Permit _ p-t
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00219
1 II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/14/2006
PARCEL: 1512600 -00300
SITE ADDRESS: 09700 SW WASHINGTON SQUARE RD NORDS ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Nordstrom Sunglass Hut. CCTV camera.
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: CCTV 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: Contact #: FAX 503- 227 -5941
PRI 503- 227 -6688
FEES Reg #: ELE 26- 562CLE
LIC 67549
Description Date Amount SUP 3609LEA
[ELPRMT] ELR Permit 9/14/2006 $75.00
[TAX] 8% State Surcha 9/14/2006 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes arid 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 - 24 -6699.
Issued By: Z/ Fr � /i Permittee Signature: s Q , A
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.
Electrical Permit Appli Cation,
4 -: ----,
• City of Tigard A ____JI ---t„ d , ? --A/ - P„mit No.' ( 642/1
13125 SW Hall Blvd., Tigard, OR 9722EP 1 4 2006
. .. ,.. Review
Other Petrol
Phonc: 503.639.4171 Fax: 503,508.1960 . . . , j••• Datr.
Ye -
Inspection Line: 503.639.4)75 .i, .2, ,. ..,:. \c e4.1. I IL, Date Rcedyfisy: 'Uri lil See Page z for
Internet: www.ei.tigard.or.uS . . ,,-.. -- rv,711 Notified/Method! .1 (j- Supplemental Information
':::..:........:.s.,: . !':4;;;. ..:,: IT::8
csi New construction 0 Addition/alteration/replacement Please cheek all that apply:
OSenrico over 225 amps. comml ['Hazardous location
D Demolition _ El Other:
.. OService over 320 amps - rating [IBuildng over 1%000 sq. ft.,
.; ............. :,::::::::'.-.:i .......:::;...-, of 1- and 2- family dwellings 4 or more new residential
1:1 1- and 2 dwelling IS3 Commercial/industrial 0 Accessory building ['System over 600 volts nominal units in ono structure
['Building over three stories ['Feeders, 400 amps or more
0 Multi-family 0 Master builder . Other:
1:10ccupsmt load over 99 persons ['Manufactured structums Of
**0:4 :...:! ' .:1 1; :.. . ' ElEfress/lighrin8 Plan RV park
Job no.:
1± site address; 9700 SW Washington Square Rd I:Wealth-care facility ['Other:
Submit i sets of plans with any of the above.
City/State/ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service.
Suite/bldg./apt. no I Project name: Nordstom Sun Glass R ;:,..::b.;;;;...1;..:,::•'::::: , P.:::.:...
, neserrp000 I Qtr. I Fee. 1 Toad I "
Cross street/ditections to job site: Washington Square Mall 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. addl 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
Tax map/parcel no.:
0
:.1• ;;;
. ,.• -4„..:,..::•. •• ....- ;;
..; ., . , • ; , • .• ....,.. . .. • . , _.... ;:..:,..,:.„,;, . ,. .. , ;.:i: ,. : .. ...,....., Limited energy. non-residential 75.0 2
•,;;-.. . A • .•:.• ...; ::. ........ t glai‘. -.: ..1. !••■••••'. 1 1'';.: w::..!" :::. • "...::0 Each manufachucd or modular
install cctv camera dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or retie:anon
200 amps or less 80.30 2
;•!: • • • ellitittifilktif••;•60041410:i...•::.;•;,;::•.1.::' r:‘,f::::;' ,..,•;. 201 amps m
ps to 400 amps 106.85 2
ti :•'•• .:.••.i • . ...'• :! • .........../a.•' ..,.... . '..'.• ::••• •••• • • ...,.,!:■... 401 amps to 600 amps 100.60 2
Name:
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: —
Temporary services or feeders installation, alteration, and/or
Phone: ( ) I Fax: ( ) relocation
200 amps or loss 66.85 1 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 , 13175 2
Owner signature: Date: Branch dreniat - new, alteration, or extension, per panel
..... 1W. . ........:07 . 4414 . 041W ALL,_L.,__L., ...4,.._,.___ j2E2f±::mLa . Iti.: A. Fee for branch circuits IsTr
service or feeder fce, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name:
without service or feeder fee,
first branch circuit 46.85 2
Address:
Each add'I branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not Included) _
Phone:( ) I Fax: : ( ) . Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E-mail:
Signal circuit(s) Of limited-
f'. :'•':',' ' _.,7 •::: .• s .' .; '!:: ::.:.::•; energy panel, alteration, or
' ectension. Describe: I Page 2 7S 2
Business name: Miser Integrated Technologies
Address: 1313 nW 17' ave Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP; portland, OR 97209 Investigation per hour (1 hr mio) - 62.50
Phone: (503) 227 I Fax: (503) 227 industrial plant per hour —J 73.75
..."
CCB Lie.: 67549 Electrical Lic.: 26-562CLE I Suprv. Lie.: 3609LEA
Subtotal
,.. • .-.
Suprv. Electrician signature, required; - . ,' Zi Plan review (25% of permit fee)
State surcharge (8% of permit (cc)
Print name: 1 tii.:, A ..s,y... i Date: 9/14/2006
aels
TOTAL PERMIT PEE Ic 14_9a
Authorized signature: •
.• /'
This permit application expires if a permit Is not obtained within 150
days after it boo been accepted OS Complete
I st
Print name: Date: 9/14/2006
i 4 A. G ein • Fee methodology an by Tri-Gtumty Building Industry Service Board
•° Number of inzpeetinns per permit allowed.
lAncirditien'ermitAELC-PanthAep.doc IVO, 440