Permit ' a CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00352
TIGARD DATE ISSUED: 9/14/2007
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S12600
SITE ADDRESS: 09779 SW WASHINGTON SQUARE RD D - 11 ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: CHAMPS
Project Description: Limited energy for voice /data. Job No. 43418 - 13
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 CACHE VALLEY ELECTRIC COMPANY
BY THE MAC ERICH COMPANY 9315 SW NIMBUS AVE BLDG 10
9585 SW WASHINGTON SQUARE RD BEAVERTON, OR 97008
TIGARD, OR 97223
Phone: Contact #: PRI 503 - 431 -6600
FAX 503- 624 -1436
FEES Reg #: ELE 26- 1135CLE
LIC 148222
Description Date Amount
[ELPRMT] ELR Permit 9/14/2007 $75.00
[TAX] 8% State Surchart 9/14/2007 $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 • • - : - ' 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503 246 6- •9 or 1 800 332.:
� / I 1 •
Issued . y: �/� ,� Permittee Sign ture: I . 2��'� L/�' /-
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, ease, 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.
09/14/2007 14:58 FAX 425 424 9966 CACHE VALLEY ELECTRIC gi001
09/14/2007 13:38 FAX 5035981960 CITY OF TIGARD el 001
_. _..._ .....■ algopm m■■ mweallle .... . . a. ..• .. ■■■■• 8 mmam •
.. .. .... . •
ctrical Pei
rmt ApplicafmtrAmotir- POt qr-r, FOR OFFICE USE ONI.,l' . .:
,
...".....—..—....—. n el ,, C.N r R.) Received ° 0 Permit No.: 0.4207-co 6'2_
City of Tigard Dato/13 .
!p 13125 SW tid I Blvd.,11gard, OR 974P 11 IQ 200 Plan Review •
it:
- Phonr. 503.6!9.4171 fax 51)159 . Other Perm
k:1 A ci' Datc/Et :
■
TIGAKD inspection Lk 3: 503.639.4175 ('VC* 1161#170 DMA Ready/By:
ed/Method: Iii See Page 2 for
ii5111 Suppleteentsanformation
htternett www.ligarn-or.gov fi gic , rjuv t a 1;
....
..,.. - ''.V 11,:-411:11.40RIC::;%.,•;;;.:V.:.:•.;,74:4-f4Th, ':0,- Notifi ",..1'•.V:i.:: li.).::.FIAN.:41.EyltWL.0,....p:;:,;;.F-y,.::::.1.:......:, .......!.:.-;. •
Please cheek Ell that apply (su =El plans w teats checked below):
0 New construction ED Addition/alteratIon/replaceMent
CI Service or reader 400 mops or more CI Building over three stories.
0 Demolition 0 Other wham the available fault current ID Marinas and boatyards.
i ....... ....r r*. • . (. !..'.:..7.r:*;t4fteikiiiir.:410?'6000.6iiii0V.!.: :: ...:...i exceeds 10.000 amps at 150 volts or in Floating banding:.
lc I ground. Or exacc09 14,000 0 Conunercial-use agricultural
CI 1- and 2-fhtrilly dwelli 10 Commercial/industrial 0 Accessory building ' amps for sii other installations. buildings.
0 Multi-family 0 Master builder 0 Other. One pump. CI installation of 75 KVA or
Istga separately derived system.
ffi.F ‘..:(i';:9.::;,m1::.::::,j:?:,:::::=:.$P CI Addition ornow motor load of 0"A",
100HP orluotc. occupancy.
Job no.:4141 11 ;lob site address: 9779 SW Washington Square Road CI Six or MGM residential units. 1:1 Recreational vehiale parks.
. 0 Health-we facilities. 0 Supply voltage for mom than
City/State/ZIP: Tigard, Cr-egon 9'7223 CIRsurdouslocatient. 600 volts notnimat
Suite/bldg./apt. no.: Dll j Project name: Champs-Washington Square D Service or feeder 600 amps orators.
SlLiY.ii,M
Cross street/directions to .I.sb site: Digcrialsaa 1 Qty., I Hee. . I Teel . . i •
New residential stogie- or multi-family dwelling unit.
Includes attached garage. .
Subdivision: I Lot no.: 1,000sqft . or less 145.15 4
Es. addi 500 sq. ft. or portion 33A0 1
Tax map/parcel no.: Limited energy. residential '75.00 2
-
7: i:: ( ' lg. a) _ ,
Limited energy, multi-family
Install two voice/data a: h 75.00 2 residential (with allot sq,11.)
Services or feeders Ensiling uonolteration, and/or relocation
200 anips or less _ 80.30 2
..,....1../.ji.':::MaiiifijiiiiiiigoWili.2,:41....:•::?.:;" El ZitgiCAP 201 amps to 400 amps 106.85 2 I
Name: Champs 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2 .
Address: over 1,000 amps Or VOHS _
454.65 2
City/Stato/Z1F: Temporary services or feeders installation, alteration, and/or 1
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
intended for sale, lease, tent, or exchange, according to ORS 447, 449, 670, and 701, 401 arnps to 599 nays 133.75 2
Branch circuits— new. Alteration. or extension. per panel _
Owner signature: Dare: A_ Fee for branch circuits with
. i . •,' t 1". above sorvice or ( =der fee. 6.65 2
each branch circuit
Business name: Cache Valley Electric B.Pee for branch circuits .
• without service or feeder fee,
Contact name: Brian Hs tnitton 46.85 2
first branch circuit
Address: 9315 SW Niro', 0 Each addi branch circuit 6.65 1 2
. Miscellaneous (service or feeder not Included) _
City/State/Z12: Beaverto3, Oregon 97008 Each manufactured or modular dwelling, service and/or feeder 90.90 2
_
Phone: (503) 431-6600 I Fax: : (503) 624.1436 Reconnect only 66.85
-
- , -
E-mail: brianh@cve.co:si Pump or irrigation circle 53.40 2
... . , -
.'''=.3::; ;r:14fiiLi;.??:>:.:',Ai!.?..7...t19■PrOTO.C!':4.;;.:::::!).:fe::WN4r:::::.;;;:;:?::::."::•.FSiiii: sign or outline llglitivg 5340 2
Signal circuit(s) or limited-
Business name: Cache valley Electric energy panel, alteration, or
Address: 9315 SW Nimbus extensio%rib_e: / Page 2 2
R-
.
City/State/ZIP: Beaverton, Oregon 97008 E additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 431-6600 I Fax: (503) 624
awestigation per hour (1 hr min) 62.50
CCB Lie.: 148222 I Electrical Lie.: 201347 I Suprv. tic.: Industrial plant per hour 73.75
.::?1.110::'ZIW.:TEECIT.tle.A01144111V Ei11iS.,.::.:::::::::::;:f.::,',%,1r;!.F.?:
Suprv. Electrician signature, required: Subtotal: 75.00
,—
Print name: Plan review (25% of permit fee):
a : e:
State surcharge (8% of permit fee): 6.00
y Authorized signature: wriVINIFIITM(LMIIP TOTAL PERMIT FEE: . 81.00
This permit =pplkistioft expires ti a permit is not obtained within 180
Print name: Brian Mare Date: 9/13/07 dsys after ft has been accepted as template.
.
Numb of inspeations allowed per permit
tteutidingweanitASLC-seantiApp.. tee amens 440-461STO nosiccavvvres
.
•
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: ELR2007- 00362
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/14/2007
Phone: (503) 639- 4171 ' .
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/2W2007 TIME: 7:00AM PAGE: 48
SITE ADDRESS: 09779 SW WASHINGTON SQUARE RD D-11 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: CHAMPS
DESCRIPTION: Limited energy for voiceldata. Job No. 43418 -13
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: . CACHE VALLEY ELECTRIC COMPANY (LM) PHONE #: 503431 -6600
Inspection Request Scheduled For: Date: 9/20/2007 Pour Time:
Code # Inspection Description Co ► irm Contact # Message
136 Low voltage 0 5997 -01 971 - 235.9454 Y
i q q FitJAL.
Corrections /Comments /Instructions:
CIP___ bl
> iz PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C.," g 6b 1.6 Date: Q 0109 Phone #: (503) 718-