Permit A »' s CITY OF TIGARD ELECTRICAL PERMIT
P E RMIT #: ELC2005 -00282
Av : • i � DEV ELOPMENT SERVICES DAT ISSUED: 4/27/2005
��' II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09516 SW WASHINGTON SQUARE RD H -4,5 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE
•
LOT :, JURISDICTION: TIG
Project Description: Electrical TI, (1) 200 or less service and (40) branch circuits. Job No. 62930
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:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: i L. W /SERVICE OR FEEDER: y 5 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:
•
WASHINGTON SQUARE LLC - FRAHLER ELECTRIC CO
BY THE MACERICH COMPANY 11860 SWGREENBURG RD
9585 SW WASHINGTON SQUARE RD TIGARD, OR 97223
TIGARD, OR 97223
Phone: 503 - 639 -8865 Phone: 503 - 639 -4627
FEES Reg #: LIC 37410
SUP 1816S
Description Date Amount ELE 34 - 13C
[ELPRMT] ELC Permit 4/27/2005 $346.30
[TAX] 8% State Surcharge 4/27/2005 $27.70 REQUIRED ITEMS AND REPORTS
Total $374.00
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
suspe or more 180 days ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rule are set forth in OAR '52- through OAR 952- 001 -0100. You may obtain copies of th- = ules or direct questions t OUNC t
50 - 246 -6699. 1- 800 -33 '34• I I
Is ued By: L l _ ,ijj 1 Permittee Sig l ature: e; , k j/►!��/�/i
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 I STALLATION ONLY
SIGNATURE OF SUPR. ELEC' _!'' / - r ... DATE:
LICENSE NO: • b(' •
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.
•
E trical Permit A l t licatio l --.k. 1 FOR OFFICE USE ONLY
r City of Tigard RL� r i . =: ":lei Review
7l PenmtNo :: _
13125 SW Hall Blvd., Tigard, OR 97223 0111110-1 Plan Phone: 503.639.4171 Fax: 503598, /. - - 1 '1 Da B
\ te . Omer Permit
Inspection Line: 503.639.4175 2dU5 ; ! . , ' i t 1 Date Ready/By: 7 H See Page 2 for
Internet: www.ci.tigard.or.us -- J Notified/Method: r Supplemental Information
5 ; ,._ .. L ti i L .c i r , ; , 1 .1. r J l t : r 22 ',1 , _, turf - ,.. r - \t 0 et, d- " .. r ..
_.' � - ' --'-' -- 'i-�i -,. ,J ._. ;...../21,1 i : _�_S_..� .n. .tic . ' - -a � �l� _.. `��3 -t� a t :
❑ New construction E "Ili • . • • : i c . .. 'l i i . Please check all that apply:
ID Demolition ❑Offer OService over 225 amps, comm'I ['Hazardous location
❑Service over 320 amps — rating ❑ Buildng over 10,000 sq.
<.: - ' I (" .:'!';' � r 7 , 1 7r 4�r .. >,;,.•"`",,.• y : ter } s ' ; of 1- and 2- family dwellings 4 or more flew residentia
❑ 1 - and 2- family dwelling [31 Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in coax structure
❑ Multi family El Master builder ❑ Other ['Building over three stories ❑Feeders, 4400 amps or mo
:4:.;),3;,, 4 T ,,.� 't _ n A _, ['Occupant load over 99 persons ❑Menufactu+tred structures
it : Lr . i cr � Fs plan RV park
.,�. .c , • �...t �i � � , Z k (oj
.' s•. iet � .... � �;' f` =" : ['Egress/lighting ['Other: Job no.: 62930 Job site address: - , SW WASHINGTON SQ ROAD ['Health-care facility •
Submit sets of plmis with any of the above.
City/ State/ZIP: TIGARD OR 97223 The above are not applicable to temporary constru ction service.
Suite/bldg./apt. no,: H05 Project name: BEN BRIDGE JEWELERS r _ �' ,
-, )�, r ..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
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40.
Tax map/parcel no.: Limited energy, residential 75.00.
ti a Limited energy, non-residential 75.00.
•?' tti .' ._.....:2, ', I i� _u:,-•- r 1 '2,1).). : 1( `' ` �: J j `. _ -3 °' Each manufactured or modular
TENANT IMPROVII�PT dwelling, service and /or feeder 90.90•
Services or feeders installation, alteration, and/ or relocation
200 amps or less 1 80.30 80.30
4.-7:-_ ' - a ` -, { , i *1 c , e, : �, • i 1 , jr �f ' ` w n 2 / 2 .1 7 r ? j ;-; 201 amps to 400 amps 106.85
401 amps to 600 amps 160.60
Name: 601 amps to 1,000 amps 240.60 -
Address: Over 1,000 amps or volts 454.65
Ci / State/ZIP: Reconnect only 66.85
�' Temporary services or feeders Installation, alte ration, and/or
Phone: ( ) Fax: ( ) relocation
200 amps or less 66.85
Owner Installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30►
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
',..s v'' 1 , 1 x . i ` � r 1 y �,, Y A. Fee for branch circuits with
_ service or feeder fee, each
Business name: branch circuit 40 6 - 65 266.00
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85
Address: each branch circuit
Each add'l branch circuit 6.65
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40
Sign or outline lighting 53.40
B-mail: Signal circuit(s) or limited - •
1 V) , l .- {'"�', -r w t w. , ' 1 r ( fr , ,wi t '^ ' 1 ' . . r ,: F ' . 7 F i .. energy panel, alteration, or
a r ...__.__ ._ -,. 5_. extension. Describe: Page t
Business name: FRAHLER FT .F,CI'RIC COMPANY
Address: 11860 SW GREENBURG ROAD Each additional inspection over allowable in any of the abov.
Per inspection 62.50
City /State/ZIP: TIGARD OR 97223 investigation per hour (1 hr min) 62.50
Phone: ( 503) 639 -4627 Fax: ( 503) 639 -4673 industrial plant per hour 73 75
a r,.;c' s ` _.;. 4rt „l,A i gfi_ 2Yf. ATr y L��PN T 5 1 1 r Tt ri....y' y -lg$
CCB Lic.: 37410 Electrical Lic.: 34 -13C Suprv. Lic.: 1816S Subtotal 346.30
Suprv. Electrician signature, r : / i�� Plan review (25% of permit fee)
State surcharge (8% of permit fee) 27.70
Print name: R. W. . , 1 01. Date: 8 g
TOTAL PERMIT FEE 374.00
Authorized signature: This permit application espiret if a permit is not obtained within 18
days a fter It has been accep as co
Print name: Date: • Fee methodology set by Teri-County Building industry Service Board
•• N umber of i per perm allowed.
evloildisawa�ffi.C- PemtitApp.doc 12/03 440- 46'Sr(mnn/COM/waa TEMPORARY PERMIT FROM 04/22/05
THROUGH 04/28/04 lek
Electrical Permit Application - City of Tigard Lt .,_
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems* r
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning •
❑ Vacuum Systems*
❑ tee:
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
MuldingWamutslELc- rem@npp.ax 04/03
CAP( OF TIGARD ,
BUILDING DIVISION PERMIT #: ELC2005.00282
. A
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/27/2005
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: - 9/8/2005 TIME:. 7 :09AM PAGE: 32
SITE ADDRESS: 09516 SW SHINGTON RD H -4,5 CLASS OF WORK:
SUBDIVISION: WASHINGTO QUARE LOT #: • TYPE OF USE:
PROJECT NAME: BEN BRIDGE is ERS
DESCRIPTION: Electrical 11, (1) 200 less service and (40) branch circuits. Job No. 62930.7126/05: Added (1) 200
or less service & (5) br- ' ch circuits.
OWNER: WASHINGTON SQUAR LC, PHONE #: 503- 639.8865
CONTRACTOR: FRAHLER ELECTRIC CO PHONE #: 503 -639 -4627
Inspection Request Scheduled For: • ate: 9 Pour-Time:
Code # • ' • . Description Con 'rm # Contact # Message
199 Electrical final )• 01517 01 • 503- 639 -4627 Y
•
Corrections /Com - - ns: (�
irkt,
• •
•
• •
•
•
•
•
•
•
•
•
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL , ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v v Date: a l Phone #: (503) 718-
. .',F "• -
j l