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Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT DEVELOPMENT SERVICES PERMIT #: ELR2005 - 00347 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/14/2005 PARCEL: 1 512600 -00300 SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD MGMT ZONING: C - G SUBDIVISION: tiMBESEIENGTON SQUARE LOT: JURISDICTION: TIG Project Description: CCTV. 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: INSTRUMENTATION: OTHER: CCVT X TOTAL # OF SYSTEMS: 1 Owner: Contractor: WASHINGTON SQUARE LLC HUSER INTEGRATED TECHNOLOGIES BY THE MACERICH COMPANY 1313 NW 17TH AVE 9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97209 TIGARD, OR 97223 Phone: Phone: 503- 227 -6688 Reg #: LIC 67549 ELE 26- 562CLE FEES SUP 3609LEA Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 10/14/200E $75.00 [TAX] 8% State Surcha 10/14/200E $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 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. Issued By: r � • Permittee Signature: � � \t\ 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 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. 10/13/2005 14:28 FAX 5036981060 CITY OF TIGARD X1001 Electrical Pernik AA r ': ,'? 1 - q� i~' 1�iik on 14.11. USE ONI.1 City of Tigard t t Yn.t //�`/ /5 Resolved. /!� / 7�� ., Faint No. 1., .. 4 , 6 ,a0g1 t� 13125 SW Nall Blvd, Tigard, OR 97223 pies aw &M Phone: 503.639A171 Fall: 503.998.1960 .� 0 f fi t• :r ",.,, ,., othereant:c • • Inspection Lb 503.619.4175 - -:, DIN4 newer / _, Stange; roe Internet www.eLtigard.otvs R l°f�P (ai•1 OF TIR lT SopPtommoil formatloo ' ;1 Please check all rawly: u New construction 14 Addition/Aeration/replacement ❑ Demolition • ❑Other ['Service over 225 amps, comm't Dlietardous laaalion 09erviet over 320 amps — rating 013vi'tdng war 10,000 sq. R, ; A t3OR3Y' I I* CONSTRUPTION, ... . • . •:' } + of I- and 2 - fatmly dwelling 4 or more new residalldal ❑ 1- and 2- family dwelling .5 CoMmercialTmdusE:ial 0 Aceennoiy building PSystam over 600 volts nominal units in out abtichue ❑ MUM-11‘12111y Master builder ❑ Other: DBnilding OVUM= =in 01'eeders, 400 tmnps or Hoorn _ 0Oempunr over 99 parsnne DMnnufacttaed structures or • • :. '' ' ', ;;i; ; OITE INF�ORM'A D LOCATIO1v',`, t.i ? . `' , t . ' ❑Egrt' Jlighting plan RV park S t hi Job no,: Iobsite address: 9585 SW Washington Rd Submit ['Health-cam facility © �" � g Subtrtit ,2�, sets claims with any of rho above. City/State/ZIP: Tigard, OR 97223 The above are not applicable to teteporet�y eervice. Sultclhldg,/ant.na: Project nttme:l,l =i C S0. Ma1( n..eopuu,A Qtr. 1 r•ef . • 1 r . a l . New residential sea or multi - fated! dwelling nett Cross street/directions ttsjob site;: S� . r Il nnt - Includes attached garage. _ 1,000 sq. R. cr lass 145.15 d W... Subdivision: L01110.: Ea. add'I S00 sq. ft or pox ion 33.40 1 r! no.: Unshod energy, regidentlat 75.00 1 2 Tax m rise �p _ Limited energy. non - residential 75.00 l 2 •'. • : . •• •• ';,, , 1, ro V11r'Vl' . .. • .' n .. 1.,7Ni no w.,venlar I Fgf.'fJlTA'1't4ayA' f'1Rlt� , •. ( dwelling, service and/or feeder ( 90.90 2 I , servieaa ov feeders installation, alteration, and /or relocadoa 200 amps or less ! _ -.L.. 80.30 j _I 2 . .p; itoiw Z'v' cryN , f • , .. U , , ,, 201 amps to 400 amps 106.85 2 - 401: .s to 600 , 160.60 3 Name: 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps yr volts 454.65 2 Reamnect only 66.85 2 City/State/ZIP: Temporatp services or feeders Iatualatloe, a and /ar Fax ( ) relocation 1?>torte: ( ) 200 amp or lass 66.85 1 Owner Installation: This installation is being made on property that I own which is not 201 amps to 400 amps 10030 2 !mended for hate, lease, rent, or exchange, according to OP$ 447, 449, 670, and 701. 401 temps 10 600 amps 1 133.75 I • 2 ClWrier aigaataret . Date: Branch circuits new, alteradolt ar extension, per panel • 1:14 -P LIf :, ``- I ', ' II cdtgr'/idr''f1LRSON • c+ • ••' .. A.FeCIbrbraneireulk whir' service or feeder fee, each 6.65 2 Business name: branch circuit • B. Fee tbrbreach circuits Contact name: wlthvut service or feeder fee, '— eaeh branch circuit 46 85 2 Address: ' ' Each add'I b taaeh circuit 6.65 2 City/State/Z1P- _wihaeltu ae (service or feeder not Included) Done: ( ) Fax:: ( ) or sign lightinia 53.40 2 ph 53.40 2 e-mail: Signal cireull(s) or limited- _.•' . " • •' - • CONTRACTOR- - - •. • ' •,'' ;r' , :. ..,I' ;:', , energy panel, alteration, or B ncsseiem : Buser Integrated Technologies e?ttense °n.11aersi _ _ 1 Paget 7�sto 2 Add: 1313 NW 17th Ave Bagb Additional Inspection aver allowable icy of tae abate - . Per inspection 62.50 I Cidy/5tatNZIP: Portland, OR 97209 " hrvastlgattonpertaro(t1¢»Z 62.50 1 p} 10rt= ( 503 227 -6688 I Fax x503) 227 -5941 Indoinciel pleat per hour 73,75 1 - - . ,.ELBCIRICAL. PERMIT. FELS' rt .. CCB Lim: 67 549 Electrical L[c_ 6--5 62 CLE .Suprv. t ic.; 36, py L E,4 Subtotal .�/ 7 S. r9�? 5upro. Eleeaician signature, required . /2,119 Plan tcvicw (25% fee) Print aa1x1� Date 1 State surcharge (856 of permit foe) .A G, �9J I rsH ; t A+r.4eh� ra !t� • 3 DS ' TOTAL PERMIT FRE ,if c61,(.7 J Authorized signature: ' 41° Mils permit application c tplree If a permit is Paratrmmed_wrrntn tan oiler it has bees auepted as complete Not name: Darn; • Fee Methodology set by TA Cotmry Building /Massy Semite Board •• Slumber of impactions per pemdt ,flowed isVitiNiA61P6111itaaCAenGrnpp ,tae tree) 640ee15rr111/cVCOMIwen ■ CITY OF TIGARD BUILDING DIVISION PERMIT #: ejR_WaS— DD34.7 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ' L INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: 9 5g5 IAI�- y Ad CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: ,Sb3 - 939 -7 8 6 7 ° CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3 Pour Time: Code # Inspection Description Confirm # Contact # Message l 3�S AL C C,i J • Corrections /Comments /Instructions: • • ► . PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: . 1' °V Date: Z-� 010 Phone #: (503) 718 - - [JI 7+U