Permit II v CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00256
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/9/2008
PARCEL: 1S12600-00300
SITE ADDRESS: 09714 SW WASHINGTON SQUARE RD F04 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
' PROJECT: JUST SPORTS
Project Description: Low voltage for HVAC
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: OUTDOOR LANDSC LITE:
OTHER: : HVAC: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WASHINGTON SQUARE LLC ARROW MECHANICAL
BY THE MACERICH COMPANY 10330 SW TUALATIN RD
9585 SW WASHINGTON SQUARE RD TUALATIN, OR 97062
TIGARD, OR 97223
Phone: Contact #: PRI 503- 692 -1565
Reg #: ELE 34 -47CLE
FEES LIC 5193
Description Date Amount
[ELPRMT] ELR Permit 9/9/2008 $75.00
[TAX] 12% State Surch 9/9/2008 $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 d' questions • as 03.246.6699 or 1 800.332.2344.
Issue By: I Permittee Signature:
/ I /!� 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.
Electrical Permit Application FOR OFFICE t'SE ONLY
lig City of Tigard D Received a O 7 m , Permit No . i , 0; ,� , _ 13125 SW Hall Blvd., Tigard, OR 97223 plan Review
' B Phone: 503.639.4171 Fax: 503.598.1960 Date/By: other Permit
1' 1 t ; A 1: i 1 w Inspection Line: 503.639.4175 Date Ready/By H See Page 2 for
Internet: ww.tigard- or.gov NatiSed/Method ([, Supplemental Information
- ,irt;'i 1, . " - TYPE OF WORK - : PLAN REVIEW
Y
❑ New construction Addition/altinationheplacement
Please check all that apply (submit 2 sets of plans whtems checked below):
❑ Service or feeder 400 amps or more 0 Building over three stories
❑ Demolition Other where the available fault current ❑ Marinas and boatyards
CAT RY OF CONSTRUCTION ; ; i : " - ' exceeds 10,000 amps at 150 volts or ❑ Floating buildings
CI 1- and 2- family dwelling E Commercial/industrial for ❑ Accessory building less to ground, a exceeds 14,000 ❑ Commercial-use agricultural
r all other installations- buildings
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency hem larger separately derived system
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: L � , 100HP or more occupancy.
9 7 `� 5W l� �s � ,r ❑ Six ar more residential amts ❑ Recreational vehicle parks
City/StateJZIP: c ® . U ❑ Health -care facilities ❑ Supply voltage for more than
_ ❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: Pf Project name: tl u a G, 3(70 ce ❑ Service or feeder 600 amps or more
FEE SCHEDULE Cross street/directions to job site:
DesalpUoa I Qty. I Fee. I Total
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. R or less 145.15 4
Ea. add'l 500 sq. ft or portion 33.40 1
Tax map/parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq ft.) 75.00 2
j �� "�7J Limited energy, multi - family
(1) 1 ® ('/C� i X� L egg 1 6e 0 -1 1 ,l .� /�`- residential (with above sq ft.) 75.00 2
/1 Services or feeders installation, alteration, and/or relocation
/ ® � Z 200 amps or less 80.30 2
❑ PROPERTY OWNER I "(TENANT 201 amps to 400 amps 106.85 2
Name:
' 37/S1 -
�- , 51 - 5/5A // �r 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 1 7 Py 6 dig 564/ Dio i- *Mtgeflda Over 1,000 amps or volts 454.65 2
City/State/ZIP: // / f ° y Oe Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) 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: Branch circuits — new, alteration, or extension, per panel -
A Fee for branch circuits with
ig APPLICANT . I Et CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: A g R ova M EGb+/t r`l l GA 1 B. Fee for branch circuits
without service or feeder fee,
Contact name: 6)4 f 97it...,_ 1s- m. first branch circuit 46.85 2
Address: lc 330 6v" `rvA I A-11,M RA. Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: -T-i, /ATI m pie, 4.706i Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: ( !p3 )4,q 2 _ 6-6 E Fax: : (60;3) £4 I -1 671 Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Signal circuit(s) or limited -
A R lZ a..k /"` 6r(A4Ar/M111A1 energy panel, alteration, or 1'
Address: l b 33 (° , 6V1 TUA 1 - T .. 'I a • extension. Describe: i Page 2 2
City/State/ZIP: `tb n �'a .0 o ft 4764z Each additional inspection over allowable In any of the above
(�� Per inspection 62.50 •
Phone: 64 2 -.16-66-- Fax: (CO?j)I I$ 74 Investigation per hour (1 hr mm) 62.50
CCB Lic.:6 iq 3 Electrical Lic.: ? , 47!16 Suprv. Lic.: 13 ,.. Industrial plant per hour 73.75
` ELECTRICAL PERMIT FEES
Suprv. Electrician signature, requiredr'll�/0 Subtotal:
Print name: Rc % r er �.4 fiQL L � 0. Date: ur Plan review (25% of permit fee): 7` 0
State surcharge (12% of permit fee): O
Authorized signs .r-' TOTAL PERMIT FEE: SC— [6
Print name: ' ` -
This permit application expires if a permit is not obtained within 180
y Date: days after it has been accepted as complete.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR20I18 Di1r56
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/912008
Phone: (503) 639 -4171 :'P`�9
Inspection Requests (24 Hrs.): (503) 639 -4175 ,_ ' "'I I_
INSPECTION WORKSHEET FOR DATE: 10/20/2008 TIME: 7:00AM PAGE: 34
SITE ADDRESS: 09714 SW WASHINGTON SQUARE RD F04 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: JUST SPORTS
DESCRIPTION: L' voltage for HVAC
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: ARROW MECHANICAL PHONE #: 503 -692 -1565
Inspection Request Scheduled For: Date: 1012012008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 076882 -01 503-'193-2843 Y
Corrections/Comments/Instructions:
AM
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I ❑ AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Zr O N 6 L. Date: 1 Oit 6 Phone #: (503) 718 - 1-ygi