Permit CITY TI CARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2005 - 00283
4 I � 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 DATE ISSUED: 9/15/2005
PARCEL: 2S 113AB -00600
SITE ADDRESS: 16165 SW 72ND AVE BLDG D ZONING: I -L
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG
Project Description: Alarm system.
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:
PACIFIC REALTY ASSOCIATES SECURITYCO INC
15350 SW SEQUOIA PKWY #300 -WMI 15495 SW SEQUOIA PKWY #100
PORTLAND, OR 97224 PORTLAND, OR 97224
Phone: Phone: 503- 968 -3300
Reg #: LIC 161567
SUP 941 LEA
FEES ELE 37- 1054CLE
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 9/15/2005 $75.00
[TAX] 8% State Surcha 9/15/2005 $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.
•
Issued By: (IP j�� � Permittee Signature: a.12,-e...
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-09-2005 09_11 HSM HONEYWELL SECURITY 503 968 3398 P.02/03
- C ity of Tigard RECEIVED Received � Pzrmit Nu.: -�'/^ r
13125 SW Hall Blvd., Tigard, OR 97223 Pla Review
Phone: 503.639,4171 Fax: 503.598.1960 F ^- {, • dBy Other ?omit
Inspection Line: 503.639.4175 SEP 0 9 2005 '' f Date Ready/By: Asir , See Page 2 for
Internet; www.ei.tigard.or.US Notitied/Method; 'r 1r Supplemental Informed=
CITY OF TLGARD , .. , . .. .. - -
:: real t l i E� ON ' .. ' • :.• .:.:.
.... • :. -:•:: N [t4V1>i, . PLAN .. • •
❑ Ncw construction ❑ Addition /alteration /replacement Pieasc check all that apply:
❑ Demolition ❑ Other: Dscrvicc over 225 amps, comet °Hazardous location
❑Service over 320 amps — rating ❑ Suildng over 10,000 sq. ft.,
_ : CATEGORY • • OF , CONSTRUCTION: :' ' • • ' . of 1- and 2- family dwellings 4 or more new residential • 0 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building El System over 600 volts nominal units in one structure
❑ Multi family ❑ Master builder ❑ Other ['Building over three stories DFeeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
' '..' :• • . JOB• S1TE: INFORMATION: AND LOCATION. • , • ❑I'gress/lighting plan RV park
Job no.: Job site address: 16165 SW 72nd Ave- OHealth -care facility ❑Other
Submit 2 sets of plans with any of the above.
City / State/ZIP: Portland, OR 97224 The above are not applicable to temporary construction service.
Suite/bldg./apt no.: Project name: Max -Viz ...,....1.;',.,.1 FEE!
Dewlpane I Qty. I Pee I Told i ••
Cross street/directions to job site: New residential single- or multi - family dwelling and.
includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Fa. add'1 500 sq. ft, or portion 33.40 t
fax map/parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
'
• :.:: ,.:!, , ..:.....•.: >, . ..:....:.:.. ::. : _DESCRIp'1TON.OF.WORK'�:;:;. ' ;'�:.,;,..;:: • • Each manufactured or modular
Install alarm system dwelling. service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or rdocation
200 amps or less 80.30 2
• :.::,. . ..... amps to 400 mnps 106 2
;..... ❑' PROPERIY;.O R .,; , • , : ,... •I . . . .:.' .. D TENANP:
- 401 amps to 600 amps 160.60 2
Name: Same as above 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, alteradon, and/or
Phone: ( ) Fax: ( ) relocation
200 amps or less 66.85 1
Owner installation: This installation is being madc 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. 40I amps to 600 amps 133.75 2
Owner signature: Date: Breach circuits— new, alteration, or extension, per panel
0 'APPLICANT . ":,::.::.:: : : D •CONTACT PERSON• A, Fee for branch circuits with
_ AN
' .. • : — service or feeder fee, each
Business name: branch circuit 6,65 2
"'-'"' 13. Fee for branch circuits
Contact name: without service or feeder fee.
each branch circuit 46.85 2
Address: Each add'i branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax ; ( ) Pump or irrigation circle 5140 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited—
:: _• •'........,..:•".. energy panel. alteration. or 1 O
:,; .. CO CIO cad Describe: 2 2
Business name: SecurityCo DBA Honeywell Security erasion. scri Page
Address: 15495 SW Sequoia Parkway Ste. #100 Each additional inspection over allowable in any of the above
--------- •.- ....... _ Per inspection 62.50
City / Statc/ZIP: Portland, OR 97224 • investigation per hour (1 hr min) 62.50
Phone: (503) 9683353 I Fax: (503) 968 -3398 Industrial plant per hour 73.75
, ,.; :.ELECTRICAL PERMIT` FEES"
CCB Lic.: 161567 Electrical Lic.: 37- 1054CLE Suprv. Lic.: 9 41LEA Subtotal 15.00
Suprv, Electrician signature, required: /U,_ Plan review (25% of permit fee)
Print name: S tr ve m4YCG 5e. Datc: 09/08/05 State surcharge (8% of permit fee) 1 up
TOTAL PERMIT FEE V I, tO
Authorized signature: htaidha This permit applleadon expires if a permit is not obtained within 180
days after It has been accepted as complete
Print name: cl t _ Date: 09/08/05 • Foe methodology set by Tr -County Building Industry Service Bo ird
V • • Number of inspections per permit allowed.
t:\nuitdtne\rcnninIEr c- PcrmitAnp,doe 121(13 440.4615T(10102VCOM/WEB
CITY OF TIGARD ,.
UILDING DIVISION V
_ PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ELR2005 00283
Phone: (503) 639- 4171aq ( 9/1512005
Inspection Requests (24 Hrs.): (503) 639 -4175 ''I �..
INSPECTION WORKSHEET FOR DATE: 9126/2005 TIME: 7 :12AM PAGE: 93
SITE ADDRESS: CLASS OF WORK:
16165 SW 72ND AVE BLDG D
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: MAX VIZ
DESCRIPTION: Alarm system.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: SECURITYCO INC PHONE #: 503-968-3300
Inspection Request Scheduled For: Date: 9!2612005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
19 I Electrical final 016523 -01 503 - 968.3353 N
Corrections /Comments /Instructions:
( (
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �' ---� Date: ‘ �4 S ` Phone #: (503) 718 -
p c )