Permit CITY OF TIGARD ELECTR ERG
RESTRICTED ENERGY
M1�I� DEVELOPMENT SERVICES PERMIT #: ELR2002 -00166
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/27/02
SITE ADDRESS: 08015 SW HUNZIKER ST PARCEL: 2S101 BD -00300
SUBDIVISION: ZONING: I -L
BLOCK: LOT: JURISDICTION: TIG
Project Description: Addition to protective signaling.
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:
PERFORMANCE CONTRACTING INC ADT SECURITY SERVICES, INC
8015 SW HUNZIKER ST 2815 SW 153RD DR
TIGARD, OR 97223 BEAVERTON, OR 97006
Phone: 503 - 684 -5533 Phone: 503 - 469 -7244
Reg #: LIC 59944
ELE 26- 209CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 8/27/02 $75.00 2720020000 Elect'I Final
5PCT CTR 8/27/02 $6.00 2720020000
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),
246 -1987.
Issued by - 4 L t• . Permittee Signature ,!:;r7■f /2/ C` --/7d
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
08/26 i)2 09:15 FAX 5034697110 ADT SECURITY el 001
Electrical PermitApplication
l Date received: tlzi0fa i Persnitno.; gzooz. I) 0
".`' and ! ��
4) ` "
„45:1 - City of Tigard p( p Pro Expire date:
City of�igard Address: 13125 SW Hall Blvd T ard; OR 97223 _ -
4 Date issued: Sy "Receipt no -:
Phone: (503) 639 -4171 • ., r -
Fax: (503) 598 1960 tti e Case file no - Payment type;
p
b
approval: ., a �Q. it 5� 1 Land use approval: ii
O 1 & 2 family dwelling o r accessory g ry lall Commercial/industrial 0 Multi-family ❑Tenant improvement
0 New construction 0 Addition/alteration/replacement 0 Other, 0 Partial
' , 1013 SITE INFORMATION •
Job address: SOIS Hi."rz. IC Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: Subdivision:
Project name: PE- . r ,, ; r a . 0 - seription and location of work on premises: '-
• on _ m V r .),;,•1.., t N , a Qrae
Estimated data of completion/inspection:
CONTRACTOR APPLICATION FEE SCHEDtLE �'
Job no: on. 001 gq -1-1q 1 O Fee Max
Business name: 410T Secoeit T � Description Qty. .(c) Tobrl . no. ins pp
Address: 28 Is s j 53 it , p 1 - New teddenplal -single or multi- fondly per �'
dwellhtgunit Inctadesattachedgarag
C ity : g ,eyer'trdlA State: OJ1; ZIP: +17066 Serviceinduded:
Phone , 49°7100 Pax Q =a7 E -mail: 1oao �, ft. orAess - _ _ 4
CCB no.: $419 4 I Elec. bus. lic. no: Z - 2Ot?CLE 'Each additional 500 sq. fl or portion thereof
{ L imited energy, residential �` 2
City /me • Iica rto.: Limited : , non - residential, 2
c • Z¢ C1 z Each manufactured home or modular dwelling
Signatu of supervising electrician (required) Date Service andlot feeder . 2
Sup. elecL name (prinq= KEN I�IQ 1iczrrseno: t q' �rvlcesorfeedcrs- insmllatlon,
PROPERTY - .t almrati000rreloatian:
n 200 amps or less 2
Name (print): - rQ CT- jAGK &1,112 €LTrEt leA �'! ail amps to 400 amps 2
Mailing address: M _ 401 amps to 600 amps • 2
601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps er volts 2
Phone: SO- ( L $ i j - $ S ' S 3I Fax: [ E -mail: Rt cottnectonly — 1
Owner installation: The installation is being made on property I own Tempo erilcca or feeders - _..
Install
which is not intended for sale, lease, rent, or exchange according to !° " ,a lteration, or relocation:
ORS 447, 455, 479, 670, 701_ 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: D ate: 401 to 600 amps 2
ENGINEER Brancliclrcolts- new,alteration, -
Name: or extetrsion per panel:
�� • A. Fee forbranch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: 'State: 'ZIP: B. Fee for branch circuits without purchase
Phone: Fax! E 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): 'r ■
O Scrvi a over 225 amps - commercial 0 Health -care facility _ Each pump or irrigation circle • 2
O Service over 320 amps - rating of 18z2 U 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,
Cl System over 600 volts nominal more residential units in one structure alter'ation,orextensiona I 7S IS 2
Q Building over three stories 0 Feeders, 400 amps or more . R,nom_
❑ Occupant load over 99 persons Q Manufactured structures or 1W park
/Fad additiooal inspection over the allowable N any of the above: -
0 lrgressrlightIng 0 Other
Per inspeclion
Submit sets or plans with any of the above. . investigation fee . I I 1 t, 1
The above are not applicable to temporary constr nctlon service. Other
Not all Jurisdictions accept ctodit cards, please call jurisdiction for mom information_ Notice: This permit application Permit fee . —
0 Visa O MasterCard expires if a permit is not obtained Plan review (at _ %) $
Crsdii card number: / / , within 180 days after it has been State surcharge (8%) $ a
I N or cardholder as shown on Omdit card -
m Expires accepted as complete. TOTAL $ • $ I
S
Cardholder signature Amount
7 57- C7- 440 -441 (6r00/COM)
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
1 BUP
Received Q Date R u sted / J Y AM PM BUP
Location (�O giL) Suite MEC
Contact Person � ! � i•-' Ph ( ) 5 PLM
Contractor Ph /� ( ) SWR
BUILDING Tenant/Owner ��/1 j (, r YL2 • � ELC
Footing et _ L f r 7
Foundation Access'. d Q t
Ftg Drain ELR / �C/
Crawl Drain
Slab Inspection Notes S // / = S
Post & Beam ( ���r •r �p D yv
Ext Sr Sheath/ors
ea Anch
th / Srs Shear I/ 7 al am p . 6 ¢�
Ext eah / T ' / I R O
Int Sheath/Shear I
Framing
Insulation
Drywall Nailing
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 -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Fire Alarm
ina Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE I I Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA �
Approach /Sidewalk Date -- �rl Inspector 11/ • Ext
�
Other: _
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
1