Permit CITY TIGARD ELECTRICAL PERMIT
,: 7 - PERMIT #: ELC2004 -00168
DEVELOPMENT SERVICES DATE ISSUED: 4/5/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S12600-00300
SITE ADDRESS: 09611 SW WASHINGTON SQUARE RD L -3
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: (10) branch circuits.
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: 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: 9 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:
PPR WASHINGTON SQUARE LLC DRYER ELECTRIC INC
BY THE MACERICH COMPANY PO BOX 86369
9585 SW WASHINGTON SQ. RD. PORTLAND, OR 97286
PORTLAND, OR 97223
Phone: Phone: 503 - 771 -5667
Reg #: ELE 26 -1142C
LIC 153466
FEES SUP 2876S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 4/5/04 $106.70
[TAX] 8% State Surcharge 4/5/04 $8.53 Rough -
Elect'I Final
Total $115.23
This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or
1- 800 - 332 -2344
Issued By: - Permit Signature: 6")- ,L1.4 C�
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO: C�
Call 639 -4175 by 7:00pm for an inspection the next business day
��1 /,
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'' Electrical Permit Ap on Received kUK OI EI EL tr ONLY
ical DateiB . . •�" Permit .. ��
SO —a(p
City of Tigard � � �y Plan g °� sign
13125 SW Hall Blvd. c • 1* Hat_ : �t No.:
Tigard, Oregon 97223 o PamitNo_
Phone: 503- 639 -4171 . Fax 55 - 59$ -19 %N� Use
Internet ttravw. orusG r Case No.:
Ct , - � � A � I Contact ∎ See Page 2 for
24-hour Inspection Regnest gg3- 39 4175 -- 1 N� e/Method: Su . lemma Information.
_ . _. _._. iIBaRW.OlitXi , .lL;piltT '.�appt)' ..: r'" ' °'•;�
- New construction ❑ Demolition - d Service over 225 amps- 0 I•Ialth-core facility
— commercial on/alteration/replacement [I Other: D mow loa0
❑ Service over 3Z0 amps-tat�g of ❑ Building over 10,000 square felt,
...1.1.1.•5: 1 Pt: 1 " a :AVEGOl R' IICTION 1 & 2'manly dwellings four or mere residential wits in
❑ 1 & 2-Family dwelling R CommerciaUIndustrial D Sy.tmt over 600 volts nominal one structure
al ACCCSSOiy Building Multi- Family ❑ Building over three stories ❑ Feedeee, 400 amps a mare
pp Occupant load over 99 persons Q Menufactsnal stn,rattes or RV park
Master Builder ❑ Other. D Egress/lighting plan 0 other
.'f!tsk� .± ? ;:• 3 G$ , f� \ t�� '..0 _ u.a , — Submit acts ofplasswItbanyofthoabe e.
Job site address: q (Q (, _ l/S4S — — _ : _ I he above "are net applicable to temporary eoaarnmon service. - -- - - : - - = - •
u %ls * 5�atriiE
Suite #. _ . I: Bld g #: . . :Number of inspections per permit allowed .
Project Name: ID 4 -1 Description Qty I Per(W Total +
Cross street/Directions to job se: New raidenda J gle or =died per
it j
J dwelling unit. Includes =died garage.
serviceinelndeds
1000sq. &aless • 14515 4
- . Each oatmeal 500 sq. R opottion thereof I 33.40 1'
Subdivision: Lot #:
Limited e uesty. reaidmtial I 75.00 ' 2"
Limited malty. non reeidtadal I 76.00 2
Tax map /parcel #: Each manufactured home or modular dwelling •
to a • r • F, e • 0.1MOR . service andla feeder ( 90.90 2
olti .I , it I . I J . A relocation: Services or feeders -
0r
200 amps or less 8030 2
201 amps to 400 amps 10655 2
401 amps to 600 amps • 160.60 r
ME oP i Y OWNER ::.: T Over 1000 stn a w 250.65 I
Name: Reconnect ea* 6635 2
Address: Temporary services or feeders - installation,
alteration, or relocation:
City / State/Zip: 200 amps or less 6685 1
Phone: _ ax: 201 amps to 400 amps 10030 I 2
401 n 600 a 133.75 1 2
MI�1'P'EL• IO'Ai�I'>i t `CONTACT PERSON — Breach tdradU -new, alteration, or
Name: atension per panel:
_ Address: -' A. Pee fa branch circuits with purchase of
service or feeder feel. each branch circuit 6.65 2
City / State/Zip: B. Fee far branch circuits without purchase of
service or fader fee. first branch circuit I 4635 2
Phone: I Fax: Each additional branch circuit '1 6.65 , 2
E-mail: Misc.(sav ee or Linda not included); -
_ - Co d'tsat1alt Each pomp or ittutatioa caek 53 4 2
-
• - - Falb out liahti . 2-
Job No: -... _ . I Slims] circuit(s) a a limited energy _. panel. .._ . -v. _ . ....._
Business Name: DRYER ELECTRIC t RASR? =r e2'
_ Address: 4012 NE CULLY BLVD CITY
City /State/Zip: u O KTLAND , OR 9 7 213 Each additional inspection over the allowable In any of the above
Per impend= per hour (min. I hour) 62.50
Phone: 503 287 6164 Fax: 5 9R9 i nhn Investigation f
CC/3 Lic. #:153466 Lie. #: s 26- 1117. -C. Other. - # ,
Supervising electrician J �_ Subtotal_ T O(' rV
signature required �� J�'�' . Plan Review (25% of Pmt Fee) S
Print Name: geeD 615.5)4 1 I Lie. # ?&7{0S __, State Sty (8% ofPermit Fro) $
S
Authorized Noting PERMIT FLEE _ S 1 1,
notidnt This permit appileadon aspires if a permit Is net obtaine
Signature Data 180 days after It has ben accepted as complete.
*Bee methodology set by Tai- County Building industry Service Board. '
(Please print name)
i:\ Dsts1PermitFormsTlePemritApp .tine:01103 ,(Q1(45 ,
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CITY OF TIGARD 24 -Hour
BUILDING, Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received / - •J Date Requested n - ' ) AM PM BUP
Location ��� /e Suite MEC
Contact Person � I Ph ( ) �_r� ��1�_ PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner `/ .. �: ELT `6o
Footing Apr
Foundation ELC
\yN4ccess:
Ftg Drain � a r J ��'� ' � ELR
Crawl Drain
Slab Inspection Notes: / SIT
Post & Beam Anchrs
Ext Sheath /SSh ear ; 1q� Q _ _ t
Ext eah/h 1V ll
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
- Other: - '
Final
PASS PART FAIL
PLUMBING 0.41,
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
PASS PART FAIL
ELECTRICAL
Service
�o�ugh -In
UG7SIan
Low Voltage
Fire Alarm
rte,. Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE El Please call for r-inspec ion RE: Unable to inspect — no access
Fire Supply Line
ADA Inspect Approach/Sidewalk D a Ins p
Other:
Final DO NOT R MOVE this Inspection record fr m the job ite.
PASS PART FAIL
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