Permit •
4 J N OF TIGARD CITY RESTRICTED ENERGY
A DEVELOPMENT SERVICES PERMIT #: ELR2003 -00138
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 DATE ISSUED: 5/19/03
SITE ADDRESS: 13221 SW 68TH PKWY PARCEL: 2S101 DA -00102
SUBDIVISION: TRIANGLE CORPORATE PARK ZONING: MUE
BLOCK: LOT: 002 JURISDICTION: TIG
Project Description: Installation of access control CCTV. A j er-
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:
TIGARD TRIANGLE I LLC HUSER INTEGRATED TECHNOLOGIES
4650 SW MACADAM AVE STE 220 1313 NW 17TH AVE
PORTLAND, OR 97201 PORTLAND, OR 97209
Phone: Phone: 503 227 - 5941
Reg #: LS03 -227
ELE 26- 562CLE
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 5/19/03 $75.00 Elect'I Final
[TAX] 8% State Tax 5/19/03 $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 throuc
Issued by Permittee Signature 0
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
n
. - ._ tlectricalPermitA I i ' 1.: it on 01,1.1t1.: utir, ON.,
REC , ,
T : 9 Date teceived:J i6 03 Pertlnit no.: /p �0/ 4 1
< , M` I City of Tigard Project/app1. no.: Expire date:
City ofTlgard Address: 13125 SW Hall Blvd. Mrd,PS 9 Date issued: : •.'r� Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 CITY OF TIGARD Case file no.: Payment type:
Land use approval: BUILDING DIVISION
'11 1'1.: Uf I'I R .1i
❑ 1 & 2 family dwelling or accessary 0 Commercial/industrial 0 Multi - family XTenant improvement
❑ New construction O Addition /alteration /replacement ❑ Other 0 Partial
Job address: 13221 SW 68th Pkwy Bldg. no.: Suite no.:200 Tax map/tax lot/account no.:
Lot: Block: I Subdivision:
Project name: E14L/ ill I Description and location of work on premises: limit energysyt t ests
Estimated date of com letion/inspection:
Job no: Foe Max
• Business name: Huser In ratted T ies.— lave - a0r' Qty. (m) Total no.fmnp
g g New reddgrtlal- nleRle orraolti -tmy Per
Address: 1313 NW 17th Ave. dwaungattit .lnclndesotuchedgaraae.
City: Portland I State: pR I ZIP: 97209 sa,keibauded:
Phone: 50322 7 6688 'Fax: 2$75941 I Email: 1000 sq. It. or leis 4
Each additional 500 sq. ft. or portion thereof
CCB no.: 67549 fopi oy [Elec. bus. lic.Ito: 26- 562CEP Limited may, residential 2
City/ , , a ; o lie. no.: 496b /o 01 03 Limited • . non - te + dential 2
_ V _I 5 /16/ 03 Each manufactured home or modular dwelling
Signawre of supervising electrician (required) Dale Service and/or feeder y 2
Sup. elect. name (prim)! • chael Bode License no: 18651, Service oca nntanatloo,
alteratlonor or r r ellocatti on:
200 amps or less --,----o 2
201 amps to 400 amps 2
Name (print): 401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: State: ZIP: Over 1000 amps or volts 2
Phone: Fax: E -mail: Reconnect only l
Owner installation: The installation is being made on property l awn Temporary service or feeders -
which is not intended for sale, lease, rent, or eXChange according to fnsullathro ,alteration,orrdocatlon:
200 amps
ORS 447, 455, 479. 670. 701. or 2
400
201 amps to 400 art+ps 2
Owner's signature: Date: 401 to 600 am 2
Wench circuits - dew, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder foe, each branch circatit 2
City: I State: [ ZIP: B. Fee for branch circuits without purchase 2
Of service or feeder fee, first branch circuit
Phone: Fax: E-mail: Each additional branch circuit:
Misc. (Service or feeder not Included):
O Scrota aver 225 arm-commercial O Health -cahc facility Each pump or Mipation Mrelc 1 2
O Service over 320 antpseatinq of 16t2 O Ifazmdoa5 location Each sjin or outline lighting 2
family dwellings O Building Over 10.000 square feet four or Signal c1natit(s) Or a limited energy panel.
O System over 600 volts nominal mace residential units in one MOO= alt0110(16011, or extension" _ , 2
une
O Building ova three stories Cl Feeders. 400 amps or mote "Description:
0 Occupant load over 99 pereotsa O Mwmfactdred structures or RV park Eacb additional inspection over the allowable in any of the above:
O Epess/lighting plan 0 Other. . per inspection I 1 1 T
Submit _ sets or plans with ann of the above. Investigation fee
The above are not applicable to temporaay, construction service. Odor
Not all jurisdictions accept credit c ale= ale caf jurisdiction to more %formation- Notice: This permit application
Not fcc 5 7 s. n-r)
0 Visa 0 MasterCard expires if a permit is not obtained Platt review (at _ %) $
Credit card number —//— within 180 days after it has been State surcharge (8%) $ t • /a7
Expires accepted as complete. TOTAL $ _ . a
More of cardholder as stows 011 credit cmd
S
Cardholder signature Amami 4404615 16100/COM)
CITY OF TIG RRD _ 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested AM PM BUP
Location . - Suite MEC
Contact Person fC)P /'4 r Ph ( - ) / y PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner H A 1 ELC
Footing
Foundation ELC
Access.
Ftg Drain ELR c
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
= Failing n L oC I ,/ E
/ ����
�
Firewall A
Fire Sprinkler �/
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Voltaq
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
s Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA D a t e 6—g Inspect Ar
Approach/Sidewalk AV
or - �� '� i
Other:
Final DO NOT REMOVE this inspection record from the Job site..
PASS PART FAIL