Permit 71 C a
-*CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00353
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/17/2007
PARCEL: 1512600 -00300
SITE ADDRESS: 09779 SW WASHINGTON SQUARE RD D - 11 ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: CHAMPS
Project Description: Installation of limited energy for voice /data. Job No. 2649
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 TRITON COMMUNICTATIONS, LLC
BY THE MACERICH COMPANY PO BOX 1091
9585 SW WASHINGTON SQUARE RD HILLSBORO, OR 97123
TIGARD, OR 97223
Phone: Contact #: PRI 503- 615 -5800
FAX 503- 628 -5689
FEES Reg #: ELE 34- 648CLE
LIC 154665
Description Date Amount
[ELPRMT] ELR Permit 9/17/2007 $75.00
[TAX] 8% State Surcha 9/17/2007 $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
Issuanc- • ' ork is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Uti • Notification • -nter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
r es or direct questio to ! C at 503.246.6699 or 1.800.332.2344.
Is - ed By: ` • , ./,,4/ / . ' Permittee Signature: 1 K 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.
!v t,
Electrical Permit Application 1 OFFICE USE ()NI.)
City of Tigard Received / Q 7 0 7 .. igi Permit No.: f.,e,Qf+G'a77 — 00 53
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 DateB Other Permit:
T G n R D Ins Line: 503.639 Date Ready/By la See Page 2 for
Internet: www.tigard or.gov Notified/Method. Supplemental Information
TYPE OF WORK PLAN REVIEW
® New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /Items checked below)
❑ 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 ", "I - 2" "I - ",
Job no.: 2649 Job site address: 9779 SW Washington Square Road 100HP or more. occupancy.
❑ Six or more residential units ❑ Recreational vehicle parks
City/State/ZIP: Tigard, OR 97233 ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt no.: Project name: Champs ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: J Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map/parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Install AudioNideo System Limited energy, multi-family 75.00 2
Y residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 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: ( ) 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: Branch circuits — new, alteration, or extension, per panel
! 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
Contact name: without service or feeder fee, 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: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal panel, or alteration, limited-
Business name: Triton Communications, LLC
energy panel, alteration, or
Address: PO Box 1091 extension. Describe: I Page 2 75 2
AN System
City/State/ZIP: Hillsboro, OR 97123 Each additional inspection over allowable in an of the above
Per inspection 62.50
Phone: (503) 615 - 5800 Fax: (503) 628 - 5689 Investigation per hour (I hr min) 62.50
CCB Lic.: 154665 Electrical Lic.: 34 -648CL Suprv. Lic.: 2826LEA Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 75
Print name: Aaron Van Fleet Date: 9/14/07 Plan review (25% of permit fee):
State sur (8% of permit fee): 6
a ,. Authorized signature: 1. TOTAL PERMIT FEE: 81.00
Print name: Aaron Van Fleet Date: 9/14/07 This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
• Number of mspectlons allowed per permit.
I.\BuitdiiPmnits\ELC- PeemitApp doc 05/23/06 440- 4615T(11/05 /COM/WEB
CITY OF TIGARD
r
BUILDING DIVISION PERMIT #: ELR2007 -00363
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/17/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/20/2007 TIME: 7:00AM PAGE: 51
SITE ADDRESS: 09779 SW WASHINGTON SQUARE RD D-11 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: CHAMPS
DESCRIPTION: Installation of limited energy for voice/data. Job No. 2649
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: TRITON COMMUNICTATIONS, LLC PHONE #: 503615 -5800
• Inspection Request Scheduled For: Date: 9/20/2007 Pour Time:
Code # Inspection Description ' onfir • Contact # Message
135 Low voltage 1.5980.01 503-710-1715 N
MC\ NO
Corrections /Comments /Instructions:
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V • us Date: 'to 09 Phone #: (503) 718- 2I