Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
l DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00245
„iks .. - 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 DATE ISSUED: 10/10/2006
PARCEL: 1S12600-00300
SITE ADDRESS: 09751 SW WASHINGTON SQUARE RD D1 ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: ADVANCED NUTRITION. Telephone lines. Job # 610523.
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 HUGHES ELECTRICAL CONTRACTORS
BY THE MACERICH COMPANY 9640 SW SUNSHINE CT STE 600
9585 SW WASHINGTON SQUARE RD BEAVERTON, OR 97005 -4689
TIGARD, OR 97223
Phone: 503- 639 -8865 Contact #: PRI 503- 626 -3344
FAX 503- 626 -3377
FEES Reg #: ELE 34 -281C
LIC 49850
Description Date Amount SUP 4025S
[ELPRMT] ELR Permit 101101200E $75.00
[TAX] 8% State Surcha 10/10/200E $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 direct questions to OUNC at 503 - 246 -6699. �
Issued By: -�, Permittee Signature: �%/R , 1,417
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 USE ONLY
L Received _
/ O / � — 0 ` 1 r, fj 6 ���.. \ �
City of Tigard Date/By. O�!/� �Permn No
114 a 13125 SW Hall Blvd., Tigard, OR 97223 n r Plan Review
IS Phone 503 639.4171 Fax 503 598 1960 i 3 Date/By Other Permit
Inspection Line: 503.639 4175 Date Ready/By tunes/ la See Page 2 for
TIGARD
Internet: www tigard-or.gov Notified/Method. ) Supplemental Information
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /Items checked below).
❑ New construction ®Addition /alteration/replacement ❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1 - and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations buildings
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
❑ Emergency system larger separately derived system
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "l - ", "l - ",
100HP or more occupancy
Job no.: 610523 Job site address;9585 SW Washington Sqare Road ❑ Six or more residential units ❑ Recreational vehicle parks
City/State /ZIP: Tigard, OR 97223 q 75—i ❑Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: Project name: Advanced Nutrition ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total 1 •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145 15 4
Ea. add'I 500 sq. ft or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75 00 2
DESCRIPTION OF WORK (with above sq ft )
Limited energy, multi - family 75 00 2
Install telephone lines. residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 80 30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160 60 2
Name:
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
ty relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
201 amps to 400 amps 100.30 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 133 75 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B Fee for branch circuits
without service or feeder fee, 46 85 2
Contact name: first branch circuit
Each add'l branch circuit 6.65 2
Address:
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or Irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53 40 2
Signal circuit(s) or limited -
Business name: Hughes Electrical Contractors, Inc. energy panel, alteration, or
Address: 9640 SW Sunshine Court, Suite 600 extension. Describe: 1 Page 2 75 2
Telephone
City/State /ZIP: Beaverton, OR 97005 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 626 -3344 Fax: (503) 626 -3377 Investigation per hour (1 hr min) 62 50
CCB Lic.: 49850 Electrical Lic.: 34 -281C Suprv. Lic.: 4025S Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 75 00
Plan review (25% of permit fee). 0 00
Print name: Greg L. Woolfe
Date: 10 -09 -06
��� State surcharge (8% of permit fee) 6 00
Authorized signature: 4... i 712 i'ri [- . TOTAL PERMIT FEE• 81 00
This permit application expires if a permit is not obtained within 180
Print name: die ( e G ( •�� Date: /6 /U' 6 6 days after it has been accepted as complete.
' Number of inspections allowed per permit.
I \Building\Permits\ELC- PermitApp doc 05/23/06 440-4 15T(11/05 /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*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
• Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1 \Buddmg\Permits\ELC- PermuApp doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2006.00.45
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/10/2006
Phone: (503) 639 -4171 . A
Inspection Requests (24 Hrs.): (503) 639 -4175 ^' I I ..
INSPECTION WORKSHEET FOR DATE: 10/11/2006 TIME: 7 :02AM PAGE: 38 '
SITE ADDRESS: 09751 SW WASHINGTON SQUARE RD D1 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: ,
PROJECT NAME: ADVANCED NUTRITION
DESCRIPTION: ADVANCED NUTRITION. Telephone lines. Job # 610523. •
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503- 639 -8855
CONTRACTOR: HUGHES ELECTRICAL CONTRACTORS PHONE #: 503 -626 -3344
Inspection Request Scheduled For: Date: 10/11/2006 Pour Time:
Co. - - • - - • • - scription Confirm # Contact # Message
199 Electrical final 038018 -01 503-816-8057 N .
Corrections /Comments/ Instructions:
€-+Cd2.406‘ / W6qt) Cliir Wer (
, a
VI PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ ' ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 4 t4 ® 1 .-. 6 Date: % of I I( O Phone #: (503) 718-1A46