Permit 4
CITY F T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
s i 11, DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00225
DATE ISSUED: 9/20/2006
"' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 113AB -00101
SITE ADDRESS: 16101 SW 72ND AVE BLDG A -120 ZONING: IP
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG
Project Description: Card Access & Burglar Alarm.
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: CARD ACCES X
TOTAL # OF SYSTEMS: 2
Owner: Contractor:
PACIFIC REALTY ASSOCIATES ADT SECURITY SERVICES, INC
15350 SW SEQUOIA PKWY #300 -WMI 2815 SW 153RD DR
PORTLAND, OR 97224 BEAVERTON, OR 97006
Phone: Contact #: PRI 503 - 469 -7100
FAX 503- 469 -7110
FEES Reg #: ELE 26- 209CLE
LIC 59944
Description Date Amount
[ELPRMT] ELR Permit 9/20/2006 $150.00
[TAX] 8% State Surcha 9/20/2006 $12.00 REQUIRED ITEMS AND REPORTS
Total $162.00
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: -- 121, ,i r ' Permittee Signature: 7 f,
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.
Sep 1906 06:19a Stephanie Pate 503469 p.1
Electrical Permit Application z ' , ; F OR O ( C SE. o\L ;
City o Tigard RE
Itcccwcd -.00,,,,,, 5
13125 SW hall 131vd., TiZ,ard, OR 97323 Plan li
Phone; 503439.4171 Tax: 503.503.1960 S E P 1 9 20,^°'`*^`7ri , DaulCty: Other Permit
( {
inspection tine: 503,639,4175 7, 1 hate Itesd 'Lt . ;ur
lnternct; www.ci.tigard.or.us CITY OF TIGMrI NOilliael/Metlwd; Supplemental Information
Tt P>r� (H�t`i(�1�iY+: G1V,J0'�' •
' PLAN REVIEW .
❑ Nev. construction . dditior / altcration/rcplaccment Plasse check all that apply:
❑ Demolition ❑ Other: ❑Spviet ova, 225 amps, comm'I ❑Haz rdous location
❑Service over 320 turps - rating ❑ B over 1 0,000 sq. fl.„
CATEGORY OF .CONSTRL(:Tl :. ,• of 1- and 2 - family dwellings 4 or more new residential •
❑ 1 - and 2 - family dwelling 14 Commercial /industrial ❑ Aece,sory building ❑System over 600 volts nominal units in oae. structure
❑Buildipg ova throe stories ❑liaaiers, 400 amps or more
❑ Multi - family ❑Master builder ❑Other: ['Occupant load ova- 99 persons El Manufactured structures or
•
.OB. : SITE INFORMATION AND .J.00ATION.. : , • I] tigrsss /lighting plan RV park
Job no.: AC ef/ / Job Hite address: / ,/0 J Se f 7,2 I"' pe ❑l Health -cure facility ❑ �'
Subunit •. seta of plans with any of the above.
City/Statc;ZIP: /347 ae 972 .2' The above are not applicable to temporary construction s )vice,
Suitc.ibldg.;ape no. - b Prtsjcct name: QU z Cd�7 • 'FEE* SCHEDULE ; ' Dexcrlpdaa J Qty. f ree. 1 .
y Total I .'
Cross street/directions to job site: New residential single - or multi - fancily dwelling unit.
Includes attached s;ara£e.
j
.� ` T��4a) �� V 1,o0o scl. ft, or less 145,15 - 4
Subdivision: Lot no,: La. add'I 500 sq. ft, orportioa 33.40 1
^- - - Limited energy, residential 75,00 2
Tax map/parcel no.: _ Limited cnta - gy. non - residential 75.00 2
DESCRIPTION"' Ulf WORK Each manufactured or modular
n de(e� rt 1/1 dwell in,c„ cr
sviur ;mcliur 9(1,90 2
(� Services ur feeders installation, alteration, and /or rck,cation _
200 amp, or lass 80.30 - 2
201 amps to 400 amps 106.K5 2
0 PROPERTY OWNER . . . a.TKNANT, '
- 40 amps to 600 anus 160.60 1 2
Name; 671 amps to 1,000 strips 24 2
Address: ^� Uyt r 1,000 amps or vnhs 454.65 2
• --- Reconnect only 66.85
City /Starc/Z1I': Temporary services or feeders installation, allcrntion, and/or
relocation
Phone: ( ) Fax; ( _ ) 300 a or Ien:� (i6 S 1
Owner inr:tal(uticm: This installation is being made on� property that i own which is not 201 an s to 400 :smp:, 100.30 2
intended for sale., lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps i 133.75 2
Owner signature. Date: Branch circuits .,. new, nitcratio_n, or extension, per panel • 0 AC PP ICAN'1' � `'� • . C{3�fCNCT 1'EILSON A, Pce for branch eimuits wir y
` sew+ ice or feeler fee, each
Business name: branch circus 6.65 2 i
13. Fee for branch ciscuils
Contact name: / , d rr i , , , withr.irr( ur feeder fee,
•-- - first branch circuit 46.35 2
Address: Each a branch circuit 6.65 ' — 2
CiryJSIatc /Z1P: Miscellaneous (service or feeder nor eneluded)
x503) (35,S - Qs 3S 1:1x: ; ( ) Pump nr itrirationCinlc 53.40 2
Phone: •
Jv i ..
Sian or outline lighting 53,41) 2
E -mail; i Signal circuit(~) or binned- ,..•.,
• CONT1tAGTO.R energy panel, alteration, Jt'
extension, Describe: f � Pace 2 2
Business name: ADT Security Services /5
Address' 2315 SW 153r Dr. Each a dditional inspection over alto viable in any of the above
,._. -- Pa. inspection M 62.50
City!St.tt& ZIP: Beaverton OR 97006 Investigation per hour (I !,r min) 62.50
Phone_ (503) 469 -7100 I Fuut: (503) 469 - 7114 industrial plant pi.- !tour • 73,75 -
ELECIRIC•.AT, )11i :1011'1 FI I,S"
CCU I,ie „: 59944 Electrical Lk.: 2h 209CI•F Suprv. Lie LEA399 Suht etal 4,-e- °`
Suprv. Electrician signature. required: . Pi:ur review (25% ufpermit fee)
-, . State, surcharge (8% of ptamit fee) 42, Q d
Print more: 1,11.-,,,/ , uy 1):11O: ■ —_._. —
TOTAI, PERMfI' trEit //&, ()O
Authorized signature: /44,4e2./ 'I prrrolt Application cx if a pt rmit is nor obtained w 180
Joys after It has teen aeee ik.d in cumptetx
Print name: 44/ 4/e9,4 cif Date: • 1 +4c melhudoic iy set by Tr Ceurlty iruildi,tg l+aluttry Service Huard
” Number el inspc<tiora per prniis allowed.
ofluildin errait - .t t'<nr,iihrpyrRrc I:I X I �L / / 9 4= 0- 46157( 1O'02JCO,N.Wt:13
CITY OF TIGARD
• BUILDING DIVISION - PERMIT #: ELR2006-00225
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20/2006
Phone: (503) 639 -4171 . ti
Inspection Requests (24 Hrs.): (503) 639 -4175 '!!+� 1L.
INSPECTION WORKSHEET FOR DATE: '12/29/2006 TIME: 7 :00AM PAGE: 36
SITE ADDRESS: 16101 SW 72ND AVE BLDG A - 120 CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: OUALCOMM
DESCRIPTION: Card Access & Burglar Alarm.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: ADT SECURITY SERVICES, INC PHONE #: 503-469-7100
Inspection Request Scheduled For: Date: 12/29/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 041625 -01 503-469.7212 N
Corrections /Comments /Instructions: I
NNN� sut , E OLo i, Ii, : u %/ ) 1
c
ttk
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cr e 4" ( W) l— Date: 1 iI 06 Phone #: (503) 718- 24%_____