Permit r CITY O F T I G A R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
�r DEVELOPMENT SERVICES PERMIT #: ELR2000 -00227
' �I I - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/4/00
SITE ADDRESS: 10218 SW WASHINGTON SQUARE RD C9 -11 PARCEL: 1S135BA -00102
SUBDIVISION: OAKBURG ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
Project Description: Installation of protective signaling.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PPR SQUARE TOO LLC MOSLER INC
BY MACERICH COMPANY 4252 SE INTERNATIONAL WY
ATTN: JANET FISHER, ASSET MGMT STE F ,
SANTA MONICA, CA 90407 MILWAUKIE, OR 97222 -8822
Phone: Phone: 800 - 667 -5371
Reg #: ELE 26- 215CLE
LIC 71309
FEES Required Inspections
Type By _ Date Amount Receipt Low Voltage Inspection
PRMT CTR 10/4/00 $75.00 2720000000 Elect'I Final
5PCT CTR 10/4/00 $6.00 2720000000
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 starte ' . 0 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requ' you to follow ules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct que :lions to OUNC at (503)
2 6 -1987.
Is ued by 1 , � Permittee Signature y.
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:
ONTRACTOR INSTALLATION ONLY
1 j
SIGNATURE OF SUPR. ELEC'N: K DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
" Electrical Permit Application
Date received: 0 - f/ Permit no.: E .t az --CO? ,
_a .f i City of Tigard Project/appl. no.— Ex I ire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: /p,, _p& n r Receiptno.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: ' ayment type: _ ;t
Land use approval:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory ti ❑ Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other: 0 Partial
JOB SITE INFORMATION
Job address: /o 2 / 54-/ k./4SN,ti4To v SQ...,4m Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: 'Subdivision:
Project name: STARi3vc./4S I Descrip on and location of work on premises: 44/2,77 l CG T✓
Estimated date of completion/inspection: 0 lc Oo
CONTRACTOR APPLICATION FEE SCIIEDU.E
Job no: Fee Max
Business name: il/los/4/2 )& C Description Qty. (ea.) Total no. insp
Address: t./21 sr /#J it, 4-r loNAL I,/ Ju Newrrgmit .Ilclidgleormuldgamgeper
Y dwelling snit. Includes attached garage.
City: iirrs fle l t t- .r/A01 ,P I State: at . I ZIP: 91 z2 Z Service included:
Phone: co3 - ‘.c( • ort3 I Fax:3 65 l rdr)$I E -mail: Coa 5 c�M°s[¢'c
r m's sq. ft. or less 4
CCB no.: '7/ go9 2 / I Elec. bus. lic. no: 2� -2(5 !x- Each additional 500 sq. ft. or portion thereof
Limited energy, residential 2
City /metro lic. no.: Limited energy, non- residential 2
CeNo-' Each manufactured home or modular dwelling
Si azure o supervising electrician (required) Date Service and/or feeder 2
Sup. elect. name (print): e • /qrJ &j [ License no: / ?y/' ficr Services or feeders — installation,
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): c,2 c trS 201 amps to 400 amps 2
g /02 i'2 .L/ 1l �? /K.(�- SQ. i /NIC
401 amps to 1000 amps 2
Mailing address: 601 amps to 1000 amps 2
City: /'/G,,,c I States .. I ZIP: 9 7 2-13 Over 1000 amps or volts 2
Phone: . I Fax: I E -mail: Reconnect only 1
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 installation, alteratioo ,orrelocation:
200 amps or less 2
ORS 447, 455, 479, 670, 701.
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
Name: or extension per panel:
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):
❑ Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 2
O Service over 320 amps - rating of l&2 0 Hazardous location Each sign or outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, /
❑ System over 600 volts nominal more residential units in one structure alteration, or extensions 1 2
❑ Building over three stories ❑ Feeders. 400 amps or more *Description: ,..��lr-r/ - riA T n Vi. J/d7/l)fttl 1x., .
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan O Other. Per inspection I I I
Submit _ sets of plans with any of the above. Investigauon fee
The above are not applicable to temporary construction service. Other
00
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ 7.7 '
0 Visa O MasterCard expires if a permit is not obtained Plan review (at _ %) $ � v
Credit card number: / / within 180 days after it has been State surcharge (8 %) $ CO
Expires TOTAL $ 1 '
accepted as complete.
Name of cardholder as shown on credit card
. $
Cardholder signature Amount 440 -4615 (6/00/COM)
Electrical Permit Fees: Limited Energy Permit Fees:
Numbei' of Inspections per permit allowed
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Service Included: Items Cost Total 4
4a. Residential - per unit Restricted Energy Fee $75.00
1000 sq R or less 5147.15 4 (FOR ALL SYSTEMS)
Each additional 500 sq. ft or
portion thereof $33 40 1 Check Type of Work Involved
Limited Energy $7500
Each Manufd Home or Modular 0 Audio and Stereo Systems
Dwelling Service or Feeder 590 90 2
4b. Services or Feeders Burglar Alarm
Installation, alteration, or relocation ,
Garage Door Opener'
200 amps or less $80.30 2 El
201 amps to 400 amps $ 106 85 2
401 amps to 600 amps $160 60 2 0 Heating, Ventilation and Air Conditioning System'
601 amps to 1000 amps $240 60 2
Over 1000 amps or volts $454 65 2 D Vacuum Systems'
Reconned only 566 85 2
❑ Other
4c. Temporary Services or Feeders
Installation, alteration, or relocation
200 amps or less $66 85 2 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
201 amps to 400 amps $100 30 2
401 amps to 600 amps 5133 75 2 Fee for each system $75.00
Over 600 amps to 1000 volts. (SEE OAR 918 - 260 -260) '
see "b" above. •
4d. Branch Circuits Check Type of Work Involved.
New, alteration or extension per panel Audio and Stereo Systems
a) The fee for branch circuits .
with purchase of service or El feeder fee. Boiler Controls
Each branch arcuit $6 65 2
b) The fee for branch arcuits D Clock Systems
without purchase of service .
or feeder fee.
El Data Telecommunication Installation
First branch circuit $46.85
Each additional branch circuit $6.65 Fire Alarm Installation
4e. Miscellaneous
(Service or feeder not included) ❑ HVAC
Each pump or hrigahon circle $53 40
Each sign or outline lighting $ 53 40 ❑ Instrumentation
Signal circutt(s) or a limited energy
panel, alteration or extension $75 00 Intercom and Paging Systems
Minor Labels (10) $125.00
4f. Each additional Inspection over ❑ Landscape Irrigation Control'
the allowable in any of the above
Per Inspection $62 50 ❑ Medical
Per hour $62 50 .
In plant - $73.75 ❑ Nurse Calls
5. Fees: Outdoor Landscape Lighting'
6a. Enter total of above fees $ El
8% Surcharge (.08 X total fees) S $
Protective Signaling
Subtotal •
6b. Enter 25% of line 6a for ❑
Plan Review if required (Sec 3) $ Other
Subtotal $
Number of Systems
❑ Trust Account # • No licenses are required licenses are required for all other installations
Total balance Due $
FEES:
ENTER FEES $
8% SURCHARGE (.08 X TOTAL ABOVE) $
TOTAL $
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested / 0 ) AM PM BLD
Location / 0 2-I tr 5 ev u/t ) 4 53 Suite C 9 — C / ( MEC
Contact Person (5/ Gacit) 53 Ph 890-6F 7-5 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR 2e4i1/- V Z Z- 7
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler c/6,..„/ l' /1rc,> !
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final N
PASS PART FAIL l
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Q.) .
Gas Line
Smoke Dampers
Final
FAIL
ELECTRICAL
Service
Rough In f
UG /Slab L
Low Voltage A
Fire Alarm
ASS ART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before ne inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA Date
Approach /Sidewalk /0 — 7X1 -= 0 v Inspector •r Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.