Description Confirm # Contact # Message
115 tlectrical service 017965 -01 971 - 246 -0351 . N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION z ❑ ADDITIONAL FEES ASSESSED
Inspector: /] 4 1/ `e Date: l 6/11 6tt Phone #: (503) 718- Ziq, j •
CtTY .OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00423
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/16/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/6/2005 TIME: 7:00AM PAGE: 51
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD CLASS OF WORK: -
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SEPHORA
DESCRIPTION: Electrical TI, low voltage systems on plans are to be done under separate permit by others. Job No. •
FS312
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: FIVE STAR ELECTRIC, INC. PHONE #: 503 - 324 -0948
Inspection Request Scheduled For: Date: 10/6/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 017622 -01 971 - 246 -0351 N
Corrections /Comments /Instructions:
P(ko, k1 } 0 4 \', YYk i ►\I SigAP51 " 11n 5 LAB
P(z-f4ID . (OD s pf1/4
AND 1^0 - 21 ,
Czo \OD/ 8 co trat_. -E-1;Fitikk)
cb ts�� - Q (9■bvue
p ?-11\1 A)6, 5 - 1 'f\AAIN . cR
.6, ov M , To c o
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G-ctizav pb c k'► 6.0.) b v q ta-, n1-
v cLN WNT 6L o N O FoL cto/ 2O . 5124,41
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
Ir., FAIL )4 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005.00423 •
13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: 8/1612005
Phone: (503) 639 -4171 4,
Inspection Requests (24 Hrs.): (503) 639 -4175 . ' °7 I : ��
INSPECTION WORKSHEET FOR DATE: 9/16/2005 TIME: 7:01AM PAGE: 30
SITE ADDRESS: U9329 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SEPHORA
DESCRIPTION: Electrical TI, low voltage systems on plans are to be done under separate permit by others. Job No.
FS312 •
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: FIVE STAR ELECTRIC, INC. PHONE #: 503 - 324 -0948
Inspection Request Scheduled For: Date: 9f16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 Ceiling cover 015919 -01 971- 246 -0351 N
Corrections /Comments /Instructions:
(“3- N co -
•
ffir PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: iN1/
"�' Date: ` / �S Phone #: (503) 718-
52 y
•
CITY�t.OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00423
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/16/2005
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/7 /2005 TIME: 7:08AM PAGE: 109
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SEPHORA
DESCRIPTION: Electrical TI, low voltage systems on plans are to be done under separate permit by others. Job No.
FS312
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: FIVE STAR ELECTRIC, INC. PHONE #: 503-324 -0948
Inspection Request Scheduled For: Date: 9/7 /2005 Pour Time:
Code # • • -ction Description Confirm # Contact # Message
125 Wall cover 015046-01 971 - 246-0351 N
Correcti• om - - - - '•ns:
•
`.PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: � ' 44 L ' Date: ! 7 Phone #: (503) 718- A142___
•
CITY. OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00423
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/16/2005
Phone: (503) 639- 4171 '' ,, i
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/29/2005 TIME: 7:13AM PAGE: 77
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SEPHORA
DESCRIPTION: Electrical TI, low voltage systems on plans are to be done under separate permit by others. Job No.
FS312
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: FIVE STAR ELECTRIC, INC. PHONE #: 503- 324 -0948
Inspection Request Scheduled For: Date: 8/29/2005 Pour Time:
Code # ■ _ : - - • I - scription Confirm # Contact # Message
105 Underground/slab co 014464 -01 971 - 246-0351 N
Corrections /Comments/ ns ' _ •
et-R 200b ; 00z ELI
un) Loo& fbk._
•
•
PASS PARTIAL APPROVAL CANCEL NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N 6 LE Date: Zg 0 Phone #: (503) 718- 2-4
•
CITY OF TIGARD 1 ', ?; •:,
BUILDING DIVISION PERMIT #: ELC200 &00423
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/16/2005
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503)639 -4175
INSPECTION WORKSHEET FOR DATE: 8/23/2005 TIME: 7:05AM PAGE: 46
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SEPHORA
DESCRIPTION: Electrical TI, low voltage systems on plans are to be done under separate permit by others. Job No.
FS312
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: FIVE STAR ELECTRIC, INC. PHONE #: 503 -324 -0948
Inspection Request Scheduled For: Date: 8/23/2005 Pour Time:
Code # Inspection Description • - it . Contact # Message
105 Underground/slab cover 014 01 971-246-0352 N
Corrections /Comments /Instructions:
► CZ. c w)/ P Tc?`
PASS • ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: cript Date: t 2 � O ' Phone #: (503) 718- 2 'I 6