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Permit • CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT �;A DEVELOPMENT SERVICES PERMIT #: ELR2005 -00318 ,. I - ' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/4/2005 PARCEL: 1S12600-00300 SITE ADDRESS: 09390 SW WASHINGTON SQUARE RD ZONING: C -G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG Project Description: HVAC. 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: OUTDOOR LANDSC LITE: OTHER: : HVAC: X PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: WASHINGTON SQUARE LLC OREGON HEATING & AIR CONDITIONING BY THE MACERICH COMPANY PO BOX 397 9585 SW WASHINGTON SQUARE RD DUNDEE, OR 97115 TIGARD, OR 97223 Phone: 503- 639 -8865 Phone: 503 -538 -2953 Reg #: ELE 522LHR LIC 125815 FEES Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 10/3/2005 $75.00 [TAX] 8% State Surcharl 10/3/2005 $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 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699. Issued By: Permittee Signature: OTC/ /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: 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. Sep 29 05 02:43p RE E V' 503- 537 -2172 p.1 ` IRr6 . . . • ... .. . Electrical Permit Applicati n005 r�. FOE. OFFICE USE ONLY p - City of Tigard SE? DateJBY gA-05- « v etmitNo- :Fide -200.5 C/v gia '� 13125 SW Hall Blvd., Tigard, OR 97223 `("� PlanReview �(PaZOO.��O Phone: 503.639.4171 Fax: 503. 9 4 Other Perrrlt: �, '� DIVISI °'."al DateBye: dy 5�a 9 Inspection Line: 503.639.4? 75 ! _ Date ReaBy kris El See Page 2 for Internet: wwwci.tigard.or.us %A LA-- - Notified/Method- T! G pp [ � V +'r Supplemental � �d •r- '' a`ta�r: � ae of MM. .e ,i s fc BCsT # ;9 �� «�i , L h y , `nai kh� t 5'•;f'.'ti�J..r ; ,i y t; c -:y _.. J s,�?,,e . &1 �'f3•� - i i (� vl.. r.. r Sk del ,` I x t ]: - a'"4 �' •lrc i`;liVe A�.k' 6� •�' - c. •.•,•. er.>,Nf`>Fi,ts�', ° .•i.,• r. • i,':3ltd •lF5 s �v<3t•,�,:�% ..,6+�m -;? ... �;`'`�, _ . ❑ New construction ❑ Addition/alteration/replacement Please check all that apply: 0 Demolition ❑ Other: ❑Service over 225 amps, comm'l ❑Hazardous location $ �� A " 9r ti br �t.' N + +•,u ., , . ❑ Buildng over 10,000 sq. ft , 14' i n 0... e s R FC,:a:s! .4 sr•;na., r. ti', :N, i - .v ;-.:.. ❑Serrice over 320 amps - rating '� ,,:' - era =ti "r1 = v= �e i t,, .4r �Y�1T2 h � R K.., © .-- - t.. ! -* :I t o i ry: }io t o :: �3rstr: ;;t_1•�.Y..- ,..� �:,�, � a,. cr.; rr1+, t:! r_; ���,. tr" �x. rr,= �+ ��y _�i•d�l (:.t' rte of 1 -and 2-family dwellings 4 or more new residential El 1 and 2 dwellin Colnmerclal /industt ia ['System over 600 volts nominal units in one structure g ❑Accessory' building ['Building over three stories ['Feeders, 400 amps or more ❑ Multi 0 Master builder ❑ Other: �, ['Occupant over 99 persons ❑ structures or �}�� yrj 1 r ; ,N.x i : a �.V -'• �' �z ,n��rl_�W,,.� %c.:a- y,.1M•�.•x r,y -�,��+ ds:w.° � y rt,�•u �.y.,t:�. ❑0 t loadove Manufzctlredstrvctur - li r- ,r o& 'll'i-'k itL`tr,0 [Oti .,.p N " „ rt1 + 1s1 �"' 1 ` :�=T•- ' -� y °'ii RV to:. c.d7 .�51cr, ._x,., v,� y `� �' , r•.r ,_: r- ❑E ess/li htin plan )Z park - ,,.a`,. - ��:.�r _ , •fi.a, , - c�.r�aaa -v •('. 1;:•.i ,�':a,- •��s� - 's � Sr g gP Job no.: Job site address', ❑Health -care facility ['Other: ..-;---- 7 �-� ; 11� i� i a iI.Sy Subrmt 2 sets of plans with any of the above. City/ State/ZIP. + 1( � 9 9D tJ not applicable The above are no ppli c able to temporary construction service. Suite/bldg. /apt no Project name : 6 aa -¢' k :- t' ' " " • ' 7 ' .:J ; : Description I Qty. 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 I 145.15 I 4 Subdivision: I Lot no.: Ea. add'] 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 ; , a � , ue , _ � -, . y r _ . Limited energy, non - residential 75.00 2 ,., -'�'' "+- `� ' ° �• �' 'Rt � ll�% Each manufactured or modular • dwelling, service and /or feeder 90.90 2 Services or feeders installation, alteration, and/or relocation 200 amps or less I 80.30 2 r 11 • ^ , a k t ',P ':- tiezi ,ii; !x o - y ,• Is; x -a ra. -,y... s to 400 s 106.65 2 �`` : r - r s: r 201 ampp O1' -'-` Y© S '''' -'- 1 w n t• r *:'. „ yam' i;ti:��' •..,a�:. * .�:� Q _. ( � � � ^ r .s ��-F�. ` i'~. !`���;ff,.`?: 401 harps to 600 amps 160.60 2 Name: •1: V •- r-A- � 1 C t e 601 amps to 1,000 amps 240.60 2 • Address: 93 90 C (� t y l k , f^ h ` f (�,Y}_„r> Reconnect 1,000 amps or volts I 454.65 2 �`` J 2 -�+-^� � ` � 1 � I Reconnect only I - 66.85 I 2 City/ State/ZIP: "� Temporary services or feeders installation, alteration, and/or Phone: ( ) 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 79►3r , f'• -- .- J.. ( `' -r `•" :r_• <GU' - .i - " - 7 -.- 1 -.< • ti c. r t l t" 1 ,a ` z d • u °r A. Fee for branch circuits with I - rrcll. .i 1i .... r `r ' r r 4 R 9 .r service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2. Address: each branch circuit Each add'] branch circuit 6.65 2 City /State/ZIP: Miscellaneous (service or feeder not included) Phone ( ) I Fax:: ( ) Pump or irrigation circle 53.40 . 2 Sign or outline lighting 53.40 2 E - mail: >.�t• ,�J x 4 W � � � -ray„ �,,_ � : <•: Signal circuU(s) or iimited- Y x��'f,•_ • ygit'ir .a�;�;,ydt"••" -, ++: {i' D '''r �4' ••. r 'f1 •?:$'< .,�•'' 1 q,4; /✓ ^f i;. •rr 7e energy Pan el, alt eration, or tr'�:tis �1�� .�Y.'....n �.�:_ <] �t:•.^t...:A't� r � >)•��- Sp�Y V.'r� C: ,. '. ; :'_..z- ., :._ extension. Describe: ( Page 2 r 2 Business name: C c • r ' -1-1-Ea 1 l ( fli f awl me l+�iV` Address: r\ Z ,tip/ �� l �• � q-_ U 1 Each additional inspection over allowable in any of the above I r � J ��% 1� `1 _ sb�n � Per inspection 62.50 - City /State /ZIP: � QS.% G�) (� ` 1 - Investigation per hour (t lir min) I 62.50 Phone: ( < < P) - D-g53 Fax :.)3 33-1 ' "7 Z Industrial plant per hour I 73.75 CCB Lic.: I )3- I Electrical Lic.: Lie.:'I ~O ( ?�. p,-a.r r - "z��'y't� ?b $: 1 : - w - ':: uprv. Subtotal qs. 60 Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: ! s l i/'t� .� I Date: ..� State surcharge (8% of per-..it fee) b 0 0 j r y , TOTAL PERMIT FEE 1.0 0 Authorized Signature. This permit application expires if a permit is not obtained nithinMO 1 Print name: Date: after it has been accepted as complete Date: • Fee methodology set by i ri-County Building Industry Service Board . " Number of inspections per permit allowed_ 0 nuildtag \Parnits\ELC- perrnstApp doe 17103 440.46 13T(10ro71Cp1 8 CITY OF TIGARD BUILDING DIVISION - PERMIT #: ELR2006 -003113 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/4/2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7:12AM PAGE: 142 SITE ADDRESS: 09390 SW WASHINGTON SQUARE RD CLASS OF WORK: SUBDIVISION: WASHINGTON SQ + ARE LOT #: TYPE OF USE: PROJECT NAME: NAARTJIE CUSTO IDS DESCRIPTION: HVAC. OWNER: WASHINGTON SQUARE C, PHONE #: 503 - 639.8865 CONTRACTOR: OREGON HEATING & AIR ONDITIONING PHONE #: 503-538-2953 Inspection Request Scheduled For: ' 11/14/2005 Pour Time: Code # Inspection Description Co` # Contact # Message 199 Electrical final 0210 01 503538 -2953 Y • Corrections /Comments /Instructions: • • • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: GI N Date: u.14-06- Phone #: (503) 718 - iiI t •