Permit I
C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
I DEVELOPMENT SERVICES PERMIT #: ELR2005 - 00110
ei 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/16/2005
PARCEL: 2S 113AC - 00103
SITE ADDRESS: 07216 SW DURHAM RD 200P ZONING: I -P
SUBDIVISION: PACTRUST LOT: JURISDICTION: TIG
Project Description: Burglar Alarm
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 ADT SECURITY SERVICES, INC
15350 SW SEQUOIA PKWY #300 -WMI 2815 SW 153RD DR
PORTLAND, OR 97224 BEAVERTON, OR 97006
Phone: Phone: 503- 469 -7244
Reg #: LIC 59944
ELE 26- 209CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 5/12/2005 $75.00
[TAX] 8% State Surcha 5/12/2005 $6.00
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 questions to OUNC at 503 - 246 -6699.
Issued By: ,
%Or . _ 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 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.
04/25/2005 16:04 FAX 5034697110 ADT SECURITY 0 001
r " Permit ADDl EIVE® FOR OFFICE USE. ONLY
-City of Tigard APR 2 2 20n'1 Received Per�tNo_: /
13125 SW Hall Blvd., Tigard, OR 97223 Dana : tti } �L f� /
Phone: 503.639.4171 1 ?eot:503.598.1960 y r , D
Plan Ravin
Other Permit:
Inspection Line: 503.639.4175 CITY OF TIGA „on', li' `' i ate
' �!_ n pax aught/By: '+ See Page 2 for
Internet: www.ci. ti>yard "ora�s BUILDING DIVI'" xot;Qed/Methol:
Supplemental 1®fo rma don
, .'t is 11 I I l.1. 1 r,f::11 nl I '1'4,7i1 i � J. ' d " ' r f' �Fi fit � +'f I I YI 1 ' i3'kf, '� '3�FY "F nL!�l �" d
t i R , (� i tilt 2(e11f I) . P •� ` Q` t. .,. •,. .1.e• � • "
.... ... ..:.....1......... . .. _. .. ' rl I ,d 1 I , � "r, � 4 , � we w 7 ,� � � s� 11 � � c , �.' e 2 ' '_
1 New construction ❑ Addition/alteration/replacement Please check all that apply:
• Demolition I ❑ Other: ❑Screi c over 225 amps, comm'l CIHazardous location
� ,.: � - '; . •; ; ,,; . '7 ... :: :.r • .:: ..': •,:..:;,;..:,.:; _ ; " i�::; :.. � ,:;:: ° �i,� „ -: • .,, . . ., , . , - . 320 amps - rating ❑ Buildng over 10,000 _ ft.,
:. I :, ., , , .,':,•'• - ••,w �c y Ili } I � ,
; crnceovc 2
. R 4 , I 11 i 3 ' 0 , s 1 f I I t ,1. ,.a l P , . I. 1 I v ,1 : of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2-family dwelling lol Comn'terciaUindustrial ❑ Accessory building ❑System over 600 volts nominal units in one stoical=
❑ Multi -family ❑ aster builder Cl Other: ❑Building over three stories [Weeders, 400 amps or more
['Occupant load over 99 persons ❑Manufactured structures or
Iir,i d P1 .1 f, )911.111 I r 1 1,1,4 . ... . ,;V:::'''' 1. 3 1 3 1 I ❑Egtem/ligiting RV, park
Job no_: )Rq ' >jib site address :lad1p S(,,� T l 11F ❑Health - ears facility ❑Other:
. Submit 2 sets of plans with any of the above.
City /State/Zfl "II a or 9- The above are not applicable to temporary construction service.
Sul apt ` - ,r' ;!',, X1`' ;; 1, -; "• j'.1 l0 ill :.Iu,`' i,i i. .- 1'w.i2,'. ,..
a P no-: 7" 11 2D Project name: W.� �Pn .y/ y � f� I �� - _.�,, 1,_. 1
�_. • ` �. t 4I� �1 1 ��l Dneription Qty. Fee. root "
Cross street/directions to job site: - New residential single- or multi- family dwelling unit.
• Includes attached garage.
1,000 sq. ft. or less I 145:15 4
Subdivisioq_ Lot no.: Fa add'1500 sq_ 1.L or portion 33.40 1
Tax map /parcel nO- - Limited energy, residential _ 75.00 2 -
r s1. e is t , •, 1 , Limited energy, non - residential 75.00 2
:...:.. : ...:. ;? .......,...__, , Eachmannfa or
. ... modWar
Lzd�J !XI UU t Jr3�, ._ dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
l, I , 7 .1.'4, I r'. , o i; i , 1 , ,. 1 1 . 201 amps to 400 amps 106.85 2
_... - . - .: : . . 401 ara,p8 W 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60. 2
Address: _ Over 1,000 amps or volts 454.65 2
- Reconnect only 66.85 V 2
City/State/ZIP: Temporary services or feeders Installation, alteration, and/or
Phone: ( ) F ax: ( ) relocation
200 amps or less 66.85 1
Owner installations: 'Ibis installation is being made on property that I own which is not 201 anzpa to 400 amps 100-30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.15 2
• Owner signature: Date: Branch _
.., ,.. ;i::,� :3 > > ':'fl•.. _ ;1 . ; , t .. .
tour new, alteration, or extension, per panel
.:: ,,:_ : : . .J.7.p.i1 , r..�� .. 1 , , :; ., .: ; : I ; ; 1:., : ,'i�` • 'i; r1.` 'i" � `;, A. Fee forbrancbaircuimx+irh
c . . d ; "_'
..:.:,... __.. . :_. ._. ,: • - .. t. <_ ,. _. ' P,: strrvicaor f ee d er fee each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: � �- • Si without service or feeder fee,
_ each branch circuit 46.65 2
Addles _ _ Each add'I branch circuit 6.65 I' 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: Q 5 61-7- g ) Fax:: ( ) Pump or irrigation circle I 53.40 2
E - mail: o Sign or outline lighting 53.40 _ ., 2
Signal circuit(s) tN ,rr,rte
a f, 1.�, .;�ii :iif 1. :1.5
� 1. ..I � +. ,.tf t �i• d�� �, l'h'. 1.'c %;> 1.' d; crier P anel ' �: p
!xenie:. ^'1'�'ro• L . , ,�, �, . }... . L; C1.. F :.:Y.:1,. .1.I! "1'i$'i(1.d• on, or
t: :.. _ .? n ''� J. ; ,1, I gip ,
extension. Describe: Page 2 2
Business name: ADT SECURITY SERVLCES, INC.
Address: 2g f 4 Each additional Inspection over allowable in any of the abovo
iRFAl Per inspection 62.50
City/State/ZIP: (503) 4697100 Investigation per how- (1 hr nun) 62.50
Phone: ( ) Fax: ( )7- /� 7 �! Industrial plant per hour 73,75
C / U r : -a -,- c { � +1 1. : i I ,P ✓' „ lNl ' ,` •'r i
CCB Lic.: .ni ;�;:':iz` : r:'iIC9Sij:'i5J ,I,S4jl' UliCri lel�5'7Jt .n L at4 !I I. �i, 1 .,. �. 1.4 „ ,6
... F ..,16
5101(.11 Electrical prv. Lic. g •
trl 1 T.IC. u Subtotal
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Phut name: i�h / t 1 C Date: 4-075_ 55 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature:
Thi1 permit application expires if a mit is cot obtained within 180
Print name: da a It b ra b een accepted per as complete
Date: 1-- 1-a5--v� * P ee methodology net by 'hi -County Building Industry Service Board
' e Number of inspections per pet - not allowed.
i: ' dos 12/03 440.11615r(10/02/COM/WRB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005 00110
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: r, /16/2005
nr 4 �mpf� m
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 •'..I
INSPECTION WORKSHEET FOR DATE: 6/3/2005 TIME: 7:09AM PAGE: 66
SITE ADDRESS: 07216 SW DURHAM RD 200 / CLASS OF WORK:
SUBDIVISION: PACTRUST LOT #: TYPE OF USE:
PROJECT NAME: WELL PARTNER
DESCRIPTION: ar Alarm — .)
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: ADT SECURITY SERVICES, INC PHONE #: 503 - 469 -7244
Inspection Request Scheduled For: Date: 6/3/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 008291 -02 503-517-8808 N
Corrections /Comments /Instructions:
// & 9 V fob a//, / �Dv
•
n PASS . PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL f l CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: of
/ Date: 1 Phone #: (503) 718-