Permit 1
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
A-4*I DEVELOPMENT SERVICES PERMIT #: ELR2006 -10026
'� :. II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 6 39 -4171 DATE ISSUED: 3/23/2006
PARCEL: 1S12600-00300
SITE ADDRESS: 09581 SW WASHINGTON SQUARE RD B8 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Limited energy for CCTV Job No. 430606 -10148
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:
INSTRUMENTATION: OTHER: CCTV X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC BROADWAY ELECTRIC - COCHRAN INC
BY THE MACERICH COMPANY 626 SE MAIN
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97214
TIGARD, OR 97223
Phone: Contact #: FAX 503 238 - 2098
PRI 503- 234 -6564
FEES Reg #: ELE 37 -546C
LIC 72942
Description Date Amount SUP 3447S
[ELPRMT] ELR Permit 4/5/2006 $75.00
[TAX] 8% State Surchar€ 4/5/2006 $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 .re set forth in OAR 952 - 001 -0010
through 0 5-2,,-001-0 0. You may obtain copies of these rules or direct :, - •ons to OUN at 503 - 246 -6699.
Issued B : i Permittee Signatu e: _, _, 1 _ . :, ffiri ∎ W
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 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 ,
Cii'y bf3`igard Received' JJ � ' ,
13125 SW Hall B1vd:,.Tigard,.OR 97223
DateB : �QW I9 t :d: ? .�Pe rm it No.: ^ J I j . •,. l�p��
Phone: 503.639:4171" Fax: 503.598:1960 p „ ,,, _ ,\,, Plan Revie
"�h-;�`�'�I Da te/B Other Permit:
Inspection Line: 503.639.4175
..iii Date Ready/By: , • • { I - ; i /See Page 2 for-
: Internet: www.ci.tigard.or.us Noufieed/Method: �e Supplemental Information.
.a 'T Y i ,- x iU Y r n , ' , t 1 . 1 . r.- J � li .R.,,l{rT 0.11 ' '" ' 4!, .J'-„ 7i- - i1: 1 . . 4 . ;.� Y "` i 1 "
.1P ,ar.�c sr._r_c'u:.. , - it_;d ._ `V.W.Q, A;W ;.. ,+w+ 6 1 ,f�.] .F' t'}h_ :�-.. ,'. r, ., , 4' .. • �t lll .t 'r, . ._
❑ New construction- ❑ Addition/alteration/replacement Pleasechec all that apply - ,, :
❑ Demolition ❑Other: Service over 225 arr>ps; comm'l ❑Ha2azdous location
, ` , . i y� r i • � FIRF�; i y� g i , i , ;v� ❑Set ce over 320 amps - rating. ❑Buildng over 10,000 sq ft.,_
dy - a Atli t � .. � - Fr.,,- -, `. 'k, Z s �.. -. 1q t +_ • ' 4 -
❑ 1- and 2 - family dwelling A of 1 -and 2- family dwellings 4 or more new residential'
Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑Bufldmg over three stories. ['Feeders, 400 amps or more
❑ Multi family ❑ Master builder ❑ Other:
` ['Occupant load over 99 persons ❑Manufactured structures or
: 3 _ 4." g�g, s �
i, °.' ,. r - L
', -, a ' � � J 1: t".-. • J ' -' - L; J�AI - 0 3t " • t £ i'i l i)Y - %' 1 4 S>1 T. t`" .__ � p RV park
..�- _''_4z _ a r c.,. __:..- �v.::. - .1,r;1•:.:1,:+4,,,-, .�Y:'...s• r i ❑ Egressfhghting plan P
Job no.:430606 -- 101y g Job site address: ?, Sf 5w i aJ 'I"" ' S Pi #6', q, ❑Health -care facility ['Other:
Submit 2' sets of plans with any of the above
City/ State/ZIP: p r
f /a „c 1 7223 The above are not applicable to temporary construction service
Suite/bldgJapt.no. - g$' Project name: oN `f , ._� ;'k' z�, ' ; i • Alit. ri •; e ;,- «°.,:. ' "
Description. Qty. Fee. Total .•
Cross street/directions to job site: I a t 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 1
Tax map /parcel no.: Limited:energy, residential 75.00 _ 2
±S xyr y-- e y 1 J �Y iq j67: -r �� t • _', ,fir
Lirmted energy, non- residential r 75.00 7 $ - 2
� - � �,. � Jy_, ; x .__ Each manu f a ctured or m odul ar
�6 1..) 0 f� dwelling; service and/or feeder 90.90, 2
(a 046r d 1 7 l/ t/ /ti, t , 4 PLY Services or feeders installation; alteration, and/or relocation.
_ °� 200 amps or less 80.30 2
r r i s t N, W(. A1; .t:_r�1' � .4 ` a ` / i a r 201 amps s
��_� .;.: { '�� i z r� z .. :.z "' - i �/':`t mP 106 85 2
`� = `"''' 401 amps to 600 amps 160.60 2
ix4P ....-. 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
Phone: ( ) Fax: ( ) relocation
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 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
i 'ih� -L: 'ar /V l i it rit`trt� ,, � _N r� ` d t t F4 ii ✓4+.8 1 ;� 4 OFii.:1 J, ::l
� ''' -2 it r1 _z -', _ .d : _... �i - ,5, - .:, -fief A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
Contact name: B Fee for branch circuits
without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'l branch circuit 6.65 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:
f ,,-- , t ,..� j ,, , Signal circuit(s) or limited-
r r s7- '1 R
; -. '_I i� ;r ' - ti_ - rte ` `,W 4 1 t energy anel, alteration, or
extension. Describe: Page 2
Business name: g 2
Address: 2 ( 5 el. Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: 0 4---Sc- „ 09-, - 7 2` Investigation per hour (I hr min) 62.50
Phone: (51o3 ) 23 _`j (, Fax: (Sv3) q In dustrial plant per hour 73.75
Zia -2 �= n� 9M ->a-- ri .��. ff , .
Electrical Lic.: 3 T -5 6c Suprv. Lc.: 34.4. - i 5 Subtotal Tc.00
Suprv. Electrician signature, required:_ 1' Plan review (25% of permit fee)
Print name: , c��C� � . Date: State surcharge (8% of permit fee) 6
TOTAL: PERMIT FEE ' ' g ` c+)
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 Teri -County Building Industry Semce Board
" N of i per pe allowed
0 . 13 tuidmg\PemutsYELC- Pcrm, pp doc 12/03 440- 46!Sr(10/02/COM/WEB
CITY OF TIGARD �Z
BUILDING DIVISION PERMIT #: Q006 -
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 - 4171 6
Inspection Requests (24 Hrs.): (503) 639 -4175 `'IL.
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: J / ` CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 - - 7- 0 (O Pour Time:
Code # Ins. = •- .-:"'^"":'^. Confirm # Contact # Message
135 a � C 5aa- 1364
1 •
Corrections /Commen • tructions:
•
16.2 - 1 04, 63
•
23
G•
IA PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6ES Date: 2 a Phone #: (503) 718- 2A4
CITY OF TIGARD - -
B U I L D I N G DIVISION PERMIT #: IR DOS /O - co
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 1i'�I!
Inspection Requests (24 Hrs.): (503) 639 -4175 W `___ -
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: q g $ I WAS L 9, g ot CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #: 5D3 — S 3 t
CONTRACTOR: C 1 PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description,. Confirm # Contact # Message
13C 9 7 at-c-f)
Liorrections /Comments /Instructions:
0 LA) (LC • q c U s 01/4(6 tow •
» wr? R eS 6 N PL w
9\
03.\ 1` %U ∎x11
J
•
•
•
•
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL • ❑ NO ACCESS
�t FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 3 4311w Phone #: (503) 71 S- 2 14 7. •