Permit •
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00334
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/6/2007
PARCEL: 1512600 -00300
SITE ADDRESS: 09689 SW WASHINGTON SQUARE RD C - 8 ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: COACH
Project Description: Low voltage cabling for data and telecommunications.
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 LAN TEL SERVICES INC
BY THE MACERICH COMPANY 1900 IRVING RD BLDG C
9585 SW WASHINGTON SQUARE RD EUGENE, OR 97402
TIGARD, OR 97223
Phone: Contact #: PRI 541 - 688 -1427
FAX 541- 688 -4642
FEES Reg #: ELE 20- 353CLE
LIC 90461
Description Date Amount SUP 113LEB
[ELPRMT] ELR Permit 9/6/2007 $75.00
[TAX] 8% State Surcha 9/6/2007 $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 are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or dire- • • - .tions to OUNC at 50 46.6699 •r 1.800.332.2344.
Issued By • /jJ ` . /J Permittee Signature: 4/3/04"(.4. �
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.
SEP -r' -2007 08:12 -
LAN TEL SVCS EUGENE P.03
EiettriCai Permit Applica - CEIVED ,:oR ,,,F K1 USE ONLY
Received
City of Tigard ,. ._, Datem . PRai Permit : E- A 200 _0
1 ki 13 125 SW Hall Blvd., Tigard, OR 9Ki2gb, 0 6 OO/ Plan Review
. '• Phone: 503.639.4171 Fax: 503.598.1-%0 Z Datellaty: Other Perrnit
al
T 1 G A R 0 Inspection Line: 501639.4175 CITVOF 11 Date Ready/By. Jals,.,, „, 0 Sec Page 2 for
Intcrrlet: www.tigard . Notified/Method H (dr Supplemental Information
? .::::::i1rAO
Please check 41 that apply (submit 2 sets of plans w/items cliecked below):
121 New construction El Addition/aiterationfreplacement
0 Service Or feeder 4 no
--, aMp-S Or MOM 0 Building over three ItOrift.
0 DemolitiOn ;::Ti El Other. where the available fault consait 0 Marinas and boatyards
:t
t :14:.' exceed D s 10,000 amps at 150 volts or Flailing buildings
;.-.. . ; ,.,....x.,..
z........,..&.,,.„gi.,„.0..7.,.... j ..p.: .....,-..-.. 0 *-:..". , ."Z.'ar- .:`;.;:- .• •••:'•• '',', less to ground, or exr-e eds 14,000 0 Commercial-use agicul tura I
0 1- and 2-family dwelling El Commercial/industrial 0 Accessory building amps for all other installations buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KvA or
larger separately denvcd system
Ei . r !' : - .. ..'4' 1 ' : ?'•? 0 Addition of new motor load of
100HP or more. occupancy.
Job no; Job site address: 9689 SW Washington SQ RD
0 sik or more residential units. (2I Recreational vclucic parks.
City/State/ZIP: Tigard, OR 97223 D Health facilities. El Supply voltage for more than
0 Hazardous locations, 600 volts nominal.
Suite/bldg./apt. no.: #C-08 I Project name: Coach Store 0 Service or feeder 600 amps or more.
'1;015 ' 31 : 1 4440 . PMe:#:; 1 .Wk#0 ,
Cross street/directions to job site: Description i qtr. I Fee. I Total •
•
New residential single or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,0005q.11. or los4
T / : Ea. add'I 500 sq. ft or portion 33,40 1
ax mapparcel no.
.... . Limited energy, residential
75 00 2
TIE*** .:.1. 0 1i ngi:Aig l ig'afigiii: (with a JO
Limited energy. multi
Low voltage cabling
residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
, „ , .
it,OMtiaofhrggTV?;:A:%g:::'S;:gg.5h.;xAtoe.iril,nR.:i2.w. 201 amps to 400 arnps 106.85 2
_ 401 amps to 600 amps
Name: Coach Store 160.60 2
601 amps to 1,000 amps 240.60 2
Address:
Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 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 599 amps 133.75 2
Owner signature: Date: Broach circuits -new, alterat1o5 or extension, per panel
A Fee for branch circuits with
M 0 . 4 4 *. :::::'.4:giii-t4280:Vaa.:g.grItti*fat:#00.4.A.::i.:§:100 above servi<m or focdcr fee, 6.65 2
each branch circuit
BUsiness name:
B. Fee for branch circuits
without service or feeder fcc,
Contact name: 46.85 2
_ first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
• dwelling. service and/or feeder 90 90 2
Phone: ( ) 1 Pax; 'I )
—
Reconnect only 66.85 2
E Pinup or irrigation circle 53.40 2
r
R-Mditt011 Sign or outline lighting 53.40 2
Business name; LanTel Services Signal circuit(s) or limited
energy panel, alteration, or 1 '75.00
Address: 1900 Irving Road Bldg. C extension. Describe: Page 2 2
— Low voltage .
City/State/ZIP: Eugene, OR 97402 _:ach additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (541) 688-1427 i Fax: (541) 688-4642 Investigation per hour (I /untie) 62.50
CCB Lie.: 90461 1 Electrical Lie.: 20353CLE i Suprv. Lic.: 113LEB Industrial plant per hour 73.75
Suprv. Electrician signature, required: E 9 / 1 :::i:V: . ■ - r . ' :
/0/1 /0; — ... • • • ' — •
Subtotal: .......,—,...,.--
75.00
Print name: Eric Russell Date: 8/30/07 Plan review (25% of permit fee):
— State surcharge (PA of permit fee): 6.00
Authorized signature. TOTAL PERMIT FEE: 81.00
—
Print name, r
zi-Lv c-Aro-a. Date: This Q ..0----p--, is permit application expires if a permit Is not obtained within 180
days atter it baa been accepted as Complete.
• NlirrIbtr of inspections allowed per pennit.
BEItolding\rehoNZLC-PermitApp.doc 05123i06 440-1615T(11/05/COMAVEB
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: ELR2007 -00334
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/6/2007
Phone: (503) 639 -4171 4 +�
Inspection Requests (24 Hrs.): (503) 639 -4175 � `�I �..
INSPECTION WORKSHEET FOR DATE: 9/25/2007 TIME: 7:00AM PAGE: 17
SITE ADDRESS: 09689 SW WASHINGTON SQUARE RD C CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: COACH
DESCRIPTION: Low voltage cabling for data and telecommunications.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: LAN TEL SERVICES INC PHONE #: 541-688-1427
Inspection Request Scheduled For: Date: 9/25/2007 Pour Time:
Code # Inspection Description ,Confirm • Contact # Message
36 Low v• _ A 056281 -01 541- 2258486 N
orrections /Comments /Instructions:
•
•
N •
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL V ❑ NO ACCESS
n FAIL , n CALL FOR INSPECTION V ❑ ADDITIONAL FEES ASSESSED
'Inspector: INIG3 Date: I 10 Phone #: (503) 718 - a -'f4'2-
O'