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Permit
ELECTRICAL PERMIT - CITY TIGARD RESTRICTED ENERGY Afl DEVELOPMENT SERVICES PERMIT #: ELR2001 - 00012 z 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/17/01 SITE ADDRESS: 12148 SW 131ST AVE PARCEL: 2S104AB 06400 SUBDIVISION: MORNING HILL NO.4 ZONING: R -4.5 BLOCK: LOT: 093 JURISDICTION: TIG Project Description: Installation of limited energy for burglar alarm system. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: X BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: • HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: Owner: Contractor: WALPOLE PHILLIPS ELECTRONICS 12148 SW 131ST AVE (DBA FOR MASTER ALARM L.L.C.) TIGARD, OR 97224 1110 NW FLANDERS PORTLAND, OR 97209 Phone: Phone: 222 - 5083 Reg #: LIC 00125364 SUP 329JLE • ELE 26- 213CLE FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 1/17/01 $75.00 2720010000 Elect'l Final 5PCT CTR 1/17/01 $6.00 2720010000 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 yGu -to-fo. ow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 00010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct question to OUNC at (503) 24 -1987. Iss ed by jk c �!i I "`f Permittee Signature J4(4 ,-,/ 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 Electrical Permit Application Date received: /— /Co -O/ Permit no.: £adsaa/MOD/ A , i� Cit of Ti and RECEIVE �; ;,.� � City g Projecdappl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receiptno.: Phone: (503) 639 -4171 JAN 16 2001 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: COMMUNITY DEVELOPMENt TYPE OF PERMIT 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial - JOB SITE INFORMATION . Job address: L /1' .. /p o/-St Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: I Block: . 1 Subdivision: Project name: W I po (e_. I Description and location of work on premises: et,,,a�Cpfr, Estimated date of completion/inspection: ..-. ' .:`�= :z5±' 01ZORJ.�4L s� -T'�•� -_ f - I : 'Y -1-' B ..n�'Tf.- ?e _-. ' I :...`r Job no: Fee Max Business name: -. 0 Description Qty. (ea.) Total no. insp n_ New residential - single or multi- family per Address: ((( /. Co, FtaePc.Qes& ..5n ++' dwelling unit Includes attached garage. City: / ,. f(cgyJ State:0,- ZIP: ?72_07 Service included: . Phonesrjvlyys-©g Fax .7 C E -mail: 1000 sq. ft. or less. ' • 4 � ZS - . � O Z6 � — (✓t;,L Each additional 500 sq. ft. or portion thereof CCB no.: El bus. lic. no: Limited ever residential 2 City /metro lic. no.: Limited energy, non - residential 2 --c1 c, Each manufactured home or modular dwelling Signature of supervising electrician (required) Date Service and/or feeder 2 Sup. elect. name (print): b - vim License no: f L Services orfeeders — installation, • alteration or relocation: .. -a. ,---- •PROPERTY OWNER ,2 W „ :.. ra. _ - : _ 200 amps or less 2 Name (print): 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City: I State: I ZIP: Over 1000 amps or volts 2 Phone: 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: 200 amps or less 2 ORS 447, 455, 479, 670, 701. 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 ;,i't" i urchase of Address: service or feeder fee, each branch circuit 2 City: I State: I ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit: 2 . Phone: Fax: E -mail: Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): ❑ Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle 2 ❑ Service over 320 amps- rating of 1&2 ❑ Hazardous location Each sign or outline lighting 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over 600 volts nominal more residential units in one structure alteration, or extension* I 7SI 2 ❑ Building over three stories ❑ Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lightingplan ❑ Other: Per inspection 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- ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ • Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ lD Expires accepted as complete. TOTAL $ s Name of cardholder as shown on credit card . / $ Cardholder signature Amount 440 -4615 (6 /00 /COM) Electrical Permit Fees: Limited Energy Fees: Com lete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY l� ' Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service'included: Items- Cost Total Check.Type of Work Involved: Residential - per unit. 1000 sq. ft. or less $145.15 4 n Audio and Stereo Systems Each additional 500 sq. ft. or _ _ _, _ __ _- _ - _ portion thereof $33.40 1 - Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular n Garage Door Opener Dwelling Service or Feeder $90.90 2 Services or Feeders n Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less $80.30 2 201 amps to 400 amps $106.85 2 n Vacuum Systems 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders Installation, alteration, or relocation TYPE OF WORK INVOLVED - COivMMERCIAL ONLY 200 amps or less $66.85 2 Fee for each system $75.00 201 amps to 400 amps $100.30 2 (SEE OAR 918 - 260 -260) 401 amps to 600 amps $133:75 2 Over 600 amps to 1000 volts, Check Type of Work Involved: see "b" above. Branch Circuits n Audio and Stereo Systems New, alteration or extension per panel a) The fee for branch circuits I Boiler Controls with purchase of service or feeder fee. n Clock Systems Each branch circuit $6.65 2 b) The fee for branch circuits n Data Telecommunication Installation without purchase of service . or feeder fee. I l Fire Alarm Installation First branch circuit $46.85 Each additional branch circuit $6.65 HVAC Miscellaneous (Service or feeder not included) n Instrumentation Each pump or irrigation circle $53.40 Each sign or outline lighting $53.40 n Intercom and Paging Systems Signal circuit(s) or a limited energy . panel, alteration or extension $75.00 Minor Labels (10) $125.00 n Landscape Irrigation Control . Each additional inspection over n Medical the allowable in any of the above • Per inspection $62.50 n Per hour $62.50 _ �_ J Nurse Calls In Plant $73.75 ri Outdoor Landscape Lighting Fees: F Protective Signaling Enter total of above fees $ I I Other 8% State Surcharge $ - Number of Systems 25% Plan Review Fee . See "Plan Review" section on • $ front of application. * No licenses are required. Licenses are required for all other installations Total Balance Due $ Fees: El Trust Account # • Enter total of above fees $ • 8% State Surcharge $ • • T otal Balance Due $ • is \dsts \forms \elc- fees.doc 10/09/00 1/-0 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 1 -24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP _;• Date Requested 3 AM PM BLD Location /Zf �`� 5'' /3 ( 5 AL.( Suite MEC Contact Person / Ph 510 75 PLM Contractor rA p5 -r Ph SWR BUILDING Tenant/Owner ELC Retaining Wall - ELR 0 o / L.-- Footing Access: Foundation (A)/9 'r FPS Ftg Drain i u t _ 13 /J - d-er-e5re Crawl Drain Inspection Notes: SGN Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling ce Roof Misc: Final PASS PART FAIL PLUMBING 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 CELECTRIGA ' Service • Rough In UG /Slab Low Voltage � F' - A - AS PART FAIL SI ._. Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date j Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. S ' (m BUP - Building Permit ELC - Electrical Permit ,{ . 4 Inspection Description Date Passed By 4 Inspection Description Date Passed By Footing /Setback Underground cover Foundation walls Wall cover Footing drain Ceiling cover Waterproof bsmt walls Electrical rough -in Slab _ Electrical service Crawl drain Electrical final Underfloor insulation Post/beam structural Shear walls /anchors ELR - Restricted Energy Permit Roof nailing I Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Z�z-17e,/ 1 j Masonry /Reinforcement ` Framing MFG - Structure set -up MEC - Mechanical Permit Insulation Drywall nailing 4 Inspection Description Date Passed By Post/beam mechanical Suspended ceiling Gas line Engineered soils Mechanical rough -in Welding Lab Final Fire damper Concrete Lab Final Duct work Bolting Lab Final Smoke detector Fireproofing Lab Final Mechanical final Structural observation Final inspection PLM - Plumbing Permit -4 Inspection Description Date Passed By BUP — Fire Protection System Permit Plumbing underslab 4 Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP /backflow preventer Fire alarm final Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer 4 Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing final Sprinkler supply lines Sprinkler underfloor /slab Catch basin /Manhole SWR - Sewer Permit Engineered soils 4 Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR MEC SIT PERMITS - CITY OF TIGARD ELECTRICAL PERMIT - 44,,, ENERGY RESTRICTED ENERGY �i�, : DEVELOPMENT SERVICES PERMIT #: ELR2001 - 00012 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/17/01 SITE ADDRESS: 12148 SW 131ST AVE PARCEL: 2S104A6 -06400 SUBDIVISION: MORNING HILL NO.4 ZONING: R -4.5 BLOCK: LOT: 093 JURISDICTION: TIG Project Description: Installation of limited energy for burglar alarm system. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: X BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: : HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: Owner: Contractor: WALPOLE PHILLIPS ELECTRONICS 12148 SW 131ST AVE (DBA FOR MASTER ALARM L.L.C.) TIGARD, OR 97224 1110 NW FLANDERS PORTLAND, OR 97209 Phone: Phone: 222 - 5083 Reg #: LIC 00125364 SUP 329JLE ELE 26- 213CLE FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 1/17/01 $75.00 2720010000 Elect'l Final 5PCT CTR 1/17/01 $6.00 2720010000 Total $81.00 1` This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes . k and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work iN 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 - 00010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct question to OUNC at (503)' 24 1987. Iss ed by %\ .4 I a Permittee Signature ,_" o �'_ee_ 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