Permit .7" A
CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2005 -00333
°�'` '� I ° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/11/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09360 SW WASHINGTON SQUARE RD ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Audio.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X 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:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC PROCOM COMMUNICATIONS INC
BY THE MACERICH COMPANY P.O. BOX 22288
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97269
TIGARD, OR 97223
Phone: 503- 639 -8865 Phone: 503- 233 -8037
Reg #: LIC 109929
SUP 2933LEA
FEES ELE 3- 397CEP
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 10/11/200E $75.00
[TAX] 8% State Surcha 10/11/200E $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 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: -,/), t j l 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.
'
eetrical Permit Application FOR OFFICE USE ONLY
City of Tigard Permit No ` O0 X33
13125 SW Hall Blvd., Ti ard OR 972 D B\ �D �� Q ���
ti ,�^ Fl to an Re\ leR- Other ]`Coil
Phone: 503.639.4171 Fax: 503.598.1960 " R. r . I ' , Date B\
In ection Line: 503.639.4175 i _� I_ Date Read\ B\ t lulr El See Page 2 for
Internet: www.ci.tigard.or.us �� 6 I .�- �00 Notified/Method 'r 'I Supplemental Information
T1 1 PLAN REVIEW
❑ New construction ® A e " °��� �
d menu Please check all that apply.
['Service over 225 amps, comm ❑Hazardous location
❑ Demolition ❑ Other:
❑Service 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
0 Building over three stories ['Feeders. 400 amps or more
El Multi - family El Master builder ❑ Other:
['Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lightingplan RV park
Job no.: Job site address. Washington Square Road ['Health facility ❑Other
Submit 2 sets of plans with any of the above.
City /State/ZIP: Tigard, OR 97223 93 U 0 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.. W -19 Project name. Godiva Chocolatier FEE= SCHEDULE
Description I Qty. I Fee. I 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'! 500 sq. ft. or portion 33.40 1
Tax map /parcel no.- Limited energy, residential 75.00 2
Limited energy, non-residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
Audio dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80 30 2
❑ PROPERTY OWNER ® TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: Godiva Chocolatier 601 amps to 1,000 amps 240.60 2
Address: 9585 SW Washington Spuare Road 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: ( ) Fax: ( )
200 amps or less 66.85 1
Owner installation: This installation is being made on propett■ that I own which is not 201 amps to 400 amps 100.30 2
intended tiar sale, lease, rent. or exchange. according to ORS 4-17. -1-19. 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 tot branch circuits a uh
service or feeder fee, each 6.65 2
Business name ProCom Communications, Inc. branch circuit
B Fee for branch circuits
Contact name: Shawn Giles without service or feeder fee,
each branch circuit 46.85 2
Address: 8326 SE 17 Ave.
Each add'l branch circuit 6.65 2
City / State/ZIP: Portland, OR 97202 Miscellaneous (service or feeder not included)
Phone: (503) 233 - 8037 Fax (503) 233 - 8052 P or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E - mail: shawn@procomcommunications.com Signal circuit(s) or limited -
C'ONTRaCTOR energy panel, alteration, or
extension. Describe: audio Page 2 5 r
2
Business name: ProCom Communications, Inc.
Address: 8326 SE 17th Ave. Each additional inspection over allowable in any of the above
Per inspection 62.50
O b City / State/ZIP. Portland, OR 97202 Investigation per hour (1 hr mm) 62.50
1 Phone. (503) 233 -8037 Fax. (503) 233 -8052 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES`
I CCB Lic.. 109929 Electrical Lic • 3- 397CLE Supry Lie.: 1172LEA Subtotal 15 —
■
Suprv. Electrician signature, required' Y Plan review (25% of permit lee)
Print name: z� J/ i7 Date. 10.11 - State surcharge (8% of permit fee) 6 —
//�� TOTAL PERMIT FEE S, —
Authorized signature: P i � This permit application expires if a permit is not obtained within 180
J � a ( ^ days after it has been accepted as complete
Print name: r , , '-t Date 10 - 11 - 05 y Fee methodology set by Tn -County Building Industry Service Board
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: ELR2005 -00333
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/1112005
Phone: (503) 639 -4171 Asb
Inspection Requests (24 Hrs.): (503) 639 -4175 4 111
INSPECTION WORKSHEET FOR DATE: 11/9/2005 TIME: _ 7:09AM PAGE: 56
SITE ADDRESS: 09360 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: GODIVA CHOCOLATIER
DESCRIPTION: Audio.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639.8865
CONTRACTOR: PROCOM COMMUNICATIONS INC PHONE #: 503 - 233.8037
Inspection Request Scheduled For: Date: 11/9/2005 Pour Time:
Code # Inspection Description Confirm # • Contact # Message
135 Low voltage 0207 603- 233 -8037 N
Corrections /Comments /Instructions: •
CI
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /). Lam., / e/ Date: 11 �� Phone #: (503) 718 -
Z
CITY "OF TIGAR®
BUILDING DIVISION PERMIT #: ELR2005 -00333
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/11/2005
Phone: (503) 639 -4171 Avon. 'bs
r .�_ 1. .
Inspection Requests (24 Hrs.): (503) 639 -4175 .1 .._
•
INSPECTION WORKSHEET FOR DATE: 10/12/2005 TIME: 7:04AM PAGE: 10
SITE ADDRESS: 09360 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE • LOT #: TYPE OF USE:
PROJECT NAME: GODIV CHOCOLATIER
DESCRIPTION: Audio.
OWNER: WASHINGTON SQUARE LLC, PHONE #: . 503-639 -8865
CONTRACTOR: PROCOM COMMUNICATIONS INC PHONE #: 503-233-8037
Inspection Request Scheduled For: Date: 10/1212005 Pour Time:
Code # . _ : _ . - Description Confirm # Contact # Message
135 018'108 -01 503 -233 -8037 N
Av 0 . 1 � Corrections/Comments/Instruction-
•
. El PARTIAL APPROVAL CANCEL NO ACCESS
❑ FAIL ❑ C LL FOR INSPECTIO ❑ ADDITIONAL FEES ASSESSED
/,
Inspector: ■1/ ,/ Date: 16 i Phone #: (503) 718-