Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
'i" DEVELOPMENT SERVICES PERMIT #: ELR2005 -00420
� �! 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/2112005
PARCEL: 1S12600-00300
SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD Y04 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Limited energy for voice /data wiring. Job No. 1219152
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 ESP TECHNOLOGIES
BY THE MACERICH COMPANY 7929 SW BURNS WAY STE. F
9585 SW WASHINGTON SQUARE RD WILSONVILLE, OR 97070
TIGARD, OR 97223
Phone: 503- 639 -8865 Phone: 503- 628 -4195
Reg #: LIC 73872
ELE 34- 269CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 11/21/200f. $75.00
[TAX] 8% State Surchar€ 11/21/200f $6.00
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 fo • -. - .dopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
thro . • OAR 952 -00 • • 0. ou may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699.
I ued By: ; _ ' , i � , .� Permittee Signature: u
/ OWNER INSTALLATION ONLY
The instalIation 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.
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
Date/B : . � / ���� Permit No..
,,,,o_. -et) ,�
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review /�'' Other Permit.
Phone: 503.639.4171 Fax: 503.598.1960 yi.•.; ;.. � Date/B
Inspection Line: 503.639.4175 Date Ready/By El See Page 2 for
Internet: www.ci.tigard.or.us Notifted/Method' Supplemental Information
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❑ New construction ❑ + .: Addition/alteration/replacement Please check all that apply:
❑Service over 225 amps, comm'l ['Hazardous location
❑ Demolition ❑ Other ❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft,
r, { x, .,,,,: t. -∎ , 0 Pi', .• i n i Li �o , i.,„!;&.411., „ 11 1. 4 o ”- O ti M .r c9: r � ,
-7.7,7. " � �� t 1, 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
['Building over three stories ['Feeders, 400 amps or more
❑ Multi family ❑ Master builder ❑ Other: _ ❑Occupant load over 99 persons ❑Manufactured structures or
y 'ri „'7"• 1- : ::- e • 'yr � i o :A i o � 9 r _ � � .t ' ❑E gress/lightmgplan RV park
/ / ❑Health -care facility ❑Other:
Job no.: i f Sy Job site address: c. . 5- �4�G���,l � � Submit 2 sets of plans with any of the above.
City/ State/ZIP: ' ey The above are not applicable to temporary construction service
c PP mP �Y
Suite/bldg./apt. no.: t G t f Project name: pe #/ - Description I Qty. I Fee. I Total ( "
Cross street/directions to job kite: 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'! 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
g j: i r 1 k '1 ''tiU 9 C. �F - .' d! %. 7'°.. -';`,� �s
_:. .:.. .yA. . �_� :,sc..�.t -�. t� c,.�- t1yP� f �.. � r �.."��' �'•.� ,:.wr � Each manufactured or modular
dwelling, service and /or feeder 90.90 2
4 r: Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
frf-'` ' ,- „;,. i 7 +' - -7,17 K � . , a ^ , 57 _._ _, rr,77•ar..,;,.. 201 amps to 400 amps 106.85 2 ■ 1 , y , ” ' � ' ' r a ' . 1r � r t � 401 amps to 600 amps 160.60 2
Name: r i /) e � 601 amps to 1,000 amps 240.60 2
��Over 1,000 amps or volts 454.65 2
Address:
T . c.() _..c i .,5_,‘;‘ ��� �c� Reconnect only 66.85 2
City/State/ZIP: — 4 rs / OR (7 4- 7 2 . _ R.3 Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) f 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 600 amps 133.75 2
Owner Si_ r ature: Date: Branch circuits — new, alteration, or extension, per panel
- -7 y z— .>fe-7, s1 ' �'ry p- .,' '';j„ ; A. Fee for branch circuits with
r, :. 1 .r ilo . 5 � i��t. Pt_ 7r; - .= l i +r .- "' • ,iJ 1Fi = ..'1.1=.,i r l , . .
t.�, ■.o � �. �._-:_ •' ...s. . =�- service or feeder fee, each
6.65 2
Business name:
branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
each branch circuit
Address: Each add'I branch circuit 6.65 _ 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( ) Sign or outline lighting 53 40 2
E -mail: Signal circuit(s) or limited -
•' "r lay ,,;'..1.1:3. , .,. ,'.r '»2/Q � * .: � `Ir:. 35 s^.sd ,p energy panel, alteration, or Pa e 2 2
` `' extension. Describe: 1 g
Business name: sr /e e 0 n k� } e i 1 t
<69) �2� ! / Each additional inspection over allowable in any of the above
Address: 7f
?1 to r- iK � � ✓ t r ` r Per inspection 62.50
City/State/ZIP: (,(,)( ( 1)/ /f l DK / / Z Investigation per hour (1 hr nun) 62.50
vr-63 ) b•.Z— f ` 1 5 • �,. ) 6 . 5 . Z 7 I Industrial plant per hour 73.75
Phone: l ` Fax: c ava .sa rr ra . ' .. 'a a L i. PI; NP.:I. f` ,'i'wl . .
CCB Lic.: 73157 2 Electrical Lic.:3/. 26.q fc Suprv. Lic.: 22$/ LL Subtotal ' DU
Suprv. Electrician signature, required' 1 - # '__. 1„___— Plan review (25% of permit fee) /
State surcharge (8% of permit fee) 6 c O 0
Print name: T� F F S a.,,..9 e.-- Date: // - 2/ - os-
-
TOTAL PERMIT FEE 6 ii Ocr.)
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 Tn- County Building Industry Service Board
•• Number of inspections per permit allowed
1 \Building\Perrmts\F.LC- PermnApp doc 12/03 440- 4615r(10/02/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - 'Supplemental Information
LIMITED ENERGY PERMIT FEES: '
1x:1'` €l oa iWLV 7 F7 E;' vu Ci irk'(C) ,
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260)
•
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
-Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
. ❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
\Huild ng\Pern \ELC•PemmtApp.doe 04!03
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: ELR2005.00420
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/21/2005
Phone: (503) 639 -4171 rh
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/22/2005 TIME: 7:02AM PAGE: 64
SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD's CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: " + -' rc} VIs.Ell
DESCRIPTION: mites energy for voice/data wiring. Job No. 1219152
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503-639-8865
CONTRACTOR: ESP TECHNOLOGIES PHONE #: 503 -628 -4195
Inspection Request Scheduled For: Date: 11/22/2005 Pour Time:
Code # - •ec ion • - . '•tio \ Confirm # Contact # Message
199 Electrical final 022239 -01 503-454 -7313 N
Corr- ions /Comments /Instructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: &347.)■6 t■ ' Date: ik 1 1.2-/Cf Phone #: (503) 718 -1
_ 4