Permit C I TY r O F TIGARD RESTRICTED ENERGY
1 DEVELOPMENT H BMENq Tigard. t! 639 -4171 DATEESSU 7/8 2004 -00198
- 13125 SITE ADDRESS: 13333 SW 68TH PKWY 1ST F PARCEL: 2S101 DA -00104
SUBDIVISION: FARMERS INSURANCE ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
Project Description: First Floor Protective Signaling
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:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
FARMERS INSURANCE GROUP ALLIED SAFE + VAULT INC
13333 SW 68TH PKWY AKA ALLIED SECURITY
TIGARD, OR 97223 530 NE COUCH ST
PORTLAND, OR 97232
Phone: Phone: 503 231 - 9550
Reg #: LIC 64465
SUP 3931 LEA
ELE 26- 243CLE
FEES Required Inspections
Description Date Amount Ceiling Cover
[ELPRMT] ELR Permit 7/8/2004 $75.00 Wall Cover
Elect'I Final
[TAX] 8% State Surcharl 7/8/2004 $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.
f .
Issued by 1L� Permittee Signatur: J/ / ,
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
I.
JUL-08-2004 08:58AM FROM- T -394 P.001 /002 F -426
", mow.
EAectrica1 P erroi ..,; 1 • 4- - gr
A -
16 K Data received: Pelmit no, '
f „� ' �.l'P City of � I Q �� Prolect/appL no.: • Epic dale:
Cry of Tigard :13125 SW Hall Blvd, T 'OR 9 77dd1 o4 Date issued By: Receipt no.:
Phone: (503) 639.4171 • —
Fax: (503) 598 - 1960 CITY OF TIGARD Case file no.: ' Payment type:
BUILDING DIVISION
Land use approval:
TYPE OF PERMIT
C71 & 2 family dwelling or accessory �ConuncrciaUmdastrial Q Multi - family 0 Tenant improvement
O New construction O Addition /alteratioa/replacemCrll 0 Other: __ 0 Partial.
JO1t SITE INFORMATION
Job Saws: j 6 i__ g Bldg, no.: Suite no.: Tax map/tax lot/account no.:
L,o4: Block. Subdivision:
o Ptoiec t name. t 1 J s .a J a Description and location of work on premises: .
Estimated dare oftbtnplctionhnspecUon: •
CONTRACTOR APPLICATION ''EE SCHEDULE
blob no:
Pm Max
•
Business name Defog alts! 4 .. e0.) Total ho. I ._! ' . F�SL Ncnres l -singleormaid-brie"
Aare= 5gC) Cale. h d1ad111tII�tbzelvd�
City: f +/a Act Istate:aawl t 7 3Z' 1C4rrimihdaae� le
Phone. V 2 ►.. Fax. ►- ) E-ii all: 1000- .. fr orea 4
•
Each addittanal S00 sq. ft or wines thereof � —
CC
B no.: ( Elect. bug. lit. no: -;;:_,.'="-- . = -tea Llmtrcdr9e�y,residetulal er - 2
' �, lit. nD.: tlf. _ • — Lirrdredenetgy.n llal 2
-v- () q >E n I1faCG� Lome dt r4odular dwel ing
signature a sopelvnsiog (rega re Borvlceand/m�racc 2
sap. elect. home (print . _ A .-.— -.a .s,� + alaaa o o at td oeatt lesion,
YJtWI'EC&TY OWNER 2O0 amps orlw 2
Neale (ono: r • r u _ u a - 20 amps to 400 amps _ a
.0 401 ampere • am 2
Mailing address: 1 3 S w • SNi t A.) 601 •• to 1000 amps 2
City: ` , .! Stan: I ZIP: - 13 over 1 , . •: or volts 2
Phone: Fax: E -mail: Reccaaectonly 1
Owner installation: The installation is being made an property I owa Temporary semen °rimless -
which is not intended for sale, lease, rent. or exchange according to Innallattan,olierstioNerrelOcatioge
law • ORS 447. 453, 479.670; 701.' 200 tip e! 2
201 stops o0 400 amps 2
Owner's Signature: Date: 401 600 2
Branch circuits alteration, .
Name: or comb= per panel: . • . A. Fee for branch circuits with purchase of
!Address: service or feeder Ste, each branch circuit 2
City: State: ZIP: B. Fee for branch ci Mite without parch=
phone: F a x : Ferrell: of s e r v i c e or feeder ice. bractouch circuit: 2
Each additional branch circuit
Mlt& (Service or ceder suit inclnded):
D Sergio:wcr7Z5 emps•cbaMercial a Heoltheotef 4Iity Each panty oritn ationdrcle . 2
D Service over 320 amps-razing of 1•52 CI nanedoosloealion Bads alga arautline 11. Meg - 2
Poclily dwellings 0 Buf t11ng c vee mono gam ices four or Sigma ehtudt(s) et 0limited acagY Paul.
D System over600 yells Donned • more TesMce6al inteeatmetea alto:Adamare+rtendona 2
O Budding aver tMx storks O Pcr4ca, 400 ampa armor* . ri on: •
o Mai/past load over99 persona 0 Manutaemred matures or RV park Each additional ham: dim over the allowable is any arthe sharer
D 6grrssnightingp1ia. 0 Mar Fainspxdonl f 1
Submit _ sets of plan with any *rem above. lavrstigenon foe
The abovearenot applicable to construction service. Other ,
r en pa:ssattoa. UCapt erect cards. g4e2,8 mlt,11111acsia+ for macs letee Notice: This permit replication Permit fee ..... ..... ...... $ •
• .. D vase 024 • expires if a permit is net obtained c ar review (at .-- %) 3
Deer road nomb� within 180 days after it has been State =Charge (8%) .... $ -
rlrraff err enC O1da as chaste an c't east opted aS complete. TOTAL ..« $
5
balder apse= � _ "a - x04615 (50340M)
(9),) .1-7__ - q
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
--7 BUP
Received Date Requested / f3 d AM PM BUP
Location /3 3. Suite MEC
Contact Person Cc� Ph ( ) 9 ?SO PLM
Contractor �Ph ( ) g-)1-
SWR
BUILDING Tenant/Owner '
Footing 06 C./ -0 0/
Foundation Access:
Ftg Drain _ 3 ' 36 � D � - pC) <
Crawl Drain
Slab Inspection Notes V 6? ki" W 7 ¶® L6,?" 'PV( W SIT
Post & Beam
Shear Anchors � C1-■V%0C-s
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
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 „y
Catch Basin / Manhole 1"�
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
P - FAIL
EL
3erviee
Rough -In -_-
UG /Slab
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
ART FAIL
S Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA Date ? /- Inspector AX-41.41/ Ext
Other:
Approach/Sidewalk
Final DO NOT REMOVE this Inspection record from a job site.
PASS PART FAIL