Permit r-
'
C ITY O F TIG A RD ELECTRICAL RESTRICTED ENERGY PERMIT
A I DEVELOPMENT SERVICES PERMIT #: ELR2005 - 00386
r's'' -11 !. 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/2/2005
PARCEL: 2S 110DC -02300
SITE ADDRESS: 11545 SW DURHAM RD B -6 ZONING: C -G
SUBDIVISION: WILLOWBROOK BUSINESS PARK LOT: JURISDICTION: TIG
Project Description: Security System.
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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:
DURHAM /99 ASSOCIATES LTD PTNSH HSI SECURITY SYSTEMS, INC
BY CRIIMI MAE SERVICES LP 3424 NE 35TH AVE.
ATTN: LOAN SERVICING PORTLAND, OR 97212
ROCKVILLE, MD 20852
Phone: Phone: 503- 287 -4604
Reg #: ELE 1578LEA
LIC 42140
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FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 11/2/2005 $75.00
[TAX] 8% State Surcha 11/2/2005 $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.
Y
Issued By: —_-7), / Permittee Signature: ed (v
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.
FROM HS I ���E ° U NOV, 1. 2085 3:39PM P 1
PHONE NO. : 503 2S7 1345
-- ----- ...... - -- - AiO\I - - -- 1.2005 .
City IGP∎RD Keetaved s
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y of Tigard � �IT � I p i�1 D ate / lay; �� � �� Pmmit No �"� /� � . � ��
13125 SW Hall Blvd.. Tigard. OK 1 V,; ` G DI Plan Review LJ C
Phone:: 503.639.4171 Fax; 56.15m-F060- / ' ",e, 14� 1) E /lsy; Other Permit;
Inspection Line: 503.639.4175 ► Date Ready /lay, Jurt: El See Page 2 for
Internet: www,ci,tigard.or.us Notified/Method: < Supplemental Information
.....:,: >::....... ,, :'I"S�PE<.Of.. �t .ORh .:::.:':.:.::',•::; >. PLiA,Ni:TtEVCEW ' .. .
New construction ton /alto] atio lacerent
❑ ❑ , 4ddii t/ Please check all that apply:
❑ Demolition Other: q� rr ,rte+ ❑Service over 225 amps, comm'1 El Hazardous location
,LI1 ( ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. 11
:,<; ;,;;:.>;,>< >:..:, <., >.!.. ... ;:.•.. < „ <..PA O)♦t;.X:-.Q11!;::.CQ ySTRtifC`F'FC)!Ftls:'' ........:. .::... Y dwellings re of 1 -and 2 -famii dwellin s 4 or mo new residential
ICI .
� .. . . . :. .. 2 .i <....: . .
......... •
1 - and 2 - fainil dwelling . dwelling �ommerclAl /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑Building over three stones C]Feeders, 400 amps or mor
01 multi-family ❑ Master buiide r ❑ Other: ['Occupant load over 99 persons ❑Manufactured structures c
„•.. ,r, •: ., :;::; a, : '.:...: RV park
: s: �°:>...,.:> .:..::.: ...::..;.J : .,9,1;)E ; :::1N1y 4.... [LO,J:.11VE C A S' 1 4rCN: '::;`.r:;:':::.:::.; >':: ❑E re ss /li 6ting plan P
� .:,,..,,.,.., ,;.. //`, g g P ❑ other
Job no.: Job site address: // 6 —1 /5" . j fl - 1 4p D kealth -care facility
Submit 2 sets of plaits with any of the above.
City /State /ZIP: - r e 04 ,7, 7 :7, - 7 7 7/22-4 .The above are not applicable to temporary construction Service.
Suite /bldg. /apt. no,: Project name G� V J y/�J}I / / ✓x ',. `FEE'f::::SCHEf ee.' ;'' ' ': ? ::':: `.:.;:.r < :: :.
I Ul t lY l �i �l �N41. Description I Qtr. P ct, l • Total •
Cross street/directions to job site: Y New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq, ft. or less 145.15
Subdivision: Lot no.; Ea. udd'l 500 sq. ft, or portion 33,40
Limited energy, residential 75,00
modular
Tax map /parcel no.: 75,00
_
; , Limited energy, non-residential
,.,.,,; :..,...;,.,: , ... .. . >::... ': (5... ..: ... .:> .. or
:, � .. ..:...
:.. > ... ... .;:: ::::; ;.:::::DESCRIi�TFtJN:! ) F�.. �' I ;. ,.. .,.: . . , ; .:. : . . . E manufactured
l_ ( Q�� dwelling, service and /or fender 90,90
6 f✓ J � �" i ' ' Services or feeders installation, alteration, antUor relocation
l 200 amps or less 80.30
.,a;.:;::•::, ,. ::.:.: ;i ..,..... 201 amps to 400 amps 106.85
401 amps to 600 amps 160,60
Name: (/ - —
�4 A 1 4 J 601 amps to 1,000 amps 240,60
Address: 1 .s ` r 41 Over 1,000 amps or volts 454.65
/ Reconnect only 66.85
�
City /State /ZIP: I 1,J Az/I Qg. , V-4 Temorary services or feeders installation, alteration, and /or
/ relocation
Phone: (' ) ?ax: ( ) 200 amps or less 66.85
Owner installation: This installation is being lr adc on property that I own which is not 201 amps to 400 amps 100,30
intended for sale, lease, rent, or exchange, accor iing to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
: ❑..AFY : Q >' 1�'�';�
_ Fee for branch circuits with service or feede r fee, each
Business name: branch circuit
B. Fee for branch circuits
Conta.et name: without service or feeder fee. 46.85
each branch circuit
Address:
Each add'1 branch circuit 6.65 r
City /State /ZIP: Miscellaneous (service or feeder not included) —
Phone: ( ) Ftlx:: ( ) Pump or irrigation circle 53.40 .
Sign or outline lighting 53.40
E -mail: Signal circuit(s) or limited- —
:..:..::
.: . . ....... ;.: ;.. >.... '.:•:.:: energy panel, alteration,
Page
- n
J
extension. Describe:
Business name: l _ f j i � i , " [SG 14///.777 f - // Ue .
,c Each additional inspection over allowable in any.of the above
Address: jjj vC
;r�y ( ,, ;77-.11 '1 " Per inspection 62.50
City /State /ZiP: ' - P I fi . 9 _/ 3.- investigation per hour ( 1 hi' min) 62.50
Phone; ( r) ) r 7 ( Fax: (oj r') �" Industrial plant per hour 73.75
Es) � G � �� / 1/ — E ; 1'E MLT :: *4 : ::: : :;.: ::' ; %::< >':
a _ 7
CCB Lie.: 1. ,/ Electrical Lic.: / L 3 gL ,3 Suprv, Lic. Subtotal
Suprv. Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of permit fee) 4+ ` a
Print name: Date:
T
` f TOTAL PERM FEE
Authorized signature: : . e This permit application expires If ii permit is n ot 0 within'
� - days after it has been accepted as complete
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Print name: r rye / I JOB D ate: //Q • Fee methodology set by i•ri- County Building industry Service Hoard
-' " Number of inspections Der Dern,it allowed.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELIR2006-00306
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/2/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 ;_s.11 II
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INSPECTION WORKSHEET FOR DATE: 1/5/2006 TIME: 7:00AM PAGE: 6
SITE ADDRESS: 11545 SW DURHAM RD B-6 . CLASS OF WORK:
SUBDIVISION: - WILLOWBROOK BUSINESS PARK LOT #: TYPE OF USE:
PROJECT NAME: DR. WILLCOX
DESCRIPTION: Security System.
OWNER: DURHAM/99 ASSOCIATES LTD PTNSH, PHONE #:
CONTRACTOR: HSI SECURITY SYSTEMS, INC PHONE #: 503-207-4604
Inspection Request Scheduled For: Date: 1/5/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135\ Low voltage 024432-01 503-936-1070
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COrrections/Comments/Instructions:
9 i
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•
./
• PASS I I PARTIAL APPROVAL El CANCEL NO ACCESS
FAIL CALL FOR INSPECTION EI ADDITIONAL FEES ASSESSED
Inspector: /7-.(..4.,,A...LAArr. Date: — - Phone #: (503) 718- 1 t i 4
CITY OF TIGARD -
1 1
BUILDING DIVISION PERMIT #: ELR2005-00386
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/212005
Phone: (503) 639-4171 :origoilt
Inspection Requests (24 Hrs.): (503) 639-4175 01...—"tik mamma
INSPECTION WORKSHEET FOR DATE: 11/4/2005 TIME: 7:08AM PAGE: 1
SITE ADDRESS: 11545 SW DURHAM RD B - 6 CLASS OF WORK:
SUBDIVISION: WILLOWBROOK BUSINESS PARK LOT #: TYPE OF USE:
PROJECT NAME: DR. WILLCOX
DESCRIPTION: Security System.
b ›
dWNER: DURHAM/99 ASSOCIATES LTD PTNSH, L PHONE #:
CONTRACTOR: HSI SECURITY SYSTEMS, INC PHONE #: 503
Inspection Request Scheduled For: Date: 11/4/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low Voltage jL_C 020415-01 603 'I'
Corrections /Comments/ Instructions:
l
ASS 0 PARTIAL APPROVAL n CANCEL 0 NO ACCESS
I I FAIL I I CALL FOR INSPECTION r7 ADDITIONAL FEES ASSESSED
Inspector: Date: //— (-/ — I9,c Phone #: (503) 718-