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Permit CITY OF TIGARD ELECTRICAL ENER - RESTRICTED ENERGY {� DEVELOPMENT SERVICES PERMIT #: ELR2001 -00065 - �`'` 4 " III 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/16/01 SITE ADDRESS: 16800 SW 72ND AVE PARCEL: 2S113AD -01700 SUBDIVISION: ROSEWOOD ACRE TRACTS ZONING: C -G BLOCK: LOT: 030 JURISDICTION: TIG Project Description: 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: BRIDGEPORT LAND LLC ADT SECURITY SERVICES, INC 3939 NW ST HELENS RD 2815 SW 153RD DR PORTLAND, OR 97210 . BEAVERTON, OR 97006 Phone: Phone: 503 - 469 -7100 Reg #: LIC 59944 ELE 26- 209CLE FEES Required Inspections Type By Date Amount Receipt Ceiling Cover PRMT CTR 3/16/01 $75.00 2720010000 Wall Cover 5PCT CTR 3/16/01 $6.00 2720010000 Elect'I Final 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) Issue 987. Issued by Permittee Signature OWNER INSTALLATION ONLY The installation is being made on property 1 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 7 Electrical Permit Application 11111111111111111111111. RECEN tut Datereceived: Permit no.. a /- Qbd(ps _,L : :11 City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 1 .97223✓ 2001 Date issued: By: I Receiptno.: Phone: (503) 639 -4171 ►•V• Fax: (503) 598 -1960 � �pt-�rc Case file no.: Payment type: CONIMUNI Land use approval: O .• TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory kCommercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address: I ,( - 7 24\ (I A Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: Block: Subdivision: %F'� Project name: t iv o _ "_scription and location of work on premises: Estimated date of completion/inspection: CONTRACTOR APPLICATION FEE SCHEDULE Job no: Fee Max Business name A DT SECURITY btttvlt,tb, INC. Description Qty. (ea.) Total no. insp Address: 2815 6. W. 153 J DR. New residential - single or multi - family per BEAVP'T(J OR 97006 dwelling wdt. IIndudes attached garage. City: State: I ZIP: Service include& Phone: 1 J( - '32II4 I Fax: q l 4 J/ dE -mail: 1000 sq. ft. or less 4 CCB no.: 5 Cl g q .,1 I Elec. bus. lic. no: ,2 (' Each additional 500 sq. ft. or portion thereof Limited energy, residential 2 C•t . metro lic. no.: Limited energy, non- residential 2 • .J I. .3 . /a , / )l Each manufactured home or modular dwelling 'tgnature of supervisin1 electrici (equired) Date I 1 Service and/or feeder 2 Sup. elect. name (print): ►�rl l ��►',L1lI Lord- Services or feeders— installation, alteration or relocation: PROPERTY OWNER .- 200 amps or less _ 2 Name (print): ' ViV 4 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: ( '(x � LO . 601 amps to 1000 amps 2 City: T 1 I State: o IP: Over 1000 amps or volts 2 Phone: �JJ I Fax: I E -mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation: ORS 447, 455, 479, 670, 701. 200 amps or less 2 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 ENGINEER Branch circuits- new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: I State: I ZIP: B. Fee for branch circuits without purchase Phone: Fax: E-mail: of service or feeder fee, first branch circuit: 2 Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc.(Service or feeder not included): O Service over 225 amps - commercial 0 Health -care facility Each pump or irrigation circle 2 O Service over 320 amps - rating of 1&2 0 Hazardous location Each sign or outline lighting 2 - family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, O System over 600 volts nominal more residential units in one structure alteration, or extension* 1 1 15 7.5 2 O Building over three stories 0 Feeders, 400 amps or more *Description: O Occupant toad over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above: O Egress/lightingplan 0 Other. Per inspection 1 1 1 • Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ 7 l J UV O Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $ - y State surcharge (8%) ,-' ^^ Credit card number / / within 180 days after it has been g ( ) •••• $ t..Y Expires accepted as complete. TOTAL $ Name of cardholder as shown on credit card Cardholder signature Amount 440-4615 (6/00/COM) 9 - -v at OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 3 / AM PM BLD Location / G 60 Suite MEC Contact Person /1 1 it Ph ( - 16 1 - 7 Z- V y PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR c 99 vt' G aa Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING �t / - /4' Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final - PASS PART FAIL MECHANICAL Post & Beam ' Rough In Gas Line Smoke Dampers • Final PASS PART FAIL L Rough ugh In \\ UG /Slab Lo a Fire Alarm PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Date v LL Inspector Insp r , / Ext Other ��/ . Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (5,03) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST / / BUP Received ''` Date Requested t ( A M PM BUP Location l ((Ogg 'ThW - 1,131SAftite MEC Contact Person Ph ( 533 ) A34 ^ ga PLM Contractor 1,T - S 0 3 - � 1' � 'L \ Ph ( h ) SWR VIA h aY BUILDING Tenant/Owner J� U P??-. �,3 b k 3 6 ELC 6;7 Footing Foundation ELC Access: Crawl r Drain ►at l� Pt ' ' L ELR Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing f,7 �) 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 Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -1n Gas Line Smoke Dampers Final P Ss, ART FAIL E CTRIC Se Rough -In UG/Slab Low Voltage ✓l! o Fire Alarm Y F ❑ PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ❑ Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Date - 47 Ins or � 1601 " l Ext Approach/Sidewalk p Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL