Permit q CITY OF TIGARD'
ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00305
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/30/2007
PARCEL: 2S 113AD -01900
SITE ADDRESS: 16640 SW 72ND AVE B10 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT: 009 JURISDICTION: TIG
PROJECT: VERIS
Project Description: Install low voltage security 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 HSM ELECTRONIC PROTECTION SERVICES
15350 SW SEQUOIA PKWY #300 -WMI 15495 SW SEQUOIA PKWY STE #100
PORTLAND, OR 97224 PORTLAND, OR 97224
Phone: Contact #: PRI 503- 968 -3353
FAX 503- 968 -3398
FEES Reg #: ELE 37- 1054CLE
LIC 161567
Description Date Amount SUP 941LEA
[ELPRMT] ELR Permit 7/30/2007 $75.00
[TAX] 8% State Surcha 7/30/2007 $6.00 REQUIRED ITEMS AND REPORTS
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 •uestions to OUNC at 50 46.6699 or 1.800.332.2344.
Issu :y: // / Permittee Signature: Si2Z, !'(. z / 1 d7
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.
JAN -01 -1900 07 10 P.02/03
r,IecTrita re TM fr fa IIearl. 11)1., 1)1.1.1t IT ' u. ' .
��
City of Tigard f A 1 lY? ramitr " ...._._ FLJQ ?.Cb7'
13125 SW Hall Blvd,. Tigard. OR 422_A ,,. .1 ' .' 3L _ i . - . ! -.
rhnnr.• 1111 h394111 Par.. 1g1,1yK t9,ij ,n OY1en DatdBt l chimi re.miL
F i r, v, n leepuction Line: 503.630.4175 I than rlcady/oy �J 121 see Tom for
Mum= wwwtigand- or.gerr JUL q 1 i,:ncdmi`thod;._ -- —_ l7 D000aoa000DOxoofo
1111 rrns■ion
, . .
:•..i..':!". ..: •, .:c. ;::.'''I:''-:.'•:::: „: -. 71,T.i?P..F.'.0 # h ,• h',i , ' � I ; i;y', , : Pl :itilV. °'RR ;
':.' •'. ,
❑ New coastlllehon ddi[ion/sl t r ¢p�ac .. u. 4, r Plwu check all that apply (submit ? 1 sets ofplatsw /acrm checked bclew): '
0 Service ur a
0 Demolition ❑ Other: C� 7i •. TI - .,. where Me e available Mutt manna h MC ❑ m marinas a
oli na noalY
.° ., .. :; .. `CA'FFCbit'K ": g R 13N S.. 1!:'' 1;',;•': =;' i%r.5 - onceda 10,000 amps u 150 volt, or a Pleating buldinga
t o r*d Tic 00 ❑ rmmiero.l �:.p
❑ 1- and 2-family dwelling NI Commercial/industrial ❑ Accessory buIldmg anon fu, an Who iestaonliulu bullll etas
0 Multi- family ❑ Mega' builder ❑ Other: ❑ Mrr pomp ❑ ini lli lnn /o a vA nr
,. c .: :.. • . , ;.;., .
,. Cam nc ct c.par d. . ".°11". b
- .
.... . :•. ..�. '1 �: our load o ,
A tlsV ' dton a y fhxw stlm nho l A e " •G",'1 " " - .d "
lob no.: Job site address: (i'e "spi b ve. - ... IDOHPut nano. occupancy.
Y i V V • r ... r'1 Six Or flllhe r¢stdhtlul mitt. ❑ �ti7artiwol vehicle woks.
City/State/ZIP: - 111 p p. �7,7i ' ❑ur ,I1t, -ra re facilities. 1'l Supply ralture for MOIL Ulan
ID Haaadooc looationc, Ann unite rpmina I
SnitrAililr./arl net PTOJCCt ie� ( kV (,/( j / j ' . ❑ Service or feeder 600 amps or tr
ob sire .... :'' i =. :: ` k ' N1;UULE, : ' .
Cross soeer/dlrecdons CO
J - t>mwbe 1 94. i Fm 1 T.ial I •
New residential single -or tnaltl•Ihndly dwelling unit.
1nduari artarhr 1 garagrr.
Subdivision: I Lot no IMO sq. ft. ter lots 145.13 4
- Ea. uJd to. II. in width' 33.40 1
t'ax rrap/parcel no residential
75.00
,,.:. ..: . .. .. ... • . :;. .. : , a , .. 1l' Rif i #� i ; =g , ( alto a aq. 111
1 tmlted energy, Im IM_nimtly
ten fil Agri 444 01-6.v.1 c'e fry 4 /etli 12 _ "Sidennat 1with awn cq. X) 1• tai /
4 etdts atu atelld fuall .tuJ1 elowthu
u
T[,' ^ A Set gists o f tlau of 'at, of 1
� I / r' 1 2UU amps or tea KU30 2
F]1. PR1)PEit Yr4S EFF : : 701 smile ro a0n a
Name. 401 amps to 600 arms 160.60 . �. 2
y 601 amps to 1,000 alt 240.00 2
Adder_..: OrcT1,000 amp orvoila 454.65 2
City /State/ZIP: Temporary service' or teeders tnstauation, alter non. entVor
reloeotion
Phone: ( ) 1 Max: ( ) 700 amps or 1&19 66 its 1
Owner installation: This installation Li being made on property that 1 own which is not 201 aTIIP0 to 400 elms 100.30 2
intended for tale, lease, rent, or exchange, according to (../Its 441, 449, 6'/U, and 11.11. 401 amps to 599 ,nips 137.75 2
Branch circuits new, alteration, or c*teuzioo, per panel
Owl ct l,ibnnlutc• nom. A. r� fin Inw& h.ii..uitS with
.:• .. -. •. - . aan Mann• eh n feeder lire,
... •r.. �. � ,�...,i►PXb14. � :.... .... - ....... : :i.i:J�'�QI`;kq:�6 N :� :� i "� �' M1 M11 7
rock carom
Rnsinacc moue:: B. Foy for branch circuits
� �
wid,vuI sav ii.e ut feeder fee. 46.85 2
Contact name: itrar hrsnrh rirrnlr
each ad41 branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /Statc/ZIP; Each manufactured or modular
_._. ........_ - -' Jwclliu larks fccdci 90,90 2
Phone: ( ) I rrax:: ( ) ! - Reconnect only 66.85 2
13 mail: Pump ur imgattun circle 53.40 2
:..: :.. : :•..' : : : :.- ;.. < :;CO I'JtA OR,:,,
1::.. : . :. Sty or outline lighting 33.40 7
,,..:. •.
Business name: B e
SM Electronic Protection Services (FISM Security)
Signal l ond(a) w alocrotlnn, l
energy or
Address: 15495 SW Sequoia Parkway Ste. 11100 extension. Describe: t Page 2 73'00 2
City/State/41P: Portland, Vrt 97724 _ _ — Felt adtltllnnal hnpecduo over allowable iu any oldie abort
Pax inspection 62.50
Phonic: (503) 96B - 3353 1 Pax: (503) 968 - 3398 investigation per hour (l 1. ,,..,.> -- 62.50
CCB Lic.: 161567 I Electrical Lic.. 37-1054t4t I Supra. Lie.: 941LCA IndusIHal plant 73 73
� - ELEcflUCAL .F RMlr FEES
cupry Electrician Si�nan MrlulrP.11 G� f1� /b 1 Subtotal; e•75.00
Pint name: Stcve Morehouse rrQOr�'�� Dot"/ " Plan review (254f ofpermit fee):
W ` Stab merchar6'e (8'% ofpemIit feu); 56.00
Authorized eignature: 14 t .cif , l 01171 TOTAL FEM./1T PEE: . 581.0,
Pnnf name: Neu Strcifcl � : /pi Tbk permit appLmtiaa c.pim, if. parson b not etsearxd wtthln 100
dm. Oar it 6.o bcc..cccptcd ea complca•
• Nvmbcr of imec:4ions allo..cd ix. 1,...,11.
1•Innarliserrnnild6f C.D.rm9 ap. Mn iii mall, 11. 45I ST(I 1..O.SeCOWWLII
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007-00305
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/30/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/31/2007 TIME: 7:00AM PAGE: 43
SITE ADDRESS: 16640 SW 72ND AVE 610 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 009 TYPE OF USE:
PROJECT NAME: VERIS
DESCRIPTION: Install low voltage security system.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: HSM ELECTRONIC PROTECTION SERVICES PHONE #: 503'966.3353
Inspection Request Scheduled For: Date: 8/31/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 054947 -01 503-793-8658 N
Corrections /Comments /Instructions:
vv
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ( V ) L T Date: O f 3('J Phone #: (503) 718- 2.-Ifg10