Permit C ITY OF TIGARD ELECTRICAL -
ENER
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR2002 - 00047
,'; 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/26/02
SITE ADDRESS: 08015 SW HUNZIKER ST PARCEL: 2S101 BD - 00300
SUBDIVISION: ZONING: I -
BLOCK: LOT: JURISDICTION: TIG
Proiect Description: Fire Alarm install.
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: X OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
LOSLI, E HOWARD TRUSTEE AND ADT SECURITY SERVICES, INC
SEABROOKE, CAROL ET AL 2815 SW 153RD DR
BY PERFORMANCE CONTRACTING, IN BEAVERTON, OR 97006
CHARLOTTE, NC 28217
Phone: Phone: 503 - 469 - 7244
Reg #: LIC 59944
ELE 26- 209CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 3/26/02 $75.00 2720020000 Elect'l Final
5PCT CTR 3/26/02 $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 �y,, %(�,vc� Permittee Signature Cam, 8640
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
03/25/2002 12:03 FAX 5034697110 ADT SECURITY x001/001
.. Electrical Permit 1 '' p {i
A.
Date received: �✓ a-( p* 2 Permit nc t�G,ea� oz -o o"°a 7
4 .)Ir City ®f and
g P roject/app],no.: Expiredatei
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR `97223
Phone: (503) 639 -417I Date issued: By:“ Receiptno.:
Fax: (503) 598 -1960 BUILDING DIVISION Caec file no.: Payment -
Land use approval:
❑ I & 2 family dwelling or accessory Till Commercial/industrial CI Multi - family 0 Tenant improvement
0 New construction 0 Addition/alteration/replacement ❑ Other: ❑ Partial
•' , - JOB SITE INFORMATION . •
Job address: g I D H ui. z ( ie r 54 . Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: I Block: Subdivision:
Project name: Per a r vh ata.ce , A c - A ; Description and location of work on prem ises: ! r t a Y'yt,x
Estimated date of completion/ins. ection:
CONTRACTOR APPLICATION FEE SCHEDULE Job no: on- DO l ey- Q7 Fee Mist
Business name: 40T $eco rs 4t, Description Qty. Ct�.) Total no. hi p
Address: -- NOW rteIdental-single ormrthi- fsrmilyper
r. dwelling auk Ineludesatlached
City: 11r. ...h2y State: ()XI ZIP: 97,304 Senlcelndudee:
PhoneS�g=y`1 * P s =" 7 E-mail: 1 °a° 9' ft' °r le - 4
CCB no.: s? e 4,� I Elec. b us. ( Each additional 500sq. ft. or portion thereof
City /metro lie. 110.: Lrrmted energy,residcntial 2 • Limited energy, non- residential . ---1 2
02_ Each manufactured home or modular dwelling
sign' re o s`, 'wising electrician (required) ► Service and/or feeder 2
Sup. elect. name (print): License no: �� orfeeders- instalidtion,
alteration or relocation:
200 amps or less 2
Name (print): la ( r ,_ A / Q z_Q 201 amps to 400 amps 2
Mailing address: 401 amps to 600 amps ' 2
601 amps to 1000 amps 2
City: State: ZIP: Over 1000 amps or volts 2
Phone:503 • &V- SS 331 Fax: J 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, Iease, rent, or exchange according to lnstaUation, alteration, orrelocation:
ORS 447, 455, 479, 670, 701_ 200 amps or Iris 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am.s 2 .
ENGINEER - Branch circuits - new, alteration,
Name: or extension per panel:
A. Fee for branch circuits with purchase of
Address: _ service or feeder fee, each branch circuit 2
City: I State: LZIP: 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 (Plea check all that apply) Misc. (Service or feeder not Included): .
O Service over 225 amps-commercial 0 1-tealth -care facility Each pump or irrigation circle 2
Cl Service over 320 amps-rating of l 0 Hazardous location Each sign oroutlineligMing • 2 -
Family dwellings Cl Building over 10,000 square feat foul or Signal circuit(s) or a limited energy panel.
•
O system over 600 volts nominal more residential units in one structure alteration, or extension* I _ 7S 75 2
O Building over three stories 0 Feeders, 400 amps or more •Description -
O Occupant load over 99 persons 0 Manufactured structures or 1W park Each additional Inspection over the allowable In any of the above: •
0 Egress/lightingplan 0 Other
Per inspection I I I.
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Na all Judedictinns accept ciedlr cards, plea call Jurisdiction for mom information, Notice: This permit application Permit fee - CO
O Visa 0 MasterCard expires if a permit is not obtained Plan review (at %) $
Credit card number. 1 / Within 180 days after it has been State surcharge (8%) ,— $ . -_
Expires accepted as complete. TOTAL $ d
Name of ce=dholder ac shown on credit card
_ $
Cardholder tagnature Amount
k.
440 -4615 (611X1/COM)
' CITY OF TIGAR 24 -Hour _
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 1 1- a z9 - 0 AM PM BUP
Location '5 i5- Sq � 1 S Suite MEC
Contact Person V41 Ph ( ) PLM
Contractor Qq Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR 9. ` C) lip 2 7 1 g
Crawl Drain
Slab Inspection Notes: W.-4V " � ik SIT
Post & Beam 1
Shear Anchors
-
Ext Sheath/Shear
Int Sheath /Shear
Framing , N
Insulation
Drywall Nailing '
Firewall l-- 1 VP16
Fire Sprinkler
Fire Alarm
(I )
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
�E
Service
Rough -In
UG /Slab
.ow'o I
Fire ° - rm
SS PART FAIL
E Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SIT Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line ?' _ ,�
ADA
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job He.
PASS PART FAIL
CITY OF TIGARD 24 -Hour •
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
C�' BUP
Received Date R u sted / — 7 AM PM BUP
Q
Location (�0 LS" 22) Suite MEC
Contact Person _ i�-� Ph ( ) 1 T6 �'I ' , 52 _ PLM
Contractor Ph / (+ ) SWR
BUILDING Tenant/Owner �� 1 j C f't t ELC
Footing c L(.7
Foundation Access: // f /
Ftg Drain ELR . Q / Co �P
Crawl Drain
Slab Inspection Notes l P(0 •60S. SIT
Post & Beam
Shear Anchors i / 7 yy � Q
Ext Sheath /Shear ' , I �l
Int Sheath /Shear l
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
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
7.;411:::, PART FAIL
SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date' --- 5 - 0/4 , 6)3 Inspector G a Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL