Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
�
DEVELOPMENT H BMEN � 639 -4171 DATE ISSUED: 2 -00039
ED: 3% g /02
SITE ADDRESS: 16600 SW 72ND AVE B -10 PARCEL: 2S113AD -01900
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L
BLOCK: LOT: 009 JURISDICTION: TIG
Project Description: Installation of low voltage for fire alarm addition. Job No. 724 -01- 22807 -13
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: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES HONEYWELL INC
15350 SW SEQUOIA PKWY #300 -WMI 15495 SW SEQUOIA
PORTLAND, OR 97224 STE 100
PORTLAND, OR 97224
Phone: Phone: 968 -3300
Reg #: SUP 941 -JLE
LIC 57824
ELE 26- 207CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 3/18/02 $75.00 2720020000 Elect'I Final
5PCT CTR 3/18/02 $6.00 2720020000
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 -00 hiaug OAR 9.2 -0 - 0. You may obtain copies of these rules or direct questions to 0 NC at (503)
246 987. '
Is ued by kid - Permittee Signature
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
MAR -14 -2002 07 23 HONEYWELL 503 968 3398 P.02/03
• pAcra a of 3
Electrical Permit Application
Date reccived: f D'r permit rto.:�; -
Aj �`i P C1P of Tig -
, • I V E D n o.: Expire date:
City q�TiRard Address: 13125 SW Hall Blvd, Ti . It. b. , )r, V {�9
Phone: (503) 639 -417 ] Dale issued:
Receipt no.:
C
Fax: (503) 598-1960 'AAR 2nn Casc tile no,; Payment type:
Land use approval: .
C OY tJr . 11tiA KJ)
1.11.1
O 1 & 2 family dwelling or accessory II Commercial /industrial 0 Multi-family 0 Tcnant improvement
O New construction 0 Addition /allcration/replaceme.ni 0 Other: _ ❑ Partial
JOB SITE INFORMATION
• Joh address; /4 4 $(,t/ 7te49( i eA.a..2 131dg. no.: Suite no.•ijidi Tax map/tax lot/account no.:
1-or: Block; Subdivision:
Project name: Pi; d / - n S Description and location of work on premises :K,r4 ff
Estimated date of c mplelion/inspection:
CONTRACTOR APPLICATION FEE_ SCIIEDLX.F
lob no; '7 - / - ..a 1'0"7 -/.1 Fee Max
Business name: HONEYWELL Description (es) Total tto.i_
al
Address: 15495 SW Sequoia Pkwy, #100 — New '"- single Of j""Rkat°°yper
dwelling unit Includes attached garage,
City: Put 1 an d Ltate :CR 2]P: 97 224 ' servlotinduded:
Phonc503 -968. -3304 I Fax: 968-33981E-mail: • Itloo sq. ft. or 'era 4
CCB no.: 57824 I Elect leas. lie. no: 26- 207CLE E ''c h diuon Soo iq• ft or ponion thereof
Limited energy, residential 2
City /metro tic. o.• 619 Limited energy, non-residential 2
5_, V-0.7„. Each manufactured home or modular dwelling
Signature o pervisinp electrician (required) Date Service and/or feeder 2
Sup. elect. name (print): Steve Morehouse Licu,se no: 94I.1LE Services or feeders - installation,
alteration or relocation;
l'ROPFIt1Y ON'NI:It 200 amps or less 2
Name (print): 201 amps to 400 amps • 2
Mailing address: 401 amps to 600 amps 2
601 amps to 1000 amp, 2
City: I State: Z.- 1P: OvCSt00D amps orvolt5 2
Phone: 1 Fax: E-mail: _I Reconnect only I
Owner installation: The installation is being madc on property 1 own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to Installation, alteration, orrelocation;
ORS 447, 455, 479, 670, 701. 200 amps or leas 2
201 amps to 400 amps 2
Owner's signature: -- Date: 401 to 600 am.
2
ENGINEER • Branch circuits - new, alteration,
Name: er rxtenstoo per panel:
• A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZU': B. Fee for branch circuits without purchase
Phone: Fax: E -mail: of Service or feeder fee, first branch circuit 2
Each additional branch circuit:
I'LAN IlEvII•: '(Please check all that apply) Misc. (Service or feeder not included):
O Service ova 225 anps•eonunetcial 0 Health -care facility Each pump or irrigation circle 2
O Service over 320 mt,ps- rating of 1&2 0 Hazardous location Each sign or outline lighting 2
family dwelling' 0 Building over 10,000 square feet four or Signal circuitts) or a limited energy panel,
O System over 600 vi,it,. nominal nrort: residential uttit! in one structure alteration, or extension' 75 2
O Building over three stoner 0 Feeders. 400 amps or mom *Description:
O Occupant load over 99 person: ❑ Manufactured structure; or kV park Bach additional inspection over the allowable m any of the above:,
O Eprexs/liphcingplan 0 Usher: Per inspection 1 1 1 i
Submit _ sets of plans with any of the !above. investigation fee
The above arc nut applicable to temporary construction service. Other •
Nok all jurisdictions at erect;; rh, plr�se call juri. , ciao to more information. Notice: This permit application Permit foe $ 7�• r7t'>
remit
Omni OMa. - ? '� ex if a perm is not obtained Plan review (at _ %) $
Credit card number., ... - i. __ ._ _. — _ _-..� within 180 days after it has been State surcharge (8%) .... $ (a .0e_
(rte -LoD f 'C.'11"-- -'- '1' s. �`, xptrer t7
Name' o1 `.. atolder s va •• accepted as complete. TOTAL $ •_g7. D
` •(der rijnplart Anima 44440)5 )6/0Q/COM)
•
CITY OF TIGARD 24 -Hour r :_
BUILDING ,, . -. _ Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested AM PM BUP
Location / (OC�Q() ` 7 - ✓71 Suite /° MEC
�-J
Contact Person ` Ph ( ) - 29 3 a Ll / 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing 1
ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors KO. / r= / l
Ext Sheath/Shear —
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fire wall�( L �� s
Fire Sprinkler 1
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final C./ \
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
PA P RT FAIL
CAL
Rough -In
UG/Slab
Low • Itage
Fines ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
4 lJ PART FAIL
S ❑ Please call for reinspection RE: E Unable to inspect — no access
Fire Supply Line /
ADA
Approach/Sidewalk Date Inspect . i /v / _ �� Ext
Other:
Final DO NOT REMOVE this Inspection record rom the : • site.
PASS PART FAIL