Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
A DEVELOPMENT SERVICES PERMIT #: ELR2005 -00199
., �� i 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/21/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09516 SW WASHINGTON SQUARE RD H -4,5 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Low voltage for fire alarm.
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: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC ADT SECURITY SERVICES, INC
BY THE MACERICH COMPANY 2815 SW 153RD DR
9585 SW WASHINGTON SQUARE RD BEAVERTON, OR 97006
TIGARD, OR 97223
Phone: 503- 639 -8865 Phone: 503- 469 -7244
Reg #: LIC 59944
ELE 26- 209CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 7/21/2005 $75.00
[TAX] 8% State Surchari 7/21/2005 $6.00
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 95 101-1100. You j.y obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: i • � „ , � Permittee Signature: 27h et 7270 -ed
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.
0?./29/Z005 14:21 FAX 5034697110 ADT SECURITY a 001
`Electrical Permit A IV E ® •
FOR OFFICE USE ONLY
City of Tigard Dat/B Received /A► Oh pemirNo. , 410 -co)? dr
13125 SW Hall Blvd., Tigard, OR. 97223 II ► 20 2005 Plan Regis '
Phone: 503.639.4171 Fax: 503.598.1960 Jl1 A l at \ D2, : OtherFeriu
Inspection Line: 503.639,41'x5 CITY �f T U GH . � L Date Ready min
El See Page z for
Internet www.ci.tigard.or.us 1 NotifiedlblethoiI "�C7 Supplemental information
D�
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G ew construction ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other ❑Service over 225 amps, comm'l ['Hazardous location
r 7 � ❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
I IIi iT11 7 r VJ I7 7 1I'IU01gc 41[i7F �Wi�� i t){P�1 �I�7 il4''irii � N AI .J�'
rsfaiai,1 4., sir +,,..:' trA,U� ..d. L17.7i. . , I.jiil :1.1.1!'5iir,9A- ' o- ,I ra ,:ls y A . , .0.. of 1• and 2-family dwellings 4 or more new residential
❑ 1- and 2 family dwelling.Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi-family El Master builder ❑ Other' ❑Building over three stories UFeeders, 400 amps or more
❑Occ t load over 99 p ersona ❑Manufactured structures or
•1' �i 1 i)iJ 41 r'W I 'v I u41I I � 14 �Iy l' lil'E l i �t I r 7 �� �I�ta re t l l 2�u nti 11 ❑ uP� P
,_ . , el ,o„ . 1c,U l l'i r' .�R! , .. , g a r '411 :- -f.:. I- t il441 jr��� ^t 4 ."! ; !i {' l ilP y: , �3-
7 � t., E plan RV park
Job no.: Job sire address: rd r. ❑Health -care facility ❑ Other:
a- t.11 4. - _ ... , i f . � .- IA : F Submit 2 sets of plans with any of the above.
City/Stare/ZIP: / I'j D 9 Op,
�) The above are not applicable to temporary construction service.
V f a6Fx � ��i� c- h ¢ .P' c I ^3 — WCJA, w' ^e q 1_:I:r -:. r,.
Suite/bldg. /apt.no.: Project name: r _I ' ,y ' 0 $,- e • ;, ` +n' ;: ;):;341 91`!" 5?1'r;,?
I'r 4J'J r .a'
- - _ .. _. . 1 _ ■ Description Qty. F. Total
Cross street/directions to jib site: 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. R. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential 75.00 2
til' }'1 t Y7 p r.r 1 14� �, r 1 c 'E i �r rt1 r } I I 71 I y i l b Lip -,� ,Ir;, Li feted energy, non- residential 75.00 2
J,In i:i
tT''r; II f . JJrI�' IrIJA � v 1 . ' t 1i a JI1yI 1,Ji`lr IIii t iYNlS'�I!+5I i� . 1 1r1I RnItl•:,in -'.J ."
- tlt...ilie:y:lj.. i isi .11f1.i1ig.a d:1._1I4.I IT 11) .o S . .lr. .1i1A_IV .,.�1_�Ju. . . Ifira ? Each manufactured or ular
.1 I ` dwelling, service and/or feeder 90.90 2
o. 1I I Ai • _ ■� +t —4 / 'AI Services or feeders Installation, alteration, and /or relocation
200 amps or less 80.30 2
,v rv. Finn. rc-rp r � e' ip, d l l 1 l 1� of F e4 ,., Sri ,, „, a r^ '1 201 s t0 400 s 106.85 2
,jt..I F'2 ;if21h - A171� 4 S, � 9 4h 'A alth r ! � 7 !f� i, Cli i tIk El 1 7, r 44 P' e I .� amp a Mp
�,_,t.,._J. �n__,Ja } : 1.} o �1s.11,7 1� ,,, 1�) >f�ft, lr�.T 7�'wIr.L.+t,ll 401 amps to 600 amps 160,60 2
Name:
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. 1 [
401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
- - `p'r .9.Ji: 1tj'::' °x417 �.:.i ^ tsii . -. I r l i t: •vr- ,:41, a1 r J rit - T�J
2• . 1 `11 41 - �l - 1 .
1 5 y� iiil'rt.'r , f, ,, [. ` � � .t fOf 4 .,,.- ; - ti ; , l r : l ttz ti' 1
T'et5i �4 .IMi. N A.s service or feeder
erde each
Business name: branch circuit fee, each 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'! branch c 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: "? _ I IL1 Signal circuits) or limited-
413: /rYi! �!f�GTY7� r u� 10 J' - ',1 1 1 7 d I r' 1 j fT_ 111 y_ !, 11 1- :1i1 {J. r. l �� I. a i i. rYa.1_f rY '1 I oa
� a I, ,r r ��.��� � I � ±�.y�lEl�, 711��� It����l 1 �, I ��llwd r� ,� ��(�h ffYp anel, alteration, nr
extension. Describe; I Page 2 16,m 2
Business name: ADT SECURITY SERVICES, INC.
Addr 2615 S.W. 153rd OR. Each additional inspection over allowable In any of the above
AFAVFRTf11, OR 970(16 Per inspection 62.50
City/State/ZIP: (503) 469-7100 Investigation per hour (I br min_) 62.50
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
±. j 1`F4 ' ,r,.- ;ry ^ .r.,,r y r, 5 • rJ.m-: r,i r . c r�
/ i 1 f i I i5P'` „�. 41x41 �, i'u �'rE ci 4�a�e. o . a, z ' r..t. 2 ;�:
'.t I�Ji. I_ L�ileLl. >�:,i.�= 1- .�'5.;,,�:a��....�,., .:F 'is ,'c. -. �"':.::s,:. ,
CCB Lie.: Ele ctrical Lie.: a. CL upr L ie,: • - Subtotal
Suprv. Electrician signature, required: /'- _: t Plan review (25% of permit fee)
State surcharge (8% of permit fee) ID.
Print name: i4eh & Date: C Z1.00
TOTAL PERMIT FEE
AutbotiZed signature: This permit appllcadon expires if a permit is not obtained within 180
r days after It has been accepted as complete
Print name: Date:', 17 1 I ()r • Fee methodology act by Tri -County Building Industry Service Board
Number of iaspeationa pa pertmt allowed -
I: 1Buildinglroremtsl131..PeradtApp.doc 12/05 44046rsr(10/021COwW2B
my_ TIGARD
BUILDING DIVISION - PERMIT ... ELR200` 10199 I
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUES 7/21/2005 - --
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 . ..411' L
INSPECTION WORKSHE OR DATE: 912005 TIME: 7:09AM PAGE: 74
I
SITE ADDRESS: 09516 SW-WASHING eN SQUARE RD H -4,5 CLASS OF WORK: 1
• SUBDIVISION: WASHINGTON SQUAR LOT #: , TYPE OF USE:
PROJECT NAME: BEN BRIDGE JEWELERS
DESCRIPTION: Low voltage for fire alarm. .
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503-639-8865
CONTRACTOR: ADT SECURITY SERVICES, INC PHONE #: 503 - 469.7244
Inspection Request Scheduled For: Date: 9/8/2005 Pour Time:
Code # Inspection Description Confirm # Con :ct # Message
- - -.- - • e 015142 -01 503 - 639 - : 65 N
‘aa r 0 A
Co -- - • .mments /Inst .ctions:
&L5% E L-R 1-006' o4t q,
F1 NAL,
•
'7i 35
,PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
tut r
Inspector: 11 Date: Ci(i( Phone #: (503) 718 - 1-,