Permit �� TY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
A-too DEVELOPMENT SERVICES PERMIT #: ELR2002 -00278
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 DATE ISSUED: 12/5/02
SITE ADDRESS: 16640 SW 72ND AVE B -10 PARCEL: 2S113AD -01900
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L
BLOCK: LOT: 009 JURISDICTION: TIG
Project Description: Low voltage: 2 systems - access control and 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: ACCESS COF4 X
TOTAL # OF SYSTEMS: 2
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: F - 968 - 3398
Reg #: SQ8- 330941 LEA
LIC 150191
ELE 26- 207CEP
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 12/5/02 $150.00 Elect'I Final
[TAX] 8% State Tax 12/5/02 $12.00
Total $162.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 9 2=001 -0010 throuc
Issued by / Z6L QtiG_, �:�( /Z/ Permittee Signature<
OWNER INSTALLATION ONLY II
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N ee nialoLtOriA W DATE:
LICENSE NO: tL7 /
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
SEC -04 -2002 14:54 HONEYWELL 503 968 3398 P.03/04
i ecirical-l P ej•mit Application - - -
1)r.re received: 0'6 6 'L Pcrinit no, :&144,$)0,2 — /
1'� L)tv Of '1 i gard I'tolccVappl. no.: Expire dew:
Cal n/Jrward Address: 1x125 SW Hall Bled. • I ipard !94� ieD Daft issued: by: o i Receipt no:
Phone: 1503) 639 -4171 a "'
Fax: 1503) 598 -1960 Case file nu.: Payment type:
Land use approval: _ tECI- 0
410 Q
C1 1 & 2 family dwelling or accessory St<omlaghaVindustrial U Multi- family ❑'Tenant improvement
U Nr.ve construction 0 AdditintUalrcration/replaccmenl 0 Other: ❑ Partial • • $013 511LINFORMATION -
)ob address: 4) -r2 • A 6 .... Bldg. no.: Suite no.: 'Tax map/tax loUaccounl no.:
l..nl: Block: Subdivision:
Project name: /Ln•iN, , e� Description and location of work on premises: ' rati Mint V.5
Estimated date of completion/inspection; 1 D
-
CONTRA(TOR APPLY(' -ArION !11 W
St OULE
Jab no: ) 1- d:11 Fre Mies Business name: HONEYWELL Dncriprion Qty. (ea.) Total ao.insp
New mitten& -sink or multi-famfly pet
Address: 15495 SW Sequoia Pkw , # ] 00 ' dwe tl - mp unit. Inductor anathedgarage.
Ciiy: Por i• l an d Suite:() ZIP: 97224 . Semite included:
Fax: 968 -339: 1` -mail: two ul- or less 4
Phorse503- 9683304 Each additional 500 sq. O. or portion thereof --
COB no i5Plei1 Elec. bus. tic. no: 26- 207&eP Limited energy, residential 2
'
C r t, /melfo le. ncL 7-4 619 Lintitcd ener gy. ran- re
Each manufactured home or modular dwelling 2 •
/ 1 �1 I Service and/or feeder 2
n air 01 au wising electrician (required) Dale '
_ ���A Senses. or ferias►- installaliolr,
sup. esea:7same (p71h1j S#EV8 I alteratives or relocation:
/PROPERTY O1VNER 200 amps or less 2
201 amps to 400 amps f 2
Natnc (print): _ ,- - 401 amps to 600 amps _ 2
Mailing address: 601 amps 10 1000 amps
City: State: ZIP: over 1000 amps or volts 2 ,
Fax: E -mail: Reconrsecr only 1
Ph one:
7tmporary services or keden, -
Ownet installation: The installation is being made on property 1 own inata Haden, sherntlon,orrelocadoe:
which is not intended for sale, lease, rent, or exchange according to 200 amps or less 2
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps . 1 2
Owner's signaluie: — —
Date: _ 401 to 600 amp/ 2
t 1:lyGINEL1t Branch circeita • new, alteration,
or corrosion pal panel:
• Name: - A. Fee lac branch Circuits with purchase of
service or feeder fee, each fs circuis
City: I State: J
2
CAddress: l B. Fri for branchcircuils without purchase 2
City: 01 service or feeder fee. first branch circuit:
Phone: Fax: I E — Each additional branch circuit:
.. WENN lttrxit V(Pleast tiled: soft that Lipp% ') Mine .l Service wleeder ant included): 2
Each pump or irrip atian Circle
O Service over 225 amps- eonuneloid 0 Health-care facility al circuit(a) i n g outline lightin 2
U Service over 320 arnps -rating of 182 O Each signor Hazardous location
family dwelling! D building over 10.000 square Itei low of S S caliun. m extension, a) in 01 a Ii limited d energy Panel, 1 IS 15 2
❑ 5vi Iem oter WO verb nominal note srsrdential units in one swcture
D Building ov ' three atones 0 Feeders. 400 amps or more • Description: -_.
—
0 (tc-cupnrsr load over 99 penult. U Mnnuf scturen strums". a! RV parr Licit stltlillunal inspection over The alIOwablr In any of the above:
0 L-preasfliphlinpplan 0 f'I,ct. .. Fes inspection .— „
Submit — sets of pions with any of the above. In /uparionler
•flu above we not applicable to temporary construction service. _ Other
- Permit fe 1,50' a
nn au ,uri,d;eurya steep mail cads. &I c junbdic lst n,nn inlumvlion. Notice: This permit application Plan review tat ^ %) $
U vise: thdasierGud expires if a permit is non obtained
Credit ca,d m mbar: .. /�
rj4 -1VOO O0t-114 - I 12 9 7/ 1 /oil within l ftfl days ;:tier if has been State surcharge (8%) .... $
p S. •
�� M tiSE __ to ire, accepted ns complete TOTAL
/p �/ • /na eft) „ wider as shown or! credit caw , Q
1. `r. I. f C — -� (� —. — 440-401 1er00rCOM )
( Cm dlrnlde , ,i�ubWfe Arnnw,t ,
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
J BUP
Received / Date Requested / AM PM BUP
Location ` < ¥ 7e3--4-0 Suite — /0 MEC
Contact Person Ph ( ) R- 3333 PLM
Contractor Ph ( J ` ) SWR
BUILDING Tenant/Owner v ELC
Footing ELC
Foundation Access:
Ftg Drain ELR ` v2 7 r
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm y 4
S
s /
usp'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
ire A
• Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
S — 0 Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA ' \\
Approach/Sidewalk Date V �n /a O,7 Inspector
• ��i s _ Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL