Permit „, A CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
4 DEVELOPMENT SERVICES PERMIT #: ELR2006 -10025
- ,_� I ” 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/22/2006
PARCEL: 1S12600-00300
SITE ADDRESS: 09710 SW WASHINGTON SQUARE RD F -1 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Limited energy for speaker wiring.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: .
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC PROCOM COMMUNICATIONS INC
BY THE MACERICH COMPANY P.O. BOX 22288
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97269
TIGARD, OR 97223
Phone: Contact #: FAX 503 233 - 8052
PRI 503- 233 -8037
FEES Reg #: ELE 3- 397CEP
LIC 109929
Description Date Amount SUP 2933LEA
[ELPRMT] ELR Permit 4/5/2006 $75.00
[TAX] 8% State Surcharl 4/5/2006 $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 0 52- 001 -0100. You may obtain copies of these rules or direct • : stions to OUNC at 503 - 246 -6699.
Issued : l �l-� Permittee Signature:., ,HIV 7 -
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.
EI ec ical Permit Application I oa OFFICE I sE ON I 1
i t of Ti d D a te / B J
C "
y g an ate/B : a e , , PermitNo.: du,cc - l�a�
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/B tither Permrt: C-L .�
Inspection Line: 503.639.4175 ,,,144- ' i,, Date Ready/By: ' ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method - 1 t a Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
ID Demolition ❑Other: ❑Service over 225 amps, comm'I ❑Hazardous location
❑ Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of I- 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 ❑ Master builder ❑ Other:
DBuilding over three stories ❑Feeders, 400 amps or more
['Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
j, ,' • n Q ❑Health-care facility ❑lei:
Job no.:
y 7/4 S� ��dH �-( " � Submit 2 sets of plans with any of the above.
e - ,,i/r7- G, !` The above are not applicable to temporary construction service.
FEE* SCHEDULE
Suite/bldg. /apt. no.: e, Love- v e- Z I
/
Description I Qty. I Fee. I Total I ••
Cross street/directions to job 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'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
Each manufactured or modular
1 dwelling, service and/or feeder 90.90 2
o v - v0 C c P \ Se eck key t.,/ i ✓ r 1 q Services or feeders installation, alteration, and/or relocation
J 200 amps or less 80.30 2
I ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: U e, s)., ; ^ o .-1 S . c r e L L C 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
- Reconnect only 66.85 2
I R /State/ZIP: Temporary services or feeders installation, alteration, and/or
f relocation
j� ) 5 % % - &�`� 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
Address: first branch circuit
Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone:
( ) I Fax: : ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
energy panel, alteration, or
Business n 1 extension. Describe: Page 2 2
• r r0 Co o n 0 . � 1,- - tt�✓ -1 S
/press: 9 3 2S 5E 1 7th, A vG Each additional inspection over allowabk in any of the above
Per inspection 62.50
City /State/ZIP: PO ✓ & t Q -, c / o R / 9 7 2 ' °1 Investigation per hour (1 hr min) 62.50
Eb�e,(5o3 2 33 - 8a 3 7 I Fax: ( ) Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
le 99 2 / 9 I' 2 ic.: I Sum. Lic.: Subtotal 7b c
Suprv. Electrician r uired: 3- 377 (.Lt 7/, /i,(p Plan review (25% of permit fee)
Print name Date: ) State surcharge (8% of permit fee) it ,. O a
TOTAL PERMIT FEE c?"
n 1
G -� This permit application expires if a permit is not obtained 180
l / // days after it has been accepted as complete
villip L4 ✓ ✓ 'r
q e t 3 -- 22- 06 • Fee methodology set by Tri -County Building Industry Service Board
•• Number of inspections per permit allowed.
tiBuilding \Permits\ELC- PumitApp.doc 11/31/05 440.4615T(I0/02/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
El Burglar Alarm
El Garage Door Opener*
El Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
El Audio and Stereo Systems
El Boiler Controls
El Clock Systems
El Data Telecommunication Installation
El Fire Alarm Installation
❑ HVAC
El I nstrumentation
❑ Intercom and Paging Systems
El Landscape Irrigation Control*
El Medical
El Nurse Calls
El Outdoor Landscape Lighting*
El Protective Signaling
El Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Building \Permits\ELC- PermitApp.doc 12/30/05
CITY OF TIGARD ; Z 2
BUILDING DIVISION PERMIT #: .2006 – / d b--
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 F'_L •
INSPECTION WORKSHEET FOR DATE: • • TIME: PAGE:
SITE : DDRES . CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ���� vJ�S `
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
•
Inspection Request Scheduled For: Date: 3 — Z 3- 0 co Pour Time: � in
Code # Inspection Description Confirm # Contact # Message
.5 - 9 % /7
Corrections/Comments/Instructions:
t i c S EGO ' - -
•
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
Uk AIL A CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
q� r 3 r
Inspector: '&4 1`S�L6 Date: 2 I �1� Phone #: (503) 718- Zglig
CITY OF TIGARD
R. r
BUILDING DIVISION PERMIT #: ELR2006-10025
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/22J2006
Phone: (503) 639 -4171 ,„A
Inspection Requests (24 Hrs.): (503) 639 -4175 .... "'I L.
INSPECTION WORKSHEET FOR DATE: 56/2006 TIME: 7:10A1v1 PAGE: 3
SITE ADDRESS: 09710 SW WASHINGTON SQUARE: RD F - 1 _ CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: FOR LOVE 21
DESCRIPTION: Limited energy for speaker wiring.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: PROCOM COMMUNICATIONS INC PHONE #: 503 - 233 - 6037
Inspection Request Scheduled For: Date: 6/5/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
`199 Electrical final 029386 -02 360. 601 -8167 N
Corrections /Comments /Instructions.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: UV 6Q (E Date: (5 Phone #: (503) 718- 2j10
CITY OF TIGARD = .., _
BUILDING DIVISION PERMIT #:4 �.0t76" /0 0 2
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 Ak° � 1 iik
Inspection Requests (24 Hrs.): (503) 639 -4175 A L
INSPECTION WORKSHEET FOR DATE: TI E: Aim p PAGE:
L D
SITE ADDRESS: Cr) D /MO L � S 1zd ' 1 e Gi CLASS OF WORK:
SUBDIVISION: Y LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #: 5 56— 5i O
CONTRACTOR: i ; PHONE #:
Inspection Request Scheduled For: Date: 3 --D-y--0 Co Pour Time:
Code # Inspection Description Confirm # Contact # Message
13 v, ^i 3,c/- V
, (rt O /Comments /Instructions:
•
•
A PASS ❑ PARTIAL APPROVAL ' ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL F R INSPECTION El ADDITIONAL FEES ASSESSED 1
ViN Inspector:
G ' ��' Date: Phone #: (503) 718- 1.--4 ,