Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00366
RI
COMMUNITY DEVELOPMENT
DATE ISSUED: 5/30/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD Y01 ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
PROJECT: THE MOBILE SOLUTION
Project Description: (1) branch circuit for new kiosk.
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: 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:
WASHINGTON SQUARE LLC LAUGHLIN ELECTRIC LLC
BY THE MACERICH COMPANY 3 MONROE PARKWAY STE. P PMB205
9585 SW WASHINGTON SQUARE RD LAKE OSWEGO, OR 97035
TIGARD, OR 97223
Phone: Contact #: PRI 503 - 449 - 7389
FAX 503 - 639 -0077
FEES
Description Date Amount Reg #: ELE C86
[ELPRMT] ELC Permit 5/30/2007 $46.85 LIC 165763
[TAX] 8% State Surcharge 5/30/2007 $3.75 SUP 5097S
Total $50.60 REQUIRED ITEMS AND REPORTS
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.
/ Permittee Signature: S.ei_ ripp Iirtuiltnr\ Issued By: 4j /vI / ' ...
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.
MAY -29 -2007 17:13 FROM: TO:5035981960 P.2
Electrical Permit Applicati f K,aa M !;y rl 'y + I „it t tI 11, I I '.1 t I\ I
. i
City of Tigard tL' , ' 1.J a . Z Reoerved C Permit ! h' g Dateor:St36 / 1- c) ELC 0 - - 00344.v
III 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
II Phone: 503.639.4171 Fax: 503.598.1960 h;AY 0 1007 Date/B : other Permit: aai• - 024'
I 1 C A R u Inspection Line: 503.639.4175 Dale Ready/By: auis. ® Sts Page 2 to
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Internet
CFI , y i y Notified/Method: Supplemental In ormatloa
_ 'l 7 r 0 'i ...0. f t
TYPE ItM IVY ItF• - - 7, r r.. I T v PLAN REVIEW
❑ New construction ®Addition tion/ropladement ' . 1 . Please check all that apply (submit l sets of plans Winans checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other where the available fautt currmr ❑ Marine and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial-use agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "l -2 ",' l -3 ",
Job no.: I Job site address: 9585 SW Washington Square Road lOOHPorroom occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldgiapt. no.: Y01 I Project name: Kiosk for Mobile Solution ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description j Qty. I zee. 1 Total l •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
'DESCRIPTION OF WORK . (with above sq. ft.)
Circuit for new kiosk Limited energy, multi- family 75.00 2
residential (with above sq. ft
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2 ,
Address: Over 1,000 amps or volts 454.65 2
City/ State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 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 599 amps 133.75 2
Owner si nattue: Date: Branch circuits - mew, alteration, or extension, r panel
g A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: Laughlin Electric, LLC B. Fee for branch circuits
Contact name: Erika M Schervem or Grant R Laughlin without service or feeder fee, I 46.85 46.85 2
g first branch circuit
Address: 3 Monroe Parkway. Suite P, #205 Each add'i branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Lake Oswego, OR 97035 Each manutltctured or modular 90.90 2
dwelling, service and/or feeder
Phone: (503) 449.7389 Fax: : (503) 639.0077 Reconnect only 66.85 2
E -mail: e.schervem @comcast.net or g.iaughlin @comcastnet Pump or irrigation circle 53.40 2
CONTRACTOR _ ' Sign or outline lighting 53.40 2
Laughlin Electric, LLC Signal panel, t(s) or limited -
Business name: Lau
g energy pane alteration, or
Address: 3 Monroe Parkway, Suite P. #205 extension. Describe: Page 2 2
City/State/ZIP: Lake Oswego, OR 97035 Each additional inspection over allowable In an of the above
503 449.7389 ( F 503 639.0077 Per inspection 62.50
Phone:
( ) ( ) Investigation per hour (1 hr min) 62.50
CCB Lic.: 1657(03 I Electrical Lic.,: 6 Suprv. Lic.: 5097S Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Supty. Electrician signature, required: "
Subtotal: 46.85
7
Print name: Grant R. Laughlin l Date: 5.29.2007 Plan review (25% of permit fee):
State surcharge (8% of permit fee): 3.75
Authorized signature: TOTAL PERMIT FEE: 50.60
Print name: Erika M. Schervem - Laughlin I Date: 5.29.2007 ThIs perm(t application expires If a permit is sot obtained within ISO
days after it has here aeerntM of emmnlele.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00366
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/30/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639-4175 "'I _..
INSPECTION WORKSHEET FOR DATE: 5/31/2007 TIME: 7:00AM PAGE: 26
SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD Y01 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: THE MOBILE SOLUTION
DESCRIPTION: (1) branch circuit for new kiosk. Located in front of Cheescake Factory
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: LAUGHLIN ELECTRIC LLC PHONE #: 503 - 449
Inspection Request Scheduled For: Date: 5/31/2007 Pour Time:
Code # Inspection Description Confirm Contact # Message
199 Electrical final 049329 -01, 360 - 773-2781 N
Corrections /Comments /Instructions:
•
s PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CY .... ' N 661-6
7 Date: 611 1(01 O' Phone #: (503) 718- IA L N
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