Permit ., CITY OF TIGARD J ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00252 •
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/2/2008
PARCEL: 1S12600-00300
SITE ADDRESS: 09487 SW WASHINGTON SQUARE RD A05 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: MRS FIELDS COOKIES
Project Description: Low voltage for 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 ARROW MECHANICAL
BY THE MACERICH COMPANY 10330 SW TUALATIN RD
9585 SW WASHINGTON SQUARE RD TUALATIN, OR 97062
TIGARD, OR 97223
Phone: Contact #: PRI 503 -692 -1565
FEES Reg #: ELE 34 -47CLE
LIC 5193
Description Date Amount
[ELPRMT] ELR Permit 9/2/2008 $75.00
[TAX] 12% State Surch 9/2/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 Notifi - _ - - ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001- 100. You may obtain copies of these
rules or erect question to • • ' % . 503.246.6699 or 1.800.332.2344.
Issue By / Permittee Signature: 1°./t.____Z(
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.
- - .. Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
Day ' i{ +8 lir Permit No IL e ' -• 40.2.5
jig
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 DBy Other Permit
- 1 . 1 f , A It it Inspection Line: 503.639.4175 Date Ready/By tans ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method e lG Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ,Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/nems checked below)
❑ Demolition ❑Other ❑ Service or feeder 400 amps or more ❑ Building over three stones
where the available fault current ❑ Marinas and boatyards
•
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings
less to ground, or exceeds 14,000 ❑ Commercial-use agricultural
❑ 1- and 2- family dwelling Commercialindustrial ❑ Accessory building amps for all other installations buildings
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
❑ Emergency system larger separately derived system
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: 9 10011P or more occupancy
7 J � � . ❑ Six or more residential units ❑ Recreational vehicle parks
City /State/ZIP: ��- \ \\ ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt no.: Project name �ij k 5 �/ l j J / ` ( s e s. ❑ Service or feeder 600 amps or more
A 1 FEE SCHEDULE
Cross street/directions to job site: Desolation I Qty. I Fee. j Total I •
New residential single- or multi -family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: Limited energy, residential
DES PTION OF WORK (with above sq R.) 75.00 2
(/),/ez.e)3 ,,� r f ,,./::.. d Limited energy, multi- family
°f < ' � Tf „:71,,,,,L d. residenti al (with above sq ft) 75.00 2
/ 1 / & /et.
Services or feeders installation, alteration, and/or relocation
l / J A fP, f y itC3 S1✓ `, 7 i 200 amps or less 80.30 2
❑ PROPE OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: ze 6 3 , 401 amps to 600 amps 160.60 2
/'l 4 �4 tAe Ei 601 amps to 1,000 amps 240.60 2
Address: (poi As+ 8,a.( � J ! ceu l i ( t — Over 1,000 amps or volts 454.65 2
.,?_, Temporary services or feeders installation, alteration, and/or
City/ State/ZIP: , '2 f 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 amp 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: Date: Branch circuits — new, alteration, or extension, p er panel
y � A. Fee for branch circuits with
io APPLICANT l igt CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: A g RC> J i!,„,. at ► 640 1 B. Fee for branch circuits
Contact name: (�yLr. e 7 O 'e A25,S without service or feeder fee, 46 85 2
first branch circuit
Address: 10330 /J u/ 7�n I ,v T1 rJ Each add'I branch circuit 6 65 2
Miscellaneous (service or feeder not included)
City /State/ZIP. «'T" lP orc. 4 -j Each manufactured or modular 90 90 2
dwelling, service and/or feeder
Phone: ( 4 6.G+ 2 _ i 6-6 r Fax.. (t ';S) tel I - i 6 - 74 Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Si 53.40 2
Business name: in ignal circutt(s) or limited -
A i Rb►eb /' 6LFIAlg` t'tI energy panel, alteration, or
extension Describe Page 2 2
Address: 3 3 6 6v1 *u.� l•wT4�l 1 ,
City/ State/ZIP: –1–La A `XTI N 0' 4746 L Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( j 6 ---15 7 / 1 /# Fax: (g03) M – 18 71 Investigation per hour (1 hr min) 62.50
CCB Lic.:b -iq g Electrical Lic.: 311- y7ta: Suprv. Lic.: 13 Industrial plant per hour 73.75
/,, ELECTRICAL PERMIT FEES R- 7,c,
Suprv. Electrician signature, required /R /0 4,,za
Subtotal I
Print name: Q O G /t r C. j A 5- L c L Date: Plan review (25% o of permit fee).
I p /6 4 ff State surcharge (12% of permit fee) -
Authorized signature TOTAL PERMIT FEE 2 y P
t
Print name: Date. This p ermit application expires if a permit is not obtained within 180
days after it has been accepted as complete
CITY OF TIGARD
BUILDING DIVISION PERMIT #: FLR2008.O02 ,2
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/217008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175- �' I �..
INSPECTION WORKSHEET FOR DATE: 11/612008 TIME: 7:00AM PAGE: 49
SITE ADDRESS: 09487 SW WASHINGTON SQUARE RD A05 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE. LOT #: TYPE OF USE:
PROJECT NAME: MRS FIELDS COOKIES
DESCRIPTION: Low voltage for HVAC
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: ARROW MECHANICAL PHONE #: 503
Inspection Request Scheduled For: Date: 1116/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
'' Electrical final 077705-01 503.692 -1565 N
Corrections /Comments /Instructions:
N
N ------- \
1
- k 7 V \ \
* PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �" Mete Date: II 6 Phone #: (503) 718- _ V440_