Permit CITY ®F T' G �4 R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00513
l IL , k‘ DEVELOPMENT SERVICES DATE ISSUED: 08/28/2000
- 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 1 S126C0 -01107
SITE ADDRESS: 09459 SW WASHINGTON SQUARE RD A -14
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G • BLOCK: LOT : JURISDICTION: TIG
Proiect Description: (1) signal circuit -
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: 1
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: 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:
PPR WASHINGTON SQUARE LLC ELECTRICAL DIMENSIONS INC
BY THE MACERICH COMPANY PO BOX 12146
ATTN: JANET FISHER, ASSET MGNT 3961 SW WILLAMS AVE
SANTA MONICA, CA 90407 PORTLAND, OR 97212
Phone: Phone: 282 -7255
Reg #: LIC 00044008
SUP 2964S
ELE 26 -432C
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Final
PRMT CTR 08/28/200C $60.00 2720000000(
5PCT CTR 08/28/200C $4.80 2720000000(
Total $64.80
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 rf 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987. y�
PERMITTEE'S SIGNATURE ISSUED BY: ( / J GJ
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 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Plan Check #
13'125'SW HALL BLVD. R ECh ( Cel Permit Application Recd By
TIGARD OR 97223 # � O37 - 3 c Date Rec'd
Phone (503) 639 -4171, x304 AUG 2 8 Z00910 3 to pur)z-r-itt. Date to P.E
Date to DST
Inspection (503) 639 -4175 Permit B- m®plj�r7
Fax (503) 598 -1960 wooly DEVELU of Type
Called ed # � C 2om0 p�►Sj
Incomplete or illegible will not be accepted
1. Job Address:
r�tQL 4. Complete Fee Schedule Below:
Name of Development wu�f SQGUAKi. m4L` Number of Inspections per permit allowed
Name (or name of business) FPCJT'LOGK't fr . Service included: Items Cost Sum 4
Address gg s -� / a (4 f taiff PIS 4a. Residential - per unit
City/State /Zip 1 +(9� 1 I) / o R 1000 sq. ft or less $ 117.75 4
r
Each additional.500 sq. ft. or
portion thereof $ 2625 1
Commercial
Residential ❑ Li mited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data base). y} -��,� Installation, alteration, or relocation
... iL(�t I�.Z+C.r
Electrical Contractor 11• ' TrY) 5 200 amps or less $ 64 25 2
Address o I A.) , La 2Z2. _ S 201 amps to 400 amps $ 85.50 2
City PD X State 0 Zi 6 !' ZZ -' 401 amps to 600 amps $ 128 50 2
R p 601 amps to 1000 amps $ 192.50 2
Phone No. 2 2 -- 7' Over 1000 amps or volts $ 363.75 2
Job No. R® 377 Reconnect only $ 53.50 2
Elec. Cont. Lice. No.2.4)- 7 Exp.Date 6 4c. Temporary Services or Feeders
OR State CCB Reg. No. 60 Exp.Date /�p 6# Installation, alteration, or relocation
COT Business Tax or Metro No. j 17 L i Exp.Date tipD 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n _Adezt„, 401 amps to 600 amps $ 1 07.00 2
Over 600 amps to 1000 volts,
License No
2 - S Exp Date /e/6//e3/ see "b" above.
Phone No. 7-53 - 7-ZSC' 4d. Branch Circuits
New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5 35 2
Address b The fee for branch circuits
without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit $ 37.50
Each additional branch circuit $ 5.35
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42 75
Owner's Signature Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy
3. Plan Review section (if required):*
panel, alteration or extension $ 60.00 60, ( f�
Minor Labels bels (10) $ 107.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 50 00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
described in N.E.0 Chapter 5 5. Fees:
5a . E t total of above fees $ (p 0 .0
* Submit 2 sets of plans with application where any of the above apply. F9) A Surcharge (.9&X total fees) $ 4 ,
Not required for temporary construction services. Subtotal *or $
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec 3) $ -
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED
Subtotal $ ------
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ & f s e
i \dsts\forms \electric.doc
"_C V OF TIGARD BUILDING INSPECTION DIVISION
k - 24.iHour Inspection Line: 639 -4175 - Business Line: 63 ° MST
BUP
_ Date Requested 7 / 3 AM PM ' BLD
Location t' fi L/ i 1 5 6 1/ 416 s 4 4I 6,,,, Suite 4/ G/ MEC
Contact Person ' - /Ph 2Er ' 7C) S, PLM
Contractor - Ph P )t . ( / 0 • / � SWR �°`�° ° ° s�
BUILDING Tenant/Owner / ELC 0 •Cpd 4/4 7
Retaining Wall y / E L R v Z `� )1 ° c $ 3 r7
Footing rr- r7:(S i.V 1� \`; Iii ;,i? �� � yV,!,: i .u.� rs♦ ,
'"` "% t FPS
Foundation . �r s L+y�` 't!',�� ��, � �` � i �� y �`�}� �'f � � � � •�, .
Ftg Drain , z. t '
I� )r t , ' d - }►I' `r"a�:'.'4= . °« !•i
:J ' '/ -
Crawl Drain - Inspection Notes:
Slab '' cuA 2 ) ' - / - SIT
Post & Beam` / , •
Ext Sheath /Shear i
Int Sheath /Shear ,•,, .
Framing _ EL 2.. 7 -+5- ), e o.� /
Insulation ^ ,-
Drywall Nailing • l
Firewall v___ " �' ``
Fire Sprinkler -7i -/t �i �0
Fire Alarm -
Susp'd Ceiling -
Roof s •
Misc: P
Final \..
1 ' ,
. 'PASS . PART : FAIL
PLUMBING - E Le ? S-77 . _ - -
Post &, Beam - •
Under Slab - .
- Top Out
Water Service ��jl�y , �a��
• •
Sanitary Sewer - -
Rain Drains - '- • d 76
Final . /
PASS ' PART FAIL , ( _ �
MECHANICAL _V — ,----
Post & Beam .. -
Rough In .
Gas Line V `
Smoke Dampers ,
Final
PASS PART FAIL .
ELECTRICAL
Service
- Rough In
UG /Slab '
I.:
V
PAS PART FAIL - I.
SITE'
• Backfill /Grading (
-
Sanitary Sewer ' " c -
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ,
[ ] Please call for reinspection RE: y /;, [ ',Unable to inspect - no access
Fire Supply Line _ r
ADA V
Approach /Sidewalk K 4
Other Date Inspector Ext
Final
PASS PART FAIL DO .NOT REMOVE this inspection record from the job site.