Permit CI TY O FTI GARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00561
DEVELOPMENT SERVICES DATE ISSUED: 10/3/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09364 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: TI Electrical.
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: 3 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 26 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 BOONES FERRY ELECTRIC INC
BY THE MACERICH COMPANY PO BOX 628
9585 SW WASHINGTON SQUARE RD WILSONVILLE, OR 97070
TIGARD, OR 97223
Phone: Phone: 503 - 682 - 4936
FEES Reg #: SUP 49185
LIC 88482
Description Date Amount ELE 3 -2230
[ELPRMT] ELC Permit 10/3/2005 $585.05
[ELPLCK] ELC Pin Rev 10/3/2005 $146.26 REQUIRED ITEMS AND REPORTS
[TAX] 8% State Surcharge 10/3/2005 $46.80
Total $778.11
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 or 1 -8 344
Issued By: Permittee Signature: SEE SACAO - MeEF7i?/`7
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
Received Q
City of Tigard Date /13 . 0 / j Pe^mt N.�[ OU S 6o / _
13125 SW Hall Blvd , Tigard, OR 97223 D P lan Review I , '
Phone 503.639 4171 Fax: 503.598�6� `� ® la Q Other Permit
ML C ENE i— 1-----'64" 0 Date/By QK/��0
Inspection Line. 503 639.4175 �' .. Date Ready /By 6t1 See Page 2 for
Internet www ci.tigard or us k ' M5 Notified/Method lurk, Supplemental Informa
TYPE OF WORK PLAN REVIEW
❑ New construction ®Additi n/a�ter o a cement Please check all that apply.
C i 4 f Ur ❑Service over 225 amps, comm'l ❑Hazardous location
El Demolition ❑ WILDING DIVISION
['Service over 320 amps - rating ❑ Buildng over 10,000 sq ft.,
, CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building OSystem over 600 volts nominal units in one structure
❑ Multi family ❑Master builder ❑Other: ['Building over three stories ['Feeders, 400 amps or more
DOccupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION Z Egress/lighting plan RV park
Job no.: Job site address: 9364 SW WASHINGTON SQUARE ❑Health -care facility ['Other
Submit 2 sets of plans with any of the above.
City/State /ZIP: TIGARD, OR 97223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: R01 Project name: OCCHIALI DA SOLE FEE* SCHEDULE fi
Description I Qty. I Fee. I Total 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 15 4
Subdivision: Lot no.: Ea. add'I 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 OF WORK Each manufactured or modular
INTERIOR REMODEL OF EXISTING RETAIL TENANT SPACE FOR NEW dwelling service and/or feeder 90 90 _ 2
Services or feeders installation, alteration, and/or relocation
TENANT "OCCHIALI DA SOLE" 200 amps or less 1 80 30 80.30 2
❑ PROPERTY OWNER I ® TENANT 201 amps to 400 amps ) 106.85 106%5 2
401 amps to 600 amps 160.60 2
Name: SUN GLASS DESIGNS D/B /A OCCHIALI DA SOLE 601 amps to 1,000 amps 240 60 2
Address: 9390 NORTH 95 STREET Over 1,000 amps or volts 454 65 2
Reconnect only 66 85 2
City/State /ZIP: SCOTTSDALE, AZ 85258 Temporary services or feeders installation, alteration, and/or
Phone: (480)451 -3958 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
❑ APPLICANT I 0 CONTACT PERSON A Fee for branch circuits with
service or feeder fee, each 2& 6.65 112110 2
Business name: OCCHIALI DA SOLE branch circuit
B. Fee for branch circuits
Contact name: TIM SCHENK without service or feeder fee,
each branch circuit 46 85 2
Address: 1120 EAST 80 STREET -SUITE 211 Each add'I branch circuit 6.65 2
City/State /ZIP: BLOOMINGTON, MN 55420 Miscellaneous (service or feeder not included)
Phone: (800) 541 -0821 Fax: : (952) 854 -4909 Pump or imgation circle 53 40 2
Sign or outline lighting 53 40 2
E -m il: tims @elderjones.com Signal circuits) or limned-
CONTRACTOR energy panel, alteration, or
extension. Describe Page 2 2
Business name: T.B.D. �ooN 6
energy
Address: /� �� Each additional inspection over allowable in any of the above
4(r
/'" X Per inspection 62 50
City/State /ZIP: 4) /G,SO /VL/it_C/ &X. 9' 74 o Investigation per hour (I hr min) 62 50
Phone: ( ) 6 Poi - y934 Fax: ( ) Industrial plant per hour 73 75
ELECTRICAL PERMIT FEES
CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal 5 a 5, 05
Suprv. Electrician signature, required: Plan review (25% of permit fee) 1 1•{ b, 2(,
Print name: Date: State surcharge (8% of permit fee) y b. '8 0
TOTAL PERMIT FEE V J 7 8, 1 I
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- County Building Industry Service Board
•• Number of inspections per permit allowed
i \Building\Permns\ELC- PermitApp doe 12103 440- 4615T(10/02/COM/WEB
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
BO9NES FERRY ELECTRIC INC
PO BOX 628
WILSONVILLE, OR 97070
Electrical Signature Form
Permit #: ELC2005 -00561
Date Issued: 10/3/2005
Parcel: 1S12600-00300
Site Address: 09364 SW WASHINGTON SQUARE RD
Subdivision: WASHINGTON SQUARE
Block: Lot:
Jurisdiction: TIG
Zoning: C -G
Remarks: TI Electrical.
Your company has been indicated as the electrical contractor for the permit indicated above. In order for
the electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Division.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
WASHINGTON SQUARE LLC BOONES FERRY ELECTRIC INC
BY THE MACERICH COMPANY PO BOX 628
9585 SW WASHINGTON SQUARE RD WILSONVILLE, OR 97070
TIGARD, OR 97223
Phone #: Phone #: 503 - 682 -4936
Reg #: SUP 49 t 8S
LIC 88482
ELE 3 -223C
AN INK SIGNATURE IS REQUIRED ON T IS F e ' M
X /
Sig ature of Supervising Electrician
If you have any questions, please call 503.718.2433.
CITY OF TIGARD -
BUILDING DIVISION • PERMIT #: ELC2005.00561
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1013/2005
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
I PECTION WORKSHEET FOR DATE: 11/2312005 TIME: 7:00AM PAGE: 42
SITE A► PRESS: 09364 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIV ON: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NA : OCCHIAU L)A_SOl F
DESCRIPTION: TI Electrical.
OWNER: WA •HINGTON SQUARE LLC, PHONE #:
CONTRACTOR: BOO S FERRY ELECTRIC INC PHONE #: 503 - 682 -4936
Inspection Request Scheduled ' .r: Date: 11/23/2005 Pour Time:
Code # Inspection Descriptio • Confirm # Contact # Message
199 Electrical final 022348 -01 503-682 -4936
Corrections /Comments /Instructions:
=MIPZEITAA
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
CITY OF TIGARD . ,
BUILDING DIVISION _ PERMIT #:ar,'?,a*005b1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 ,, 1 �i
Inspection Requests (24 Hrs.): (503) 639 -4175 ....L F:
INSPECTION WORKSHEET FOR DATE: • 11 TIME: PAGE:
SITE ADDRESS: X 361{ S' & vs) k6kk 4 S�. CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: c
OWNER: ® l t `��'� PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: U•11. 0 Pour Time:
Code # Inspection Description Confirm # Contact # Message
k f--I csL. e't-Ec CAL.
Corrections/Comments/Instructions:
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PAN witay.:No c,L.Rekk ke.E Fea, Nre i 11 1b
�a n- -11 '6,4z.. V occ s cANN i br c1.141
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
A FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
n` KK r L y ,L
Inspector: V'��Q.. 1 V C B L Date: %1 1(05 Phone #: (503) 718 - �..��k6
CITY OF TIGARD
BUILDING DIVISION 5 PERMIT #: ELC2005`00561
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/3/2005
Phone: (503) 639 -4171 i,,1 ii
Inspection Requests (24 Hrs.): (503) 639 -4175 .. `'I —
INSPECTION WORKSHEET FOR DATE: 11/16/2005 TIME: 7:03AM PAGE: 38
SITE ADDRESS: 09364 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
g c-c-Tiu PROJECT NAME: DA SOLE )
DESCRIPTION: E Erical.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: BOONES FERRY ELECTRIC INC PHONE #: 503 -682 -4936
Inspection Request Scheduled For: Date: 11/16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 021435 -01 503 -682 -4936 N
Corrections /Comments /Instructions:
NO r' 6 j tA;11 A B C. Ai<t
� �cu Acs a �`Tl,' r \j w t^! 's ..
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❑ PASS XPARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: GA N LE Date: k j I (:)` Qr Phone #: (503) 718- 24 •
CITY OF TIGARD . . .
BUILDING DIVISION PERMIT #:6a.C w06'. aosid
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: _
Phone: (503) 639 -4171 AndNto
Inspection Requests (24 Hrs.): (503) 639 -4175 ^_ ..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: gg4' Sid IIJI -? CLASS OF WORK:
SUBDIVISION: A LOT #: TYPE OF USE:
PROJECT NAME: Ou,N 14-x, j p4— rjv
DESCRIPTION:
OWNER: �� PHONE #:
CONTRACTOR: ' �J` - / s•. "`4— PHONE #6p? •
�—/ T.4.
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
01 ' *0 bi i wi Co -eV 4144.141--- 93 5 097
Corrections /Comments /Instructions:
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clov De A u 6 0 5 S. v A(-- A R-tdL TO
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•
❑ PASS (► ∎1' PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N 66 Date: IA 1' Phone #: (503) 718- Ili4
CITY OF TIGARD ' '`
" ELC2005-00561
BUILDING DIVISION \ ' PERMIT #: 10/3/2005
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 �a
Inspection Requests (24 Hrs.): (503) 639 -4175 e1J1.
10/24/2005 7:02AM 64
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
09364 SW WASHINGTON SQUARE RD
SITE ADDRESS: WASHINGTON SQUARE CLASS OF WORK:
SUBDIVISION: OCCHIALI DA SOLE LOT #: TYPE OF USE:
PROJECT NAME: TI Electrical.
DESCRIPTION:
WASHINGTON SQUARE LLC,
OWNER: BOONES FERRY ELECTRIC INC PHONE #: 503 -682 -4936
CONTRACTOR: PHONE #:
10/24/2005
Inspection Request Scheduled For: Date: Pour Time:
Cc 2 # I / I ?ctiver Description SMi r 01 5a tgga 4 936 Mevage
617;rd'r 1191
Corrections /Comments /Instructions:
P
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N IJ1 Date: Cbi ZZ Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION ' "` PERMIT #: ELC2005 -00561
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/3/2005
Phone: (503) 639 -4171 /tyyi
Inspection Requests (24 Hrs.): (503) 639 -4175 J .44.1 ' - 7 1
INSPECTION WORKSHEET FOR DATE: 10/21/2005 TIME: 7:08AM PAGE: 41
SITE ADDRESS: 09364 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: OCCHIALI DA SOLE
DESCRIPTION: TI Electrical.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: BOONES FERRY ELECTRIC INC PHONE #: 503- 662 -4936
Inspection Request Scheduled For: Date: 10/21/2005 Pour Time:
,-
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 019001 -01 503 - 682 -4936 N
Corrections /Comments /Instructions:
c PROvith - O 65 ('8g- � 7 r T AND
Kr maib br6cdomm 46 A.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Q\ 'ki'v Date: 1 0124( Phone #: (503) 718- Zit-V)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00561
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/3/2005
Phone: (503) 639- 4171 j I l l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/7/2005 TIME: 7:05AM PAGE: 27
SITE ADDRESS: 09364 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: OCCHIALI DA SOLE
DESCRIPTION: TI Electrical.
OWNER: WASHINGTON SQUARE LLC. PHONE #:
CONTRACTOR: BOONES FERRY ELECTRIC INC PHONE #: 503-682 -4936
Inspection Request Scheduled For: Date: 10/7/2005 Pour Time:
Code # Inspec ' • • ! - _ '. ion Confirm # Contact # Message
105 Underground/slab cover 017747 -01 503 - 682 -4936 N
Corrections - • mments/Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G-A9- N Date: I Of 'I Us, Phone #: (503) 718- 2 L I S () *
CITY OF TIGARD L .: A v•
BUILDING DIVISION PERMIT #: ELC200Er00561
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/3/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1211/2005 TIME: 7 :08AM PAGE: 32
SITE ADDRESS: 09364 . .; WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHIN ' ON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: OCCHIALI SOLE
DESCRIPTION: Ti Electrical.
OWNER: WASHINGTON S ARE LLC, PHONE #:
CONTRACTOR: BOONES FERRY EL CTRIC INC PHONE #: 603. 6814936
Inspection Request Scheduled For: Date: 12/1/2005 Pour Time:
Code # **t" —' = ription Confirm # Contact # Message
199 Electrical final 022757 -01 503 - 682 -4936 Y
Corrections /Comments /Instructions:
\&E- ' 1 � _ 4T 1
.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �" ES13 Date: %2-- I • Phone #: (503) 718 - 2.4'It0'