Permit C ITY OF TIG ARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00407
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/5/2007
PARCEL: 1S12600-00300
SITE ADDRESS: 09393 SW WASHINGTON SQUARE RD S11 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: ABERCROMBIE & FITCH
Project Description: Data telecommunication install.
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A: RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
• INSTRUMENTATION: OTHER: .
TOTAL # OF SYSTEMS: 1
Owner: ) Contractor:
WASHINGTON SQUARE LLC LIBERTY COMMUNICATIONS
BY THE MACERICH COMPANY 2191 NE LIBERTY AVE.
9585 SW WASHINGTON SQUARE RD GRESHAM, OR 97030
TIGARD, OR 97223
Phone: Contact #: PRI 503- 674 -4922
FAX 503- 674 -4932 ,
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Reg #: ELE 26- I035CLE
FEES LIC 101807
Description Date Amount SUP 3990LEA
[ELPRMT] ELR Permit 11/5/2007 $75.00
[TAX] 8% State Surcha 11/5/2007 $6.00 REQUIRED ITEMS AND REPORTS '
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 quest'•ns to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: /, _ / . f 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.
aL e -. ' RTY COMM. INC 503 - 674 -4932 P. 1
Electrical Permit' App c:' ' ta CE i . 1 ' s*
' "" t' — - -- - FOR - OFFICE LISE - - -- - - - - - --
' ' City of Tigard Received
] Received
: v r v1<7T O 5 200
Date/By 1/57.21 Pennil No.' 05 V — OD Y, /
13125 SW Hall Blvd Tigard, OR N an Review
Phone 503 Fax 503 598.1960 DateBy Other Permit:
TI G A RD Inspection Line: 503.639 1 Date Ready/By )uri� la See Page 2 for
Internet: www.tigard - or.g T Y V� d jC � Nottfied/Mcahod Supplemental Information
D' tl As foNi PLAN REVIEW
. Ncty' construction ❑ Addition/alteration /replacement Please check all that apply (submit 2 sets of plans whteins checked below)•
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other:
where the avadabte fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings
El 1 - and 2-family dwelling Commercial /indusVtal less to ground, or exceeds 14,000 ❑ Commercial-use agricultural
❑ Accessory building amps for all other installations buildings
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system
❑ Addition of new motor load of ❑ "A ", "E', "I -2 ", "1 -3
Job n0.' Job site addreS 1�� /^ P���J/ IOOHPormore ocwupanc}
3 "" �,)a5� pet ' ❑ Six or more residential units ❑ Recreational vehicle parks
City/State /ZIP: 'r! // JJ � r� D t2 q 7 ^ / 3 ❑ Health -care facilities ❑supply voltage for more than
l r� rd I V - r/ ❑ Havaidous locations. 600 volts nominal
Suite /bldg. /apt. no.: Project name: fi`• eit j/m h , f /• k/ /i ❑ Service or feeder 600 amps or more
Cross street/directions to job site FEE SCHEDULE
Dexnpiio° I Qn. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.. 1,000 sq. R. or less 145.15 4
Tax map /parcel no.. Ea. add'I 500 sq. R. or portion 33 40 1
' Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq Il.)
k P /) S / t „ L Limited energy, multi - family
75.00 2
�, ��..[[�� C I_!� -/ J residential (with above sq fl )
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
N
•
ame: 401 amps to 600 amps 160.60 2
Address:
601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 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 1 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 599 amps 133.75 2
Owner signature: Branch circuits — new, alteration, or extension, panel
Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
Business name:
each branch circuit 6.65 2
B Fee for branch circuits
Contact name: without service or feeder Ice, 46 85 2
first branch circuit
Address: Each add branch circuit ' 6.65 2
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Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular
Phone' ( ) Fax: : ( )
dwelling, service and /or feeder 90.90 2
Reconnect only 66.85 2
E-mail Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Q
Business name: ; 6 L.rr L ` Signal circuit(s) or limited -
mufti C /
a J energy panel, alteration, or
Address 1q I �6 1.-1 h ' x 1-11/ - extension Describe' Page 2 2 cA,
City/State /ZIP: (, a__� J U % 7L) 3 a Each additional inspection over allowable in any of the above
Phone: �" (�/} 3 ) W� // __ I Fes 6a3) i / 7 1 - q Per inspection 62.50
' > � - J 'i [ �� 6 .J t: n per hour (I hr min) 62 50
e „ •
tJ CCB Lie.: / pi � 7 Electrical Lic. G ,� / (,Q prv. Su L Ic. .99 O Industrial pl per hour 73.75
1.� U Investigation on ELECTRICAL PERMIT FEES i
Suprv. Electr signature, required: 7 � - tit. a/ Subtotal:
V O Print nameO }{. / id
Date: I , ---6 7 I f/ Plan review (25% of permit fee)
"`"'�ff�� t
Authorized signature: State surcharge (8% of permit fee): e°- / . TOTAL PERMIT FEE: • . "� ■
Print name: - Date: C This permit application expires if a permit is not obtained within 180
v days after it has been accepted as complete.
CITY OF TIGARD ■
BUILDING DIVISION PERMIT #: EI-R2007.00407
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/5/2007
Phone: (503) 639-4171 174,01,1111'
Inspection Requests (24 Hrs.): (503) 639 -4175 . ' ..
INSPECTION WORKSHEET FOR DATE: 11/20/2007 TIME: 7:00AM PAGE: 6
SITE ADDRESS: 09393 SW WASHINGTON SQUARE RD 511 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME. AI3E RCROMBIE R FITCH RA L
DESCRIPTION: Data telecommunication install ---
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: LIBERTY COMMUNICATIONS PHONE #: 543 - 674 - 4922
Inspection Request Scheduled For: Date: 11/20/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 EIectiical final 060021 -01 646-54B-28M N
Corrections /Comments/ Instructions:
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J,A
v\
0 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ► Nt8 Date: ti ( A P I Phone #: (503) 718- ���'V