Permit Alb CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
� � DEVELOPMENT SERVICES PERMIT #: ELR2005 -00288
.,� I - ' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/16/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09345 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Fire alarm.
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: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC OREGON ELECTRIC CONST /GROUP
BY THE MACERICH COMPANY 1010 SE 11TH AVE
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97214
TIGARD, OR 97223
Phone: 503 639 - 8865 Phone: 503 234 - 9900
Reg #: LIC 203
SUP 4460S
FEES ELE 26 -95C
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 9/16/2005 $75.00
[TAX] 8% State Surchart 9/16/2005 $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- 1 -01 . Yo may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: 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 : 1 1 *. 6 -05 08:39AM FROM-Oregon Electric Estimating 5032313587 T-032 P.002/005 F-219
4,.. ,, , ,, 0 Imib",...3%.as,.....• a ••••■ ALAAA. .....e. .................--....—
,. Received -
City of Tigard mi-
n:
1.1 ECEIVE ' ...,., q/n9(o6 B.) Permit No.:a4z205"....00
13125 SW Hall Blvd-. Tigard. OR 972 ' ' Plan Review Other Permit:
Phone; 503.639.4171 Fax: 503.598.1960 ''''. .11?' DateBy:
inspection Line: 503.639.4175 SEP 1 - r`TReadYechOclil : -J fil See Page 2 for
1 16 Supplemental Information
internee www.ei.tigard.Or.US 6 20r. N7„A
- . ' : -:''.?, :=';: .":: :' .::, ! I.PI:AN. REVIEW ::-• • ..:: c: '-•-:,-:.%:,_••••.•. • -._
ID New construction 121 AaliiittigiftaINIASIliNgment Please check n11 that apply:
['Service over 225 amps. corm I 01(azardous location
El Demolition 0 Other: _ . ['Service over 320 amps - rating 1:1Buildng over 10,000 sq. ft..
c4TEGQiii - 6zisl*P0101 4- :':',:' , ::::-:':; - 7 .,:ftf,',::.:..:(.. of 1- and 2-family dwellings 4 or more new residential
CI 1- and 2-family dwelling El Commercial/industrial 0 Accessory building ['System Over 600 volts nominal units in one structure
0Building over three stories ['Feeders. 400 amps or more
0 Multi ['Master builder 0 Other: ['Occupant load over 99 persons IJManufactured structures or
7 2-1-:P .::.;;;.! .:; 1/09woricnir')kw•-Loc4070kr;=:;: ::!:-..-..- 0E0m/lighting plan RV park
Dicalth-rare facility ['Other
Job no.: 18574-103 Job site actr 9 315 SW Washington Square Rd
. Submit 2 sets of plans with any of the above.
City/State/ZIP: Tigard, OR 97223 ' The above ate not applicable to temporary construction service.
Suite/bldg./apt. no.: Project name; Pottery Barn Kids ' ' ' • ' ' '' - - ' ' TEE* 'SCHEDULE :7 ,. :•,. -, , •,. : . . _
. • .. ..- . • . . . •
DescOption ' Qt7. I tree. I Tole I "
Cross street/directions to job Site: New residential single- or multi-family dwelling unit.
Includes attached garage.
1.000 sq. ft. or less 145.15i I 4 -
Subdivision: I Lot no.: Ea. addi 500 sq. ft. crr portion 33.40 1
— Limited energy. residential 75.00 2
Tax map/parcel no.: -
Limited energy, non-residential 75.00 2
:.•',-.' . . ; , . . . . ; _ ,':.•:-: - .,: 4 ....'.-C-....: ';..::::•-TESckikt.1014 W O R K . .':::',..... 7 • '".' .. • : ,:;: •'.., \ .. Each7nanufactured or modular
Install low voltage wiring and cabling for Fire Alarm - dwelling, service and/or feeder - 90.90 2
gaevici& or feeders Installation, alteration, and/or relocation ,
200 amps or less 80-30 2
. . 201 amps to 400 amps 106.85 2
:.' ' lgr:PktiiiititAl i O 111 0W - : , .: - .":' - '.1.'.. '.!' : . '.. '.' -TEPTASTT.• - .. -: l'.:' , :. '
• • • • • • - . 401 amps to 600 amps 160.60 2
Name: Washington Square LLC 601 amps to 1.000 amps 240.60 2
Address: 9585 SW Washington Square Rd Over 1.000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax ( ) 200 amps or less 66.85
Owner installation: This installation is being made on property that I own which is not "20 amps to 400 amps 100.30
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133-75 _1
Owner signature: Date: Branch circuits- new, alteration, or extension, per panel
;-,::: -.,,:. ;.;,' la-imixidANT:.", : .,:: : .:;...„::....1:1 ' ;;.... ....: :;
A. Pee for branch circuits with
service or feeder fee, each
6.65 2
Business name: Oregon Electric Group, Inc. branch circuit _ _ .
— B. Fee for branch circuits
Contact name: Loni Martin without service or feeder fee,
46.85 2
each branch circuit
Address: 1010 SE 11 Ave Each addl branch circuit 6.65 2
City/State/ZIP: Portland, OR 97214 Miscellaneous (service or feeder not included)
Pump
Phone: (503) 234 I fax: : (503) 535-2620 or irrigation circle 53.40 2 -
Sign or outline lighting 53.40 2
E-mail: loni@oregon-eleetric.com Signal circuit(s) or limited-
.: ..;;.:,.; '; • ..-. .. ., .::,....-:, 2..•,: :- , '...L.1: '.. .:.';'.;.;' -. '.'. ;...... .'. •.: .. ,.. :,...., .-.:....: energy panel, alteration, or , -
.. .: ._ z
extension. Describe: f Page 2 - 7 5 ' 2
Business name: Oregon Electric Group, Inc. - - - -
Address: 1010 SE 1 1th Ave . Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: Portland, OR 97223 Investigation per hour tt hr min) 62.50
_ .
Phone: (503) 234-9900 I Fax: (503) 535-2620 Industrial plant per hour 73.75
' :'....; ..-".• ... ... ' ' .. ELECTRICAL • PERMIT. .FEZ5? :-.'..• , - '. ' , •
CCB Lie.: 203 Electrical Lic.: Suprv. Lic.: 4/- c/ & c:;_, Subtotal -- ( .1 5.; *
Suprv. Electrician signature, required: A . Plan review (25% of permit fee)
—
State surcharge (8% of permit fee) (.,"
Print name: it-tiA K 16 .4. V / #: 9/15/05 - Z•
TOTAL PERMiT FEE g'i `----•
Authorized signature: The permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete
Print name: Date: 9/15/05 • Fee methodology in by Tri-County Building Indusuy Service Board
..... Number of inspections per permit allowed.
It1131.1WinalPen3kskELC.PemitApp.Joc 1243 140-1615T(10/02/COMAVEB
,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005.00280
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/1612005
Phone: (503)' 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 F _ ..
INSPECTION WORKSHEET FOR DATE: 11 /8/2005 TIME: 7:00AM PAGE: 106
SITE ADDRESS: 09345 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: POTTERY BARN KIDS
DESCRIPTION: Fire alarm.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639 -8865
CONTRACTOR: OREGON ELECTRIC CONST /GROUP PHONE #: 503 - 2349900
Inspection Request Scheduled For: Date: 11/8/2005 Pour Time:
Code # Inspection Description • • -- Contact # Message
199 Electrical final 020554 -02 503-793.7177 N
Corrections /Comments /Instructions: r
11 ^ r IJ , G . • go <J � .
pctiDv i v_ 41 ALL biv'► c f o- v Pis
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
lA FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v ry Date: VI(' SN cY5 Phone #: (503) 718- ultAke