Permit CITY T I OAR D ELECTRICAL PERMIT
PERMIT #: ELC2003 -00635
,L I�A DEVELOPMENT SERVICES DATE ISSUED: 10/15/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S126C0 01107
SITE ADDRESS: 09651 SW WASHINGTON SQUARE RD
SUBDIVISION: WIINGTON SQUARE ZONING: C -
BLOCK: LOT : JURISDICTION: TIG
Project Description: Tenant Improvement
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: 10 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 ST JOHNS ELECTRIC INC
BY THE MACERICH COMPANY 4415 NE MINNEHAHA
9585 SW WASHINGTON SQ. RD. VANCOUVER, WA 98661
PORTLAND, OR 97223
Phone: Phone: 360 693 - 5100
Reg #: LIC 43135
SUP 3024S
FEES ELE 37 -350C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 10/15/03 $113.35
[TAX] 8% State Tax 10/15/03 $9 Ceiling Cover
Wall Cover
Total $122.42 Elect'I Service
Elect'l Final
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: Permit Signature:
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 639 -4175 by 7:00pm for an inspection the next business day
Electrical Permit Application
: . .
Date received: Permit no.: _/
..,-
'I City y Of Tigard PP Expircdate: / "'••
b • t.no.:
Ciryoj7igard Address: 13125 SW Ha[�g'� Pro1 cct/a 23
Phone: (503) 639 -4171 e ee Date issued: By: Receipt no.:
Fax: (503) 598 -1960 � 14 2003 C8_CC file! nn • Payment type;
Land use approval:
WO
fk'Pc. OF PERMIT
:
CI 1 & 2 family dwelling or accessory •� CommcrciaUindusttial U Multi-family Y E) Tenant improvement
New construction
0 Addition/alteration/replacement 0 Other: _ _ ❑ Partial
JOB SITE INFORMATION
Job address: 9585 SW Washington Sq. Rd . 97223 Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Blnek: [Subdivision
Project name: Tenemos Tacos I Description and location of work on premises: inter space t . a .
Estimated date of completion /inspection: (food court)
- CONTRACTOR APPLICATION FEE SCIIEDILE
Job no: Western - Tenemos Tacos
Business Hama Fee Max
ST. JOHNS ELECTRIC, INC. Description Qty. (ea.) Total no. insp
Address: 4415 NE Minnehaha Street
New reddnutal- tangleoramlq.pmityper
City Vancouver
[ State: WA I ZIP: 98661 Se a mc�luded&ttka attached garage.
Phone :360- 693 -510 Fax :699- 1345IE -mail: 1000 sq. ft. or less
4
3 7 -350C Each additional 500 sq. ft. or portion thereof
(C B no.: 43135 Elec. bus• tic, no:
City /met 1
Limi�edene Limited energy, residential 2
non- 2
� . 10/14/03 acy residential
2nch manufactured home or module' dwelling
S igns , of su isi4 cctrician ( .uired) Date Service and/or feeder
2
Sup. elect. name (print�Dean R. Bjur License no: 3024S Services or feeders ittctallat;otr,
PROPERTY 01VNER alteration orrelocation:
200 amps or less 2
Name (print); 201 amps to 400 amps 2
Mailing address: — 401 amps to 600 amps 2
City: — 601 amps to 1000 amps 2
State: I ZIP: Over 1000 amps or volts
Phone: jFax: [E -mail: Reconnect only - 2
Owner installation: The installation is being made on property I own Temporary services or feeders I
which is not intended for sale, lease, rear[, or exchange according to toga nation, ulleratIon, o r relocation:
ORS 447, 455, 479, 670, 701. 200 amps or less
2
Owner's signature: 201 amps to 400 amps 2
—
Date: 40) t0600 am. s
5 EIN (.LNEER Branch circuits • new, alteration, 2
Name: or extension per panel:
Address: A. Fee for branch circuits with purchase of
_ service or (ceder fu, each btam:it circuit 2
City: State: ZIP: R. Fee for branch circuits without purchase '/ f
Phone: Fax: E-mail: of service or feeder fee, first branch circuit I ti(p,�Cl 1 4616 2
PLAN R1 :�'lE«' (Yleacc thee[: a ll that apply) Each additional branch circuit: �
1 p' ) Misc. (Service or feeder not included):
0 Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps- rating of 1 &2 ❑ Hazardous location Each sign or outline lighting
family dwellings 2
El building over 10.000 square feat fnnrnr Sicna nrnt it(s) nr a —mi nndrgy panel.
A System over 600voltt more residential units in one structure alteration, or extension"
CI Building over three stories 0 Feeders, 400 amps or more . 2
O Occupant load over 99 persons ❑ Manttfacturorl 5tntctures or RV park Description.
Each 0 Egress/lighting plan ❑ ()they Each additional htspection over the alto` y of the a}
Submit _ sets of plans with any of the above. 1ltvcs
Per stiliFga I I
ati on fee
The above are not applicable to temporary construction service. Other -
N „t all jurisdictions accept credit cards, please call jurisdiction for more infwtlo Permit fee $ l 1,3.
7( Visa ❑ MasterCard N otice: This permit app
expires if a permit is not obtained Plan review (at _ %) $ _
G card number _ / / within ISO days after it has been State surcharge 8%
nuires
Name o' der as ihoo, a oo credit card accepted as complete, TOTAL $ 1 j z , e �Z
C ardholder sigma= Amount
$1 Z 2 • �f Z
g —
i
440-4615 (6pprOM)
51.1t1°C
2.4 StrEISS909E 'zoai3 l c�S_ d6E�ZT co .1,1 '40o
CITY OF TIGARD 24 -Hour
BUILDING -Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / 3 d AM PM BUP
Location / cc A • 50 - Qe p Suite • MEC
Contact Person Ph (_31 0) 7 7 a " 18 I S PLM
Contractor Ph ( -36 0) 1 00 SWR
BUILDING Tenant/Owner / ELC 3 — O
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof •
- Other: - --
Final•
PASS PART FAIL
PLUMBING
Post & Beam
. Under Slab
Rough -In
Water Service
Sanitary Sewer •
Rain Drains
Catch Basin / Manhole )1/0 V
��� (,, I �- �. ) 0 9s1 3
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL -
MECHANICAL
Post & Beam
Rough -In
ine
Smoke Dames
in
T FAIL
ELECT ICAL
Service
Rough -In •
UG/Slab
Low Voltage
Fire Alarm
a Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
_ PART FAIL
SITE ❑ Please call for reinspect • RE: El Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date/c/ 6 c Inspector A Mr4
` / Ext
Other:
Final DO NOT REMOVE this Inspection record f Om the • b site.
PASS PART FAIL