Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
A DEVELOPMENT SERVICES PERMIT #: ELR2005 -00271
' 4-111 "' - ' 13125 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/12/2005
PARCEL: 1512600 -00300
SITE ADDRESS: 09336 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Low voltage for HVAC.
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: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC HVAC INC
BY THE MACERICH COMPANY 5188 SE INTERNATIONAL WAY
9585 SW WASHINGTON SQUARE RD MILWAUKIE, OR 97222
TIGARD, OR 97223
Phone: 503 639 - 8865 Phone: 503 462 - 4822
Reg #: LIC 50897
ELE 26 -571 CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 9/12/2005 $75.00
[TAX] 8% State Surcharl 9/12/2005 $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 foil. . -s adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through •AR 95 001 -s .'. ou may obtain copies of these rules or direct questions to OUNC t 503 -? -6699.
Issued = : �' _ Permittee Signature:,fr+ p A AftAil nip (m/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.
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Rece
a( es.-- Permit No �je'R'(/r/65-4 vt/0/7/
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone 503.639 4171 Fax: 503 598.1960 4 ' F " ii (t\ Date/By Other Permit -
Inspection Line 503.639.4175 ■ i e•I I Date Ready/By 1 ® See Page 2 for
Internet www ci tigard or us Notified/Method I ( C . Supplemental Information
'` ... . _. - TYPE-01'`WORK . 7 ;^'-.: . '� -. _' PLAN:-REVIEW
❑ New construction Addition/ terario placement 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 ,
-' - - - 'CATEGORIC -QF CONSTRUCTION f `, " "=- .,: - ' "'= •i•-: •::::::: of 1- and 2- family dwellings 4 or more new residential
❑ 1 and 2 family dwelling AgninercialAdustrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder El Other. ❑Building over three stones ❑Feeders, 400 amps or more
['Occupant load over 99 persons ['Manufactured structures or
- -- .,�„ .,.,...,•,• ' 4_OB SITE INFORMATION AND LOCATION - , _ r ,_ ❑Egress/lighting plan RV park
Job no.: Job site address: g3 3(p P ❑Health -care facility ❑Other
l Submit 2 sets of plans with any of the above
City/State /ZIP: The above are not applicable to temporary construction service
Suite/bldg. /apt. no.: Project name.W , 7 Ao / A pi [ In k - - -- FEE *:SC` E DULE '� *• Uv �` 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 1 45.1 5 4
Subdivision: Lot no.: Ea add'l 500 sq ft or portion 33.40 l
Tax map /parcel no.: Limited energy, residential 75 00 2
Limited energy, non - residential 75 00 2
> ••-;,_ . _ - • . '• ;DESCRIPTION. .01? ' - , x; "i k ;t: » • x ,- Each manufactured or modular
dwelling, service and /or feeder 90 90 2
v 0 Services or feeders installation, alteration, and/or relocation
�SL P.0 CNLN``t 'VL I l& ' .+
() 200 amps or less 80 30 2
g �. • _- - •-:•;_-- . - - > • _ - ;5 201 amps to 400 amps 106 85 2
� " Q PRQPERTY-OWN -, ". ❑ + - TENANT 2 '• „a r
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
•: k ' ` w .47 i , _ `AW LES , ` , -'`" . ; `- _ _ '= ' - • r " - A Fee for branch circuits with
' - !' .--•s : x- E I _ : ~ - -t �' 'x , t• ::i f r? l _ .,,.. _ T ACT Py- , . ,- , # .
service or feeder fee, each 6.65 2
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'I branch circuit 6 65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax:: ( ) Pump or imgation circle 53 40 2
Sign or outline lighting 53 40 2
E -mail: Signal circuit(s) or limited-
. , .,:''1;; «` n ,7 , : ,::-/:.`,„', ° .. `CONTRA(-rOR' r : �. ; ' . 2;::,:::: ' '?; . : ,', , ,;:l y;- energy panel, alteration, or
extension Descnbe• Page 2 2
Business name: J ) c l ��� r
Address: St S-- 'k sE - - r , LL ' ^ Each additional inspection over allowable in any of the above
ter` "- Per inspection 62 50
Ctty /State /ZIP:_�� f (?� ' �� Investigation per hour (i hr min) 62 50
Phone: ( ) �f (n2 ^-t{ a,-�� F ( ) C Industrial plant per hour 73 75
���111 �a"��S ✓ : , tr , . . "• ELECTRICAL PERMIT 11EES* • '
CCB Lic.: SoSCI 1 Electrical Lic..4_ca71 CC F Supry Lic. • a( t-! Subtotal
/J �
Suprv. Electrician signature, required: Plan review (25% of permit fee) /
-
Print name: L S Date. / ' I 0 5 State surcharge (8% of permit fee) o
TOTAL PERMIT FEE U r .
ri
Authozed signature . � � 1■te.-0 i3v1 This p ermit a expires if a permit is not obtained within 180
\ days after it has been accepted as complete
Print name: ��t vie_ 2�bW,s1� -\ Date. 9 ` 1 • • Fee methodology set by Tn-County Building industry Service Board
t •• Number of Inspections per permit allowed
i \Building\Permits\ELC- PemutApp doe 12/03 440-46157 I 0/02/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
, ESIDENT CV O...IT®NTY W:kzai :V _ ig
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
r O` RGIA OrataI MEa
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire 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:
*No licenses are required. Licenses are required
for all other installations
\Bwldmg\PamIo\ELC- PemmApp doc 04/03
Standards for Electrical Plan Submissions
Electrical plan review limitations:
(1) Plan reviews can only be required if the installation involves one or more of the
following:
(a) Square footage. More than 10,000 square feet;
(b) Ampacity:
(A) More than 320 amperes continuous rating, metered through a self - contained metering
device, for one- and two - family dwellings; or
(B) More than 225 amperes for service and starting at 400 amperes for feeders for other
than one- and two - family dwellings;
(c) Voltage. More than 600 supply volts nominal;
(d) Height. More than three stories;
(e) Occupancy. Four or more residential units in one structure, or occupancy rating of
more than 99 persons;
(f) Classified area. Any area or structure containing a special occupancy as described in
Chapter 5 of the National Electrical Code adopted by the board by OAR 918 -305-
0100; or
(g) Manufactured Structures Park or Recreational Vehicle Park. A new manufactured
structures park, a temporary manufactured structures park, or recreational vehicle park, or
any addition or alteration to an existing park.
(2) Standardized Format for Plan Review. When electrical plan review is required the
electrical plan shall meet the following requirements:
(a) Copies. Submit two sets of electrical plans;
(b) Readability. The plans shall be drawn to scale, contain definitions for legends used,
be of sufficient clarity to indicate the location, nature and extent of the work proposed
and show in detail that it will conform to the applicable electrical code requirements,
laws, ordinances, rules and regulations;
(c) Contents. The plans shall contain the following minimum requirements:
(A) Feeder riser diagram showing panel location and circuit schedules;
•
•
(B) One line riser diagram showing bonding and grounding and conductor sizes;
(C) Available fault current on the line side of service disconnect;
(D) Complete load calculations, or provide applicable load records, for all new
installations and for additions to existing installations;
(E) Fixture schedule, showing type, location and layout of the fixtures;
(F) Address of the installation and name of owner and address;
(G) Identification of the employer, identification and signature of person who prepared
the plan, license number if the person is an electrical supervisor and professional
registration number if the person is an architect or registered professional electrical
engineer; and
(H) Location of emergency systems, identifying the power source and the system on plan.
(3) Nothing in these rules shall prohibit a jurisdiction from requiring a lighting energy
budget.
[Publications: Publications referenced are available from the agency.]
Stat. Auth.: ORS 479.870
Stats. Implemented: ORS 479.870
Hist.: BCA 33- 1991(Temp), f. & cert. ef. 9- 30 -91; BCA 44 -1991, f. & cert. ef. 12- 26 -91;
BCD 19 -1996, f. 9- 17 -96, cert. ef. 10 -1 -96; Renumbered from 918- 320 -0330; BCD 23-
2000, f. 9- 29 -00, cert. ef. 10 -1 -00
s �vr .
CITY OF TIGARD • �!
BUILDING DIVISION . PERMIT #: ELR2Q0S -00271
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/12/2005
Phone: (503) 639 -4171 1 gugI�I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/10/2005 TIME: 7:04AM PAGE: 75
SITE ADDRESS: 09336 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: WFIITEHOUSE BLACK MARKET
DESCRIPTION: Low voltage for HVAC.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503- 639 -8865
CONTRACTOR: HVAC INC PHONE #: 503 -462 -4822
Inspection Request Scheduled For: Date: 10/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 017868 -01 . 503.462 -4822 N
Corrections /Comments /Instructions:
•
•
ii KL PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G" a. - 1'48 Date: fl Ui Phone #: (503) 718 2114
e �
CITY OF TIGARD • ���
BUILDING DIVISION .- .
PERMIT #: ELR2005 -00271
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/12/2005
Phone: (503) 639 -417 +�
Inspection Requests (24 Hrs.): (503) 639 -4175 ': 1.L
INSPECTION WORKSHEET FOR DATE: 10/6/2005 TIME: 7:02AM PAGE: 34
SITE ADDRESS: 09336 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: WHITEHOUSE BLACK MARKET
DESCRIPTION: Low voltage for HVAC.
OWNER: WASHINGTON SQUARE LLC, • PHONE #: 503- 639.8865
CONTRACTOR: HVAC INC PHONE #: 503-462-4822
Inspection Request Scheduled For: Date: 10/6/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 017639 -03 503 -462 -4822 N
Corrections /Comments/ Instructions:
Sapp CO `.- 510 wic i4
cbp 6' NOCZMVRLI PAN N 6IL. ,
•
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
A FAIL g CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 6 Phone #: (503) 718 -� •
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005.00271
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/12/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 '_ I..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 46
SITE ADDRESS: 09336 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON „SQUARE LOT #: TYPE OF USE:
PROJECT NAME: WHITEHOUSE BLACK MARKET
DESCRIPTION: Low voltage for HVACI
OWNER: WASHINGTON SQUARE C, PHONE #: 503- 639 -8865
CONTRACTOR: HVAC INC PHONE #: 503- 462 -4822
Inspection Request Scheduled For: : 10/31/2005 Pour Time:
Code # Ins ection Description Confir # Contact # Message
199 Electrical final 019836 -0 503 -4f32 -4822 V
Corrections /Comments /Instructions: •
•
•
•
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL • ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: IQ* Le Date: 1 Q1� Phone #: (503) 718- Z
1