Permit A .
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00191
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/14/2006
PARCEL: 1512600 -00300
SITE ADDRESS: 09432 SW WASHINGTON SQUARE RD K - 2 ZONING: C -
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Sprint, CCTV installation.
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: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: CCTV X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC SIEMANS BUILDING TECHNOLOGIES INC
BY THE MACERICH COMPANY 3025 SW CORBETT AVE
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97201
TIGARD, OR 97223
Phone: Contact #: FAX 503- 234 -8030
PRI 503- 234 -9995
FEES Reg #: ELE 37- 962CLE
LIC 133041
Description Date Amount SUP 795LEA
[ELPRMT] ELR Permit 8/14/2006 $75.00
[TAX] 8% State Surcha 8/14/2006 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503 -2k6 -6699.
Issued By: Permittee Signature 6
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
. Pleettleal Permit Ails 1' • WI Y ; l Y . FOR OFFICE U •
m t' rte, i t /}, Q
City of Tigard Received Permit No.: v /
13125 SW Hall Blvd., Tigard, OR 97223 1 [� P Plan Review
Phone: 503.639.4171 Fax: 503.598.1960AUG 1 , 2006 '� Date/B Other Permit:
I � �
Inspection Line: 503.639.4175 y'I I ; Date Ready/By: ram . See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
U1 Ur JJih$ .R i
at Pfi T RI�
O 1 1TVII�T,. • PLAN REVIEW
❑ New construction ddition/alteration/replacement Please check all that apply:
❑Demolition ❑Other: ['Service over 225 amps, comm'l ❑Hazardous location
['Service over 320 amps - rating DBuildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
1=1 I- and 2- family dwelling ;Commercial /industrial 1=1 Accessory building ['System over 600 volts nominal units in one structure
❑ Multi- family ❑Master builder ❑Other: ❑Buildin over three stories ['Feeders, 400 amps or more
['Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION • DEgress/lighting plan RV park
Job no.: Job site address: Qt'' fa ❑Health -care facility ['Other:
sW (AJ s�� - a � u Submit 2 sets of plans with any of the above.
f l
City/State /ZIP: e &Y � t 1 2 .3 The above are not applicable to temporary construction service.
,
Suite/bldg./apt. no.: / FEE* SCHEDULE
Project name: (� ((
5 Poll 14 IV0 qa 1 (� Description Qty. I Fee. 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'l 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
-�.� I I hSr A.�DESCRIPTION OF WORK Each manufactured or modular
CCCTV V � a� 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: S P Q kir 601 amps to 1,000 amps 240.60 2
Address: 6 10 0 5er�y�{. Va rkw,r Over 1,000 amps or volts 454.65 2
f Reconnect only 66.85 2
City/State /ZIP: QVeytaVa( I it KS 4 ( P 2, / 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 ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
first branch circuit 46.85 2
Address: Each add'l branch circuit 6.65 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 73 4
n t extension. Describe: Page 2 2
Business name: 5 I e 4Ake l � ut ickw C�elo
Address: 30Q5 5 (, J NA L-% Age_ J Each additional inspection over allowable in any of the above
` Per inspection 62.50
City/State /ZIP: ?oy.t a g. L aO I Investigation per hour (I hr min) 62.50
Phone: (()3 _ 51 Fax: 9;3) 0 23y —g 30 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lie.: 13301.kk Electrical Lic • 7 9 I Sup Lic.:793 ,6 py Subtotal
Suprv. Electrician signature, requir Plan review (25% of permit fee)
// State surcharge (8% of permit fee)
Print name: ( Date:
TOTAL PERMIT FEE 8/ 0 0
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.
i ABuilding \Permits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02/COM/WEB
1 . _
CITY OF TIGARD
BUILDING DIVISION T PERMIT #: ELR2006 00191
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/14/2006
Phone: (503) 639 -4171 ''",, i ;\ illri
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/29/2006 TIME: 7:01AM PAGE: 38
SITE ADDRESS: 09432 SW WASHINGTON SQUARE RD K - 2 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SPRINT
DESCRIPTION: Sprint, CCTV installation.
OWNER: WASHINGTON SQUARE L.LC, PHONE #:
CONTRACTOR: SIEMANS BUILDING TECHNOLOGIES INC PHONE #: 503 - 234
Inspection Request Scheduled For: Date: 8/29/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 035711 -01 503-891 -4359 N
• 1 C: ‘, q •NL- -
Corrections/Comments/Instructions.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Q N V LE Date: % Vi• Phone #: (503) 718. '