Permit a
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00110
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/8/2008
PARCEL: 1512600 -00300
SITE ADDRESS: 09619 SW WASHINGTON SQUARE RD L04 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: POTTERY BARN
Project Description: Installing (1) low voltage data system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC SERVICE COMMUNICATIONS INC
BY THE MACERICH COMPANY 4120 SE INTERNATIONAL WY A -109
9585 SW WASHINGTON SQUARE RD MILWAUKIE, OR 97222
TIGARD, OR 97223
Phone: Contact #: PRI 503- 723 -6415
FAX 503 - 723 -6416
FEES Reg #: ELE 3- 365CLE
LIC 90175
Description Date Amount SUP 3833LEA
[ELPRMT] ELR Permit 5/8/2008 $75.00
[TAX] 12% State Surch 5/8/2008 $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 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: / Permittee Signature: y r) , z
/.0
/ 7% 2 jj
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.
, May -06 -2008 04:39 PM Service Communications, Inc. 503. 723.6416 1/2
1 Dc- 2 . pope
, ��,
'Electrical Permit Application 4173 639
Inspection Line: 503 1 OR iH.I WE 1.66: ONLY
R etelvod omut No.:
City of Tigard �� r t • 0 Resets . 9r� t+ f /I ' ���� �'�
a 13125 SW Hall Blvd., Tigard, OR 9722 A
III
3 ` 1 1,. 0 plc '� i t/_
II Phone: 503.639.4171 Fax: 503.598.1960 `► ` ` alit it/./ See r / 0
Its .. \`t • By: age 2 f
f1GAltl) p c'�G �l:I etitod: SupplementallofarmatIon
Internet; www.tlgard- or.gov �T w ' °'
TYPE OF WORK ' ., PLAN` REVIEW ., , ,
Please cluck all that apply (submit 2 sate ofpmtu wlltems clucked below):
® New construction 0 Addition/alteration/ t ❑ Service or feeder 400 amps or mote 0 BuIlding over th stories.
❑ Demolition ❑ Other: where Ma available Mutt currant 0 Marinas and boatyards,
• CATEGORY OF CONSTRUCTION exceeds 10,000 amps at ISO volts or 17 floating buildings.
lets to ground, or exceeds 14,000 ❑ Commercial - use agricultural
❑ l - and 2- family dwelling ® Commercial/Industrial ❑ Accessory building orrtps for all other hnmllations. buildings.
0 Multi- family ❑ Master builder 0 Other: ❑ Fire pump. ❑ lnnotlalton of73 KVA or
AND LOCATION ❑ Emergency
dltlenotno "A", ","1 derived
JOB SITE INFORMATION AN
_ ❑ Addltlan of now motor load of CI 'A", "g", "1- 2 ". "1,3",
100HP or more. occupancy.
Job no.: CROTE89I1 I Job site address: 9585 SW Washington Square ❑ Six or more residential units. ❑ Recreational vehicle perks.
City/State/ZIP: TI and Oregon 97223 n ❑ Health -oars fl,eilitics. ❑ Supply voltage fbr more than g _ ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: C 01A Project name: Pottery Barn Cabling ❑ service or feeder 600 amps armore.
FEE SCHEDULE
Cross strect/directions to job site: Off HWY 217 x Greenberg Rd De rlotIonn I our, I,/ P e Tams " •
Now rosidentlal single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. tt or less 145.15 4
Ea. edd'I 500 sq. ft. or portion 33,40 I
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. fl.) _
Limited energy, multi - family 75.00 2
Install ing Low Voltage Cabling residential (with oboneV-)
Services or feeders installation alteration, and/or relocation
aiiiii °C') v'r ct // 200 amps or loss 80.30 2
❑ PROPERTY OWNER • ■ TENANT 201 amps to 400 amps 106,85 3
Nana: 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
Ci /State /ZIP: Temporary services or feeders installation, alteration, and/or
tY relocation _
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 I
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, or p
Owner signature: Date: A. Foo for branch circuits with
❑ APPLICANT 1 ❑ CONTACT PERSON
above service or feeder ibe, 6.65 2
each btaneh circuit
Business name: B. Fee for branch circuits
without service Or tbeder fee, 46,85 2
Contact name: _ first branch circuit
Each add'/ breach olrouit 6.65 2
Address: Miscellaneous (service or feeder not included)
City / State/ZIP: Each manufactured or modular 90.90 2
dwelling, service and/or fbeder
Phone: ( ) I Fax: : ( ) Reconnect only 66.85 2
e-mail: Pump or irrigation circle 53.40 2
CONTRACTOR • Sign or outline lighting 53.40 2
Signal clreult(s) or limited -
Business name: Service Communications Inc.
energy panel, alteration, or
Address: 4120 SE International Way Suite A 109 extension. Describe: Page Paget 575.00 2
City/State/ZIP: Mllwaukie, Oregon 97222 Each additional Inspection over allowable in an of the above
Per inspection 62.50
Phone: (503) 723 -6415 Fax: (503) 723.6416 _ Investigation per hour (I Iv min) 62.50
CCB Lic.: 9017,1 I Electrical Lie.: 3 -365CL Suprv. Lie.: 3833E Industrial plant per hour 73.75
1 1.)/./ if %., /// 1� r r ELECTRICAL PERMIT FEES '"
Suprv. Elecet trician signature, r 1 i ed: Subtotal; $75.00
..as Plan review (23% of permit fee):
Print name: Desna DeCoster� gate: 5/06/2008
% '; l./ State surcharge (12% of permit fee): $9.00
Authorized signature: - .` TOTAL PERMIT FEE: $84.00
t_� r D ata: 05/06/2008 — fhb permit app cation expires If a permit Is not obtained wrthln 180
Print name: Bill I4alg days attar It has been accepted as complete.
• Number of inspections allowed par permit.
lattllding ennitsTLGPemdtApp .doe 05/21/06 440.4615T(11105nAMIWB13
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EI-R2008- 00110
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/8/2008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 J `'' L
INSPECTION WORKSHEET FOR DATE: 5/16/2008 TIME: 7:00AM PAGE: 34
SITE ADDRESS: 09619 SW WASHINGTON SQUARE RD L04 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: POTTERY BARN
DESCRIPTION: Installing (1) low voltage data system.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: SERVICE COMMUNICATIONS INC PHONE #: 503-723-6415
Inspection Request Scheduled For: Date: 5/16/2008 Pour Time:
Code # Inspection Description zairlfirm # Contact # Message
199 Electrical final 069981 -01 971 - 570.4321 N
Corrections /Comments / Instructions:
2 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • Ku) Lei Date: GI I 6 V p Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR200B -001 10
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 5/8/0008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/16/2008 TIME: 7:00AM PAGE: 40
SITE ADDRESS: 09619 SW WASHINGTON SQUARE RD L04 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: POTTERY BARN
DESCRIPTION: Installing (1) low voltage data system.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: SERVICE COMMUNICATIONS INC PHONE #: 503
Inspection Request Scheduled For: Date: 5/16/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 069966 -01 971-570-4321 N
Corrections /Comments /Instructions:
Q /A
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G` • N 0e L Date: SII 17101 Phone #: (503) 718- PillO