Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
,, �I DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00037
.� DATE ISSUED: 1/26/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S135AB -03400
SITE ADDRESS: 10260 SW GREENBURG RD 170 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /LINCOLN TOWER LOT: 014 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:
EQUITY OFFICE PROPERTIES TRUST HSI SECURITY SYSTEMS, INC
ONE SW COLUMBIA ST #300 3424 NE 35TH AVE.
PORTLAND, OR 97258 PORTLAND, OR 97212
Phone: Contact #: FAX 503- 287 -1345
PRI 503- 287 -4604
FEES Reg #: ELE 1578LEA
LIC 42140
Description Date Amount
[ELPRMT] ELR Permit 1/26/2006 $75.00
[TAX] 8% State Surcha 1/26/2006 $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 questions to OUNC at 503 - 246 - 6699.
Issued By: ' c %� � Permittee Signature: � . e. Alp
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 -25 -2006 06:37 PM HSI SECURITY SYSTEM 5032871345 2/2
E - - -- --- FOR.O.FFICE : USE .OI LY — -- ' —_ _ __ _ � .
,�1t;ctrica1 Permit Application na
City of Tigard ,, . 1' Received /_ �, /j�/ 0 �/�
' Date/B Q _ I -- Permit No. t_J�• / ' !Nt? 06.3
Tigard, OR 97
13125 SW Hall Blvd., Ti �
g ,iy' � ' Plan Review
Phone: 503.639.4171 Fax: 503.598( i t.. ,, J JI Date/By: other Permit:
Inspection Line: 503.639.4175 t; - ' et1 „ Date Ready/By: Ions: EI See Page 2 for
Internet: www.ci.tigard.or.us 9 ' Notified/Method: f i Supplemental information
.,. t.
� -
'PLAN :Ri; W '�.r ?:'i- .
�Tl'PL :OT� {. '4 �
- - E New construction - - ® Addit gdte rt 1 ld — - - -- - Please check all that apply:
❑ ❑ Oth:A Demolition V,�.VI 1 ['Service over 225 amps, comm'l ❑Hazardous location
❑ Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
- ,'"_r,:;•` :"'':.Cr>`TEGO1iX OF;CQNSTRTJCTiON:. - ;� w - =: <•..''''s;• of 1 -and 2- family dwellings 4 or more new residential
❑ 1_
and 2- family dwelling ®Commercial /industrial ❑Accessory building CI System over 600 volts nominal units in one structure
['Building over three stories ❑Feeders, 400 amps or more ,
❑ Multi family ❑Master builder ❑Other:
❑ Occupant load over 99 persons ❑ Manufactured structures or
MA'rt NAND ::LOCkFION' :. .1 -n ; ';? ' i_, : : v
7..!'.: • .:�:.. .;T- :::._. SITE?AYROIt.r .. 0.. , " . ❑ Egress/lighttn plan RV park
Job no.: Job site address: 10260 S.W. Greenburg Road ❑Itealtlt - care facility ❑Other:
Submit 2 sets of plans with any of the above.
City /State /ZIP: 97223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: 170 Project name: First American Title = " ' ' `: - .` ` :`FEE :SCfICAUX G :'. '' 1` - ` ;
Description :. I Qty. I Fee. I + Totnt `
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, nott residential 75.00 2
- DESCRII'- TIOlY 4'.O 1. -, , ,,.`, -'.'",; Each manufactured or modular
Security System dwelling, service and /or feeder 90.90
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
,` i "i ; ;.a } ' ;.i ;:, -:;;.:1, 201 amps to 400 am 106.85 2
`PROFER`I'X:.OVI'NLH`; -'i;;.. , '' , TENA 1 VTi a -._ - r= 'o•=
. , .._. 401 amps to 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 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
( ) relocation
Phone: ( )
Fax 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps 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 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
- ;a - 'ONTACT.�P•LRSON " A. Fee for branch circuits with
' .... : ..� " , •,..... ..... -... ...., _ ... ... ........ . ... . - . - .r,:... .. .... - - service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: withortt service or feeder fee, 46.85 2
first branch circuit
Address: .
Each add'I branch circuit 6.65 2
City/State /ZIP: Miscellaneous (service or feeder not included)
' Pump or irrigation circle 53.40 l 2
Phone: ( ) Fax: : ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
:[.;, - :;ie; 4Z :!;;;::.' :lr `;,; i,5'..? energy panel, alteration, or
; y... .. ' .CONTR CT.OR.�: `... j.:_: _,.:.
`- � extension. Describe: Page
Business name: HSI Security Systems, Inc.
Address Portland, OR 97212 Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State /ZIP: _ investigation per hour (I hr nrin) 62.50
Phone: (503) 2874604 Fax: (503) 287 -1345 Industrial plant per hour 73.75 ,
. _, : :1 _P srELECTRIC4:' -1 RNIIT-;FEES'` . . ??,/.":
CCB Lie.: 42140 Electrical Lic.: 26 -755 Suptv,, 4 .: 1578 r A Subtotal 7
Suprv. Electrician signature, required: ,.7 & � , Plan review (25%ofpermit fee)
/A/ State surcharge (8% of permit fee) t o
Print name: e,,, _ Q �p h ". l/ Date: 1 -25- 6
TOTAL PERMIT FEE er. ov
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it lras been accepted as complete
Print name: / raj 0 2,0/1 /7 7' Date: 1 -25 -06 r Fee methodology set by Tri -County Building Industry Service Board
•' Number of inspections per permit allowed.
i \ Buihuing Tennits\ELC- PermitApp.doc 12103 440 -4615T(10l02 /COM/WEL
CITY OF TIGARD
BUILDING DIVISION
A PERMIT #: ELR2006 00037
• 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/3612006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 Aig■
INSPECTION WORKSHEET FOR E: 21612006 TIME: 7:02AM PAGE: 33
SITE ADDRESS: 10260 SW GREENB ,'!G RD 170 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/LI '.: TOWER LOT #: 014 TYPE OF USE:
PROJECT NAME: FIRST AMERICAN 11TL:.
DESCRIPTION: Security System.
OWNER: EQUITY OFFICE PROPER IES TRUST, PHONE #:
CONTRACTOR: HSI SECURITY SYSTEMS, ", C PHONE #: 503.287.4604
Inspection Request Scheduled For: Date: 2/6/2006 Pour Time:
Code # Inspection Description onfirm # Contact # Message
136 Low voltage 26320-01 603-936-1070
\CA CA
Corrections/Comments/Instructions:
N U\
J
PASS PARTIAL APPROVAL 7 CANCEL NO ACCESS
FAIL I CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
inspector: Y Date: 7-4 'Ot Phone #: (503) 718- 1.411t
_ . .