Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
I DEVELOPMENT SERVICES PERMIT #: ELR2006 -10035
^' '�' I DATE ISSUED: 7/6/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1512600 - 00300
SITE ADDRESS: 09577 SW WASHINGTON SQUARE RD B7 ZONING: C -
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: 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
Reg #: ELE 34 -47CLE
FEES LIC 5193
Description Date Amount
[ELPRMT] ELR Permit 7/6/2006 $75.00
[TAX] 8% State Surcha 7/6/2006 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
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 Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 50� 3- 224 6
Issued By: GGl ( /� 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.
06/27/2006 15:50 5036911879 ARROW PAGE 01
Electrical Permit ,A,u Iratii-6 FOR 01V FI(•I: t S►?. ONLY
2006 PermitNa- � /1.p 35 '
City of Tigard JUG 2� o�udB`"y � /Ota 8 � ��- --�- -- "
13 125 SW Hall Blvd., Tigard, OR 97223 Plan Ravi v
Phone: 503.639.4171 Fax: 503.598.1960 m " ' R I t�e/gy. Other Permit
Inspection Line: 503.639.4175 C, L . la I I GA :. 11 11 Dare ee d edlM B � /10 /D n ( 't • ( See Page z for
Internet: www.ci.ligard.or.us BUILDING DIV! I Supplemental Information
:
K : .' '�,' } Yaw ti" y '1,� ` -1 a'•r W .� i v ,i r y,. 1 � . i5.ve - i, .., ...� • i.. ...wi
`Tq".5; a So .r:,� � y} �Ir °'•��„m �, '':.5�'i'`r_ `'�, ,X , �.y� }'t'1 try d I k �Ni • s,
:45.`: 1 . � :G? ",.•' ,'�`t, ' �Y _ •t�• $;C.,,_ . !.�i' :: 6: r. L�4:. Y, �, t�., �aC,.i.'`rn�iGs��•.�:i.Lj.'�1.
U Ncw construction ❑ Addition/alteration/replacement
Please check all that apply:
❑ Demolition El Other: ❑ice over 225 amps, comm'I ❑za
Hardous location
Service over 320 amps -rating ❑ Buildng over 10,000 sq. R,
,h:'r r.4 ey 4= �y• r'lCiI1 ge:g0: �ONSIlti� 0'$;M {' ;y:,.'I ,,r,_�'! iif;„ of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling eir Commercial/industrial 1:1 Accessory building ClSyatem over 600 volts nominal units in one structure
❑ Multi ❑Master builder ❑Other: ['Building over three stories ['Feeders, 400 amps or more
( i ` 4 :, `,; x ❑Occupant load over 99 persons ❑Manufactured structures or
; 7\;`,1' • .4 D ITE •I ritit AU0N AND ri.00A"1'ibN v' *t'tt:•trs" •"."".+ ?
. -.,.,Y..,. ' � •$ i . .. -• " • u�=I� ❑Bgrgdlightingplan RV park
t 'TLsr( ❑Health -care facility ❑tea=
Job no.: "6133 I Job Site address: °ic 77 LJe . JRv w., Jai . • Submit 2 sets of plans with any of the above.
City/ State/ZIP: - D Q It S 7 2.7. '3 ,M.- The above are not applicable to temporary construction service.
: '..44' `1. t:,! trEE! :SCHEDULE. ii7ht�h�.z';V.' ' ' ' " '
Suite/bldg./apt no.: ' l3 p, 0 7 J Project name: Oh +" $ " rk.erlptien 1317-
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
r 1,000 sq. ft or leas _ 145.15 4
Subdivision: I Lot no.: Ea. add'I 500 sq. ft or portion 33.40 1
. Limitcd energy, residential 75.00 2
Tax map/parcel no.:
Limited energy, non - residential 75.00 2
• : DESCRIPTION OF WORK . - i Each manufactured or modular
/ dwelling, service and/or feeder 90.90 2
(.- OW �t e' i 1 Ace) f• W t Services or feeders installation, alteration, and/or relocation
\/ 200 amps or less 80.30 2
I PROPERTY OWNER . ❑ TENANT 201 amps to 400 amps 106.85 2
I 401 amps to 600 amps 160.60 2
Name: W A.44. t AST t.1 4evt mar l..(� L 601 amps to 1,000 amps 240.60 2
Address: �p ( Over 1,000 amps or volts 454.65 2
QSfi�� vcL��11xr�Tel �QvA►eF p-�• Reconnect only 66.85 2
City / State/ZIP: E l dpti> 0 t q 7 al Temporary services or feeders installation, alteration, and/or
rc ) _ , G' Fa x; ( ) relocation
Phone: (
J 3 6 3 �� � J -_-__ - - _ - - - - -_- _--_ -_ 200 amps or lcss 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, least. rent. or exchange, according to ORS 447, 449, 670, and 701. -
401 amps to 600 amps 133.75 2
Owner signature: Date: _ Branch circuits - new, alteration, or extension, per panel
` - , 'Xi APPLICANT. ' , 1 . 7 ;.t.' . . . ❑ cON•PAG"I'•1!)i!.R9pN .. .... A_ Fee for branch circuits with -
service or feeds fcc, each 6.65 2
Business name: branch circuit
B. Fce for branch circuits
r Contact name: k ' L;} A G z rP , w service or
lthour i feeder fee, 46.85 2
each branch circuit
Address: I0 330 rte. ,a/. , Tt.2Al P.TI N gel Each add'/ branch circuit 6.65 2
City / State/ZIP: •^ rig ti Tr M z Miscellaneous (service or (ceder not Included)
Pump or irrigation circle 53.40 2
Phone: (403) 6 a (rb s Fax: : 0605) 6 1;-/e( Sign or outline lighting 53.40 2
E - mail: Signal circuits) or limited - \ p
CONTRACTOR energy panel, alteration, or
,
oxhmsio 1b ' Page 2 2
Business name: A Et ,,,./ A v4:44A41 col G "y Jr' v
Address: 1 L? 7 ? - 2 ,0 5- w E.!, additional inspection over allowable in any of the above
TOP 1 r saTl Al I Q� • Per inspection 62.50 _
City/State/ZIP: er-i . 1 AT . OR. (17-1Z", Investigation pa- hour(I hr min) 62.50
Phone: ( 5 r r Fax: ( P;i� 3 ) C.,C1 I - , • Industrial plant per hour 73.75
6 e I / ) ELECTRICAL PERMIT FEES'
CCI3 Lie.: i I 3 Electrical Lie.: `3 ,...-N 7c.14 Supry . .: z'i f LEf Subtotal .cx�
r Suprv. Electrician signature, required: Planrcvicw(25 %of permit fee) 7
�� �' _/S� Stale surcharge (8%ofpermit fee) & . ly c�
Print name: � " • -- - A � Date ���_ TOTAL PF.RMrf FEE 81 . 0 0
Authorized sip-talon:: �� Thin permit nppliention expires if a permit is not ahtsined within tea
�•- _ days after it has been accepted as ennptcee
Print namc: KT ? ! ' r 6 t; 11 - _ i . I Date: ( - -" 5' Fee methodology tel by Tri•Cnunty Building industry Service Board
• • Number of inlpcctiotlt per ',crimp allowed,
i\ Bu i l ding \PermihVii Pemitn I: /n 1 .Iaaef.ieTnan''rMtnvten
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: I OW'
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUE :
Phone: (503) 639 -4171 11 A
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1. Li. t TIME: PAGE:
SITE ADDRESS: CtS1 1 S W NSN S� CLASS OF WORK:
SUBDIVISION: 6 LOT #: TYPE OF USE:
PROJECT NAME: S%CM. 7,7
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
C Inspection Description Confirm # Contact # Message
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: � 1V 8 Date: n 2,1 Phone #: (503) 718 -1-44