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Permit - - €ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00366 - 1 DEVELOPMENT SERVICES DATE ISSUED: 6/21/2004 „� 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S12600-00300 SITE ADDRESS: 09800 SW WASHINGTON SQUARE RD • 1~•UBDIVISION: WaiiNGTON SQUARE ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: 4 branch circuits for replacing 22 exit lights. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 3 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: PPR WASHINGTON SQUARE LLC JARMER ELECTRIC INC BY THE MACERICH COMPANY 5105 SW45TH AVE 9585 SW WASHINGTON SQ. RD. PORTLAND, OR 97221 PORTLAND, OR 97223 Phone: Phone: 246 - 5381 Reg #: LIC 6924 SUP 4044S FEES ELE 26 -144C Description Date Amount Required Inspections [ELPRMT] ELC Permit 6/21/2004 $73.25 [TAX] 8% State Surcharge 6/21/2004 $5.86 Rough -in Elect'l Final Total $79.11 o 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 or 1 -800-33 344. Issued By: m a) Permit Signature: 11 M , 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 639 -4175 by 7:00pm for an inspection the next business day ;- 10 Electrical- Per m><t Auulica am COVF , ► `) F OFFlct: Lis, O I.,• City of Tigard ©0� y / MM.. — 67,1 /4' 13125 SW Hall Blvd., Tigard OR 97223 r Plan • ' Phone: 503.639.4171 Fax 503.598.1960 "LJ o ? - . ' / r•.= ` I \ Date/B . Other Pert Inspection Line: 503.639.4175 1±i ' Permit Date Ready/By: lmit ® See Page 2 for Internet: www.ci.tigard.or.us TIC Notified/Method: Supplemental Information • ARD _ TYV. - K� O1�' :: \ ^�= Rt 1i, - ,r,':': . i ' ', .. _. P40::: * M ' ❑ New construction Addition/alteration/replacement Please check all that apply: ❑ Demolition ❑Other ['Service over 225 snips, comm'I ['Hazardous location ❑Service over 320 ant's - rating ❑Buiildng over 10,000 sq. ft., r •- ; - CATEGORY OF . CONSTRUCTION • • sz of 1- 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 ['Building over three stories ['Feeders, 400 > or more ❑Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATI , ..)6;, -• ` " = �1 �, ❑Egress/lightingplan RV park Job no.: 5 74.4 I Job site address: 43 800 Su) !,tke.stil' al ❑Health -care facility ❑ h Submit 2 sets of plans with any of the above. City/State/ZIP: G a, - d OIL 1 3'} 2•• "3 / The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: J I Project name: Sears S T e 10.1-9 `'FEB�' $4'I�IDULE,'' ` `' '' �}' ' D eo f aba I Qry• I Fee' I Teed 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: I Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map/parcel no.: Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK - Each manufactured or modular �� l4� :% dL ( �� T dwelling, service and/or feeder 90.90 2 ( T �( Services or feeders installation, alteration, and/or relocation J S 200 amps or less 80.30 2 ❑ PROPERTY OWNER I l '" C } �, 201 amps to 400 amps 106.85 2 ❑ TENANT �; - ' + '' � . , . �,,. 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 Reconnect only 66.85 2 City/State/ZIP: Temporary services or feeders installation, alteration, and/or Phone: ( ) I Fax: ( ) relocation 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 Contact name: B. Fee for branch circuits without service or feeder fee, I 46.85 L 1 5 2 Address: each branch circuit Each add'I branch circuit 3 6.65 aG 2 City/ State/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) I Fax: : ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- • •,' . • CONTRACTOR , • energy panel, alteration, or _. � . . ' �: extension. Describe: Page 2 2 Business name: ZJ %Q ' f2_ Et_Ecr'axe t II.jC, - Address: S/ a 6 Y S , Sr - 1� Each additional inspection over allowable in any of the above n Per inspection 62.50 City/ State/ZIP: /�prn 7 •t) 4 0 /Q 4, 7 2 2 / Investigation per hour (I Iv nun) 62.50 Phone 3 7 Indus plant p er h our 73.75 � 2q (, - $ 3&/ Fax:(J 3)2 /y O t CCB Lic.: (oCj y I Electrical Lin Z�- / U S upty. .: S/Dx/5/5 Subtotal 7bj r Suprv. Electrician signature, required: ' Plan review (25% of permit fee) '' State surcharge (8% of permit fee) S, o Print name: X A 2 Je)t-,Q iv e ate: TOTAL PERMIT FEE I Authorized signature: This permit application expires If a permit is not obtained within 180 days after It has been accepted as complete Print name: Date: • Fee methodology set by Tri -County Building Industry Service Board •• Number of inspections per permit allowed. i tBuildng\Permims\ELC- PamnAppdoe 12103 410.461 ST(INO2/COM/WEB CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION'DIVISION Business Line: (503) 639 -4171 MST BUP Received /,d1 to Requested (..A0 ' ■ PM BUP Location � •' � • � • ! � tt`i1!. MEC Contact Person Ph ( I ) � </ SP/ PLM • Contractor Ph ( ) SWR / BUILDING Tenant/Owner D9-C -c- — ELC �a` � — 54 6 Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL E_CECTRICA Service Rough -In UG/Slab Low Voltage Fire Ala ap 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PAS ART FAIL SITE fl Please call for reinspection RE: 0 Unable to inspect — no access Fire Supply Line ADA e -64-1 / Approach/Sidewalk Date ` I nspector L Ext . Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL