Permit a CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00836
�i� DEVELOPMENT SERVICES DATE ISSUED: 10/26/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600 - 00300
SITE ADDRESS: 09502 SW WASHINGTON SQUARE RD J -3 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: TI Elec. and low volt. voice /data.
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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 17 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000 + /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
WASHINGTON SQUARE LLC LAUGHLIN ELECTRIC LLC
BY THE MACERICH COMPANY 3 MONROE PARKWAY STE. P PMB205
9585 SW WASHINGTON SQUARE RD LAKE OSWEGO, OR 97035
TIGARD, OR 97223
Phone: Phone: 503 - 449 -7389
FEES Reg #: LIC 165763
ELE C86
Description Date Amount SUP 5097S
[ELPRMT] ELC Permit 10/26/200: $234.90
[TAX] 8% State Surcharge 1 0/26/200' $18.79 REQUIRED ITEMS AND REPORTS
Total $253.69
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 •tification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or , ir: t qu - o OUNC at
503 - 246 -6699 or 1 -800- 2 -2
Issued By: �� Permittee Signature: k , /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.
' r t2lito— Electrical Permi -',. . USE °NI .
,
Received
City of Tigard , DateB . [ D a 06 L33 Permit No F-4, a- Zit, 8'3(
7
13125 SW Hall Blvd., Tigard, OR , 223 c , - Plan Review
Phone: 503.639.4171 Fax: 503.{ 8.1960: o 2005 C -. °t•. �+ i `'• Date/B Other Permit.
Inspection Line: 503.639.4175 J -'l L Date Ready/By Jw s ® See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method Supplemental Information
BU I L DINEEDMI MONK PLAN REVIEW
❑ New construction Addition/alteration/replacement Please check all that apply:
El Demolition Other: OService over 225 amps, comm'I 0 Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION . - of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building OSystem over 600 volts nominal units in one structure
El Multi [ � Master builder ❑ Other: ❑Building over three stories 0 Feeders, 400 amps or more
DOccupant load over 99 persons ❑Manufactured structures or
JOB , SITE INFORMATION AND LOCATION DEgress/lighting plan RV park
Job no.: Job site address: SQ.,,, Sw3 ❑Health - care facility ❑der
Submit 2 sets of plans with any of the above.
City/ State/ZIP: 9502 5a u ...
"7r'" 5. R p The above are not applicable to temporary construction service.
• - FEE* SCHEDULE
Suite/bldg. /apt. no.: 703 Project name: sb.orl vit€ 1 eh Description I Qy. I Fee. I Tar 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: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
La /i) 1/ (4y dwelling, service and/or feeder 90.90 2
/ Services or feeders installation, alteration, and/or relocation
UL// 200 amps or less 80.30 2
El • PROP RTY OWNER I ' ❑ 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 1 33.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
' ❑ APPLICANT • I ❑ 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, I 46.85 26 2, 2
Address: each branch circuit
Each add'I branch circuit 17 6.65 11.3.o5 2
City/ State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax::( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
Q CONTRACTOR energy panel, alteration, or
1 Business name: t � / r - . e a yc LL B extension. Describe Page 2 - 7 1/4 5 - . 2
i Address: 3 4„,,,,,,L A...,4 Kie. f p,,,�g ZOS Each additional inspection over allowable in any of the above
Per inspection 62.50
I City/State/ZIP: hie 0 oe Investigation per hour (1 hr min) 62.50
r Phone: (60 ) yq9 - -71,69 F a x : (',jd3 ) (3q a -77 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: /65-763 Electrical Lic.: L 86 Suprv. Lic.: A911 75 Subtotal
Suprv. Electrician signature, required: iti !./( e _ 10/I /a ? Plan review (25% of permit fee)
I 10 St ate surcharge (8% of permit fee)
Print name: 4 A L...yl.� io/ 0� Date: �Q. ZS . s /K• 7 6 t TOTAL PERMIT FEE A5-3_ _ to
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\ Building \Pennits\ELC- PermiAppdoe 12/03 440- 4615T(l0/02/COM/WtB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined........ $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
I COMMERCIAL WORK ONLY: _" .:
Fee for each commercial system. $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i \Bwldmg\Permtts\ELC- PamitApp d« 04/03
CITY OF TIGARD
BUILDING DIVISION R. PERMIT #: ELC2005 -00836
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/26/2005
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175 - `' I L •
INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7:12AM PAGE: 39
SITE ADDRESS: 09502
SW WASHINGTON SQUARE RD J-3 CLASS OF WORK:
. SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SMART WIRELESS
DESCRIPTION: TI Elec. and low volt. voice/data.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: LAUGHLIN ELECTRIC LLC PHONE #: 503-449-7389
Inspection Request Scheduled For: Date: 11/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 Ceiling cover 021150 -01 503-449-7420 N
•
Corrections /Comments/ Instructions:
n10st- (Z.
•
(l PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL 5ct C L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: YV 41 '- Phone #: (503) 718- . V/4
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00036 '
13125: W.Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/26/2005
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/27/2005 TIME: 7:16AM PAGE: 7
SITE ADDRESS: 09502 MA/WASHINGTON SQUARE RD J-3 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SMART WIRELESS
DESCRIPTION: 11 Elec. and low volt. voice/data.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: LAUGHLIN ELECTRIC LLC PHONE #: '503.449
•
Inspection Request Scheduled For: • Date: 10/27/2006 Pour Time:
Code # Inspection Description m Contact # Message
120 - = 019553-0 503 - 449-7420 N
16 c-Aws °" t
Corrections /Comments /Instructions:
A PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1 Date:
Inspector: °12ri(— #: 718
� �T � NoV tai Q� Phone : (503) - 2"►`'�b
CITY OF TIGARD .
BUILDING DIVISION .. PERMIT #:a_C , ?005_ d d g'3 6
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 _..'.� ^ IL.
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
5 2
SITE ADDRESS: (1fr , S 0. RI) CLASS OF WORK:
SUBDIVISION: , LOT #: TYPE OF USE:
om -2
PROJECT NAME: ,n y� .
DESCRIPTION: W '�
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: // - /S Pour Time:
Code # Inspection Description Confirm # Contact # Message
/C-6 oa
/3 /'7
Corrections /Comments /Instructions:
CO w -
•
El PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
I
Inspector: oe - Date: 1 I C6
4 Phone #: (503) 718 - `� 4
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Li e: (503) 639 -4171 MST
BUP
Received Date Requested sacM PM BUP
lor
Location SQ Suite MEC
Contact Person Ph (.Z5 J7 t & 4 4 3 PLM
Contractor _ - Ph ( ) SWR
/
BUILDING Tenant/Ow - IN -1/4.11 Z - - - / A Z aJ ELC
Footing ELC2.0 O }..
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Note- • SIT
Post & Beam
Ext Sr Sh ea Anchrs
th /SSh ear /97 aisee 19
Ext eah/h I'
Int Sheath/Shear •
Framing
Insulation
Drywall Nailing (` (� I
Firewall , kts 1 5 �1 _1 �1 11�E)q. �L f' CAL. OAV-
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: 111. F-11)44 S R
Final -
PASS PART FAIL
PLUMBING 1Cs N\—& \
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In .
Gas Line
Smoke Dampers
Final
IL
ELECTRICAL
Se -
Rough -In
UG/Slab
Low Voltage
Fire Alarm
ZIP El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA I
Approach/Sidewalk Date 7 6. Inspector ��7 Exi» 4
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD ELF Q
BUILDING DIVISION PERMIT #:nd 3 0 6 8 3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 rl
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR ' DATE: TIME: PAGE:
SITE ADDRESS: 7,56-2_, �- . S O KO, CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: P n t .) P C. •
DESCRIPTION:
sI W 6.
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: /l r / 7 Pour Time:
Code # Inspection Description Confirm # Contact # Message
i q q £ aS3- 416 ? -(6 36
Corrections /Comments /Instructions:
•
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES,ASSESSED
Inspector: 6 N Date: 4lI 1 1f C]J Phone #: (503) 718 - 1•k.