Permit - CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00619
i DEVELOPMENT SERVICES DATE ISSUED: 11/26/02
I II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S135BA-00102
SITE ADDRESS: 10100 SW WASHINGTON SQUARE RD A -1 ZONING: C -G
SUBDIVISION:
BLOCK: LOT : 001 JURISDICTION: TIG
Project Description: Tenant Improvement - Sign Permit #SGN2002 -00258
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: 3
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: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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 SQUARE TOO LLC VANCOUVER SIGN COMPANY, INC
BY MACERICH COMPANY 6615 SW HWY 99
ATTN: JANET FISHER, ASSET MGMT VANCOUVER, WA 98665
SANTA MONICA, CA 90407
Phone: Phone: 360 - 693 - 4773
Reg #: ELE 37 -46CLS
FEES
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 11/26/02 $160.20
[TAX] 8% State Tax 11/26/02 $12.82 Elect'l Final
Total $173.02
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 - 332 -2344.
Issued By: Permit Signature:
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
6GN 260 - oo a-,Sg-
Electrical Permit Applicat
Date received: Permit no ,_ ta „ 0D 4
ddertl At t y l i •
l , •j 11 A City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory $l CommerciaUindustrial 0 Multi - family . ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement 0 Other: ❑ Partial
JOB SITE INFORMATION
Job address: t: 0/ 00 sw co"ASIliN . ?DN ,fa. go. Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: ISubdivision:
Project name: PO R6$,N I Description and location of work on premises: 74t4ip4y'- (3) S'(6? S
Estimated date of completion/inspection: lNErK
CONTRACTOR APPLICATION FEE SCHEDU.E
Job no: . Fee Max
Business name: V VV4vcitA/t *. SIGN !.A Description Qty. (ea.) Total no.insp
New residential - single or multi- family per
Address: 66er * 4 i dwellingunit. Includes attached garage.
City: V4t o - I State: . * I ZIP: 064f Service included:
Phone: 3 t f(1.; ? I Fax: j f o4 fj l t' E -mail: 1000 sq. ft. or less 4
CCB no.: G 39 s) I Elec. bus. lie. no: 71- V4 Gfis Each additional 500 sq. ft. or portion thereof
Limited energy, residential 2
t• /m li.� ...:/ 2v2.1- ? Limited energy, non- residential 2
- �_ e f / / Each manufactured home or modular dwelling
S - re of su. 31 isi 7M trician (required) Date ` Service and/or feeder 2
Slect. name (. nt): "'Samos Sx, ,woe. License no:C /3 -S /6' Services or feeders — installation,
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only I
Owner installation: The installation is being made on property I own Temporary services or feeders
which is not intended for sale, lease, rent, or exchange according to bnstallation ,alterattoa,orrelocation:
200 amps or less 2
20
ORS 447, 455, 479, 670, 701. 201 1 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am s 2
Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E-mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc.(Service or feeder not included):
O Service over 225 amps - commercial 0 Health -care facility Each pump or irrigation circle 2
O Service over 320 amps - rating of 1&2 0 Hazardous location Each sign or outline lighting 3 . 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension* 2
O Building over three stories 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable In any of the above:
0 Egress/lightingplan 0 Other. Per inspection I I I I
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information Notice: This permit application
Permit fee $ /6 o' 2- 0
O Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / I within 180 days after it has been State surcharge (8 %) $
Expires accepted as complete. TOTAL $ 1 7 o
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440 -4615 (6/00/COM)
Electrical Permit Fees: • Limited Energy Fees:
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4, Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33 40 1 ❑ Burglar Alarm
Limited Energy $75 00
Each Manufd Home or Modular Door Opener
Dwelling Service or Feeder $90.90 2
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System"
Installation, alteration, or relocation
200 amps or less $80 30 2 Systems*
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160 60 2
601 amps to 1000 amps . $240.60 2 n Other
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918 -260 -260)
201 amps to 400 amps $100 30 2
401 amps to 600 amps $133 75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts, 11] see "b" above. Audio and Stereo Systems
Branch Circuits -
Boiler Controls
New, alteration or extension per panel
a) The fee for branch circuits
with purchase of service or D Clock Systems
feeder fee. I �� I
Each branch circuit $6.65 2 I I Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service r Fire Alarm Installation
or feeder fee.
First branch circuit $46.85
Each additional branch circuit $6.65
Miscellaneous r7 Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 and Paging Systems
Each sign or outline lighting $53.40 (Z�/
Signal circuit(s) or a limited energy ❑
panel, alteration or extension $75.00 Landscape Irrigation Control
Minor Labels (10) $125.00 ❑
Medical
Each additional inspection over
the allowable in any of the above Calls
Per inspection $62.50
Per hour $62.50 ❑
In Plant $73.75 Outdoor Landscape Lighting
Fees: ❑ Protective Signaling
Enter total of above fees $ / Q n Other
8% State Surcharge $ / ' . V Number of Systems
25% Plan Review Fee
See "Plan Review" section on $ No licenses are required Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $ / 73, dcZ
Enter total of above fees $
El Trust Account # 8% State Surcharge $
O 1Ig1 Total Balance Due $
l c -
I \fists \fomu \elc- fees.doc 10/09/00 / b L
-r 9h - ° 1'1°1
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
[� BUP
Received Date Requested - - 1 AM PM BUP
Location 10 (0 0 (f) fl v S Q' Suite MEC
Contact Person (46 Ph ( d r l 3 - /7 7 3 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner _ ELC 6 /
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: C � „ • SIT
Post & Beam l/
Ext Shear Sheath/Shear th / ear 6 /L_,& �a��
Ext eah/h
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING C
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer i
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
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fre Alarm
4gEm.,P Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
.7 PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record rom th ob site.
PASS PART FAIL