Permit i l� CITY ®F G/"iR® ELECTRICAL PERMIT
PERMIT #: ELC2006 00022
„..,,41,1. MI
DEVELOPMENT SERVICES DATE ISSUED: 1/12/2006
, 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PARCEL: 1S12600 - 00300
SITE ADDRESS: 09378 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: 5 branch circuits.
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: 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: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 4 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 TIMBERLINE ELECTRICAL CONTRACTORS
BY THE MACERICH COMPANY PO BOX 298
9585 SW WASHINGTON SQUARE RD LAKE OSWEGO, OR 97034
TIGARD, OR 97223
Phone: Contact #: PRI 503 - 969 -8488
FAX 503 - 254 -4227
FEES
Description Date Amount Reg #: LIC 160037
[ELPRMT] ELC Permit 1/12/2006 $73.45 ELE 26-121 IC
[TAX] 8% State Surcharge 1/12/2006 $5.87 SUP 4957S
Total $79.32 REQUIRED ITEMS AND REPORTS
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. c estions to OUNC at
503 - 246 -6699 or 1 - 332 -2344.
By: , 4 Permittee Si natur "W.?, /
Issued B
Y .L�i ���= ��c l./.c t 9
OWNER INSTALLATION ONLY (
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: (LATE:
i.
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503 - 6394175 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 1pteiggMgail FOR OFFICE USE ONLY
City of Tigard Received ,, 0/ Permit No. vl �{,Q��
Date/By: r�
13125 SW Hall Blvd., Tig � 0',' 172232006 Plan Review Oth rPermit:
Phone: 503.639.4171 Fast. 03.598.1960 ( ' ' 1 /
Date/By:
Line: 503.63
BO 1 I + El See Page 2 for
�1r7 OF � �G Date Ready/By: J
Internet: www.ci.tigard. 33 Iv1910w Notified/Method: L. Supplemental Information flan,
_ - •TYPE OF WORK ' -- -.--' - .PLAN -= REVIEW. -_
,a r
ew construction .ddition/alteration/replacement Please check all that apply:
❑Demolition El Other: ['Service over 225 amps, comm'l 0 Hazardous location
['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
- - . .. ' 'CATEGORY OF CONSTRUCTION . - • r _ of 1- and 2- family dwellings 4 or more new residential
❑ 1 - and 2 family dwelling ' ommercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories ❑Feeders, 400 amps or more
❑ Multi family ❑ Master builder ❑ Other: DOccupant load over 99 persons ['Manufactured structures or
- - JOB SITE IN FORMATION AND_ LOCATION ❑Egress/lighttng plan RV park
❑Health -care facility DOther:
Job no.: /Z-z, Job site address: 0137g S (J, tA l )1l )yTYI s5 /t Submit 2 sets of plans with any of the above.
City/State/ZIP: -nGl40, O e_, 1-)z,7,3 The above are not applicable to temporary construction service.
S `.. -"FEE* SCHEDULE-.
Suite/bldgiapt no.: Project name: l�L� �P
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: ( ca Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
�(• Limited energy, residential 75.00 2
Tax trap /pare 1 no.: • Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK _ • Each manufactured or modular
A ^ ^ { 1 dwelling, service and/or feeder 90.90 2
Ac 2 -1 y 44 G I . . �� t!J 1,1 e _1_Pc V� /� • Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
El PROPERTY OWNER , • ' I 0 TENANT_ : 201 amps to 400 amps 106.85 2
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
.APPLICANT • I .. . ❑` CONTACT PERSON - A. Fee for branch-circuits- wit/,__
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 I 46.85 (6.85 2
Address:
Each add'l branch circuit 4 6.65 4.4D 2
City/ State/ZIP: Miscellaneous (service or feeder not Included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
_' _ ' ' . , CONTRACTOR _ - - energy panel, alteration, or
extension. Describe: Page 2 2
Business name: ¶1!--44 - G, COKrZ2�i nyis
Address: t� Uf i-_ Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: O-�v, R'7D39' Investigation per hour (1 hr min) 62.50
Phone: (So ) t351 ' ‘..iD89 Fax: &cab ) Z.Sy car? Industrial plant per hour 73.75
ELECTRICAL 'PERMIT FEES• • : .
• CCB Lic.: I(Oc03 -7 Electrical Lic.: zh, - a L c Suprv. Lic.: c./Si 8s Subtotal 73. y5
Suprv. Electrician signature, required: pp. Plan review (25% of permit fee)
Print name: Cf? (� 40 Date: ./z . d6 State surcharge (8% of permit fee) 7
TOTAL PERMIT FEE 1 9 . g ,
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 Tri-County Building Industry Service Board
•• Number of inspections per permit allowed.
1
,■ CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006-00022
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 1/12/2006
Phone: (503) 639 -4171 1
Inspection Requests (24 Hrs.): (503) 639 -4175 ... I L.
INSPECTION WORKSHEET FOR DATE: 11/1/2006 TIME: 7:03AM PAGE: 52
SITE ADDRESS: 09378 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: DUCK SHOP
DESCRIPTION: 5 branch circuits.
OWNER: WASHINGTON SQUARE LLC. PHONE #:
CONTRACTOR: TIMBERLINE ELECTRICAL CONTRACTORS PHONE #: 503-969 -8488
Inspection Request Scheduled For: Date: 11/1/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
,
199 Electrical final 039108 -01 503-313-0331 N
Corrections /Comments /Instructions:
ki
.PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v (e-9 Date: i I 1 • 6.6 Phone #: (503) 718- _244L__