Permit PM .
a CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00192
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/7/2008
PARCEL: 1512600 -00300
SITE ADDRESS: 09567 SW WASHINGTON SQUARE RD B03 B ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: FRED MEYER JEWELERS
Project Description: Installation of low voltage for protective signaling.
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: X
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC COOK SECURITY GROUP
BY THE MACERICH COMPANY 5841 SE INTERNATIONAL WAY
9585 SW WASHINGTON SQUARE RD MILWAUKIER, OR 97222
TIGARD, OR 97223
Phone: Contact #: PRI 503- 786 -5173
FAX 503- 786 -3792
FEES Reg #: ELE 3 -541 CLE
LIC 151552
Description Date Amount
[ELPRMT] ELR Permit 7/7/2008 $75.00
[TAX] 12% State Surch 7/7/2008 $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 •: - _ • er. T •se rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or . rect questions • 0 N at 503.246.6699 or 1.800.332.2344.
0 Issue. By: , - AO , / Permittee Signature: A
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.
la trical Permit Application FOR OFFICI: USE ONLY
Received 7�d b L 00/ 9 ` Z
City of Tigard Date/B I Permit No.: a '_
I II ° 13125 SW Hall Blvd., Tigard, OR 97223 plan Review
II Phone: 503 639.4171 Fax: 503.598.1960 Date/B : Other Permit.
TI 1. n R l7 Inspection Line: 503.639.4175 Date Ready /By. Juris ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method. �0p, Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction lin Addition/alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling 18 CommerciaUindustrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I -3 ",
�� .lJT<W '' ! 4 1 + o p itigue / � i ixo rmo more occupancy.
' Jobno.: Job site address , � v 1n 1' J
tw ❑ Six or more residential units ❑ Recreational vehicle parks.
City/State /ZIP: pod-1414 �0/j gin, ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suit ldg. /apt. no.: i' O Project name: Fad 04,T Te ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I 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
Tax map/parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi- family
HP At9r-f-e...-77-1/e residential (with above sq ft.)
75.00 2
r Services or feeders installation,alteration, and/or relocation
5? 0,)i¢G // 6 200 amps or less 80.30 2
. _ ❑ PROPERTY OWNER I - , ❑ TENANT - . ». . 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 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 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
fa first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited-
' Business name: Co pes Strict/WI) 6 J/"G • energy panel, alteration, or
Address: S ( sr �wNNrt 4 , O �..�,/ extension. Describe: Page 2 2
City/State /ZIP: lik t ( ,,,...4.4 oi g 7Z74, Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (SD; ) 78,6 — so) Fax: ( S4 ) 18l - 37
Investigation per hour (1 hr min) 62.50
CCB Lic.: /5/55 3— Electrical Lic.: 3- 51//eL4 Suprv. Lic.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: 7 /I (I( Subtotal: 75 °o
Print name: Date: Plan review (25% of permit fee):
(12% of permit fee:
ge )
9, °
/ State surch
Authorized signature: A q,• 1:314 , 00
I � This permit application expires if a permit Is not obtained within 180
y
Print name: JO( F/Afsr^ Date: 7 0 6 days after It has been accepted as complete.
• Number of inspections allowed per permit.
I \Building\Permrts\ELC- PermuApp doc 05/23/06 440- 4615T(I I/05 /COM/WEB
,
CITY OF TIGARD ' Ait, ,' 1.
BUILDING DIVISION PERMIT #: ELR200B 00192
13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: 7/ 7/2018 •
Phone: (503) 639 -4171 ,, 11
Inspection Requests (24 Hrs.): (503) 639 -4175 ...'�!�- �p
INSPECTION WORKSHEET FOR DATE: 7/10/2008 TIME: 7:00AM PAGE: 25
SITE ADDRESS: 09567 SW WASHINGTON SQUARE RD B03 B CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: FRED MEYER JEWELERS
DESCRIPTION: Installation of low voltage for protective signaling.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: COOK SECURITY GROUP (---) c , e. L\ PHONE #: 503
Inspection Request Scheduled For: Date: 7/10/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 072432 -01 503- 970 -5346 Y
1 9 ° 1 f 114 OA- .
Corrections /Comments / Instructions:
l ..
\
�V .
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ' ADDITIONAL FEES ASSESSED
Inspector: Cr-' u`) 661..6 Date: 1 ` 61 Phone #: (503) 718- 2417