Permit r
4 CITY OF 1 l G R D ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00202
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/14/2008
PARCEL: 2S 102AC - 01101
SITE ADDRESS: 12562 SW MAIN ST 250 ZONING: CBD
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: RMG FINANCIAL
Project Description: Installing (1) protective signal 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:
TWO G'S REAL ESTATE LLC ADT SECURITY SERVICES, INC
18395 WOOD THRUSH ST 2815 SW 153RD DR
LAKE OSWEGO, OR 97035 BEAVERTON, OR 97006
Phone: Contact #: PRI 503- 469 -7212
FAX 503- 469 -7114
FEES Reg #: ELE 26- 209CLE
LIC 59944
Description Date Amount SUP LEA389
[ELPRMT] ELR Permit 7/14/2008 $75.00
[TAX] 12% State Surch 7/14/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 or 1.800.332.2344.
� r
Issued By: / !— 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.
Jul 14 03 07:09a Stephanie Pate 503469 p.1
_Electrical Permit
FOR OFF10E USE ONLY
City of 1xrd
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' e► Maw 503.639.4171 Fan 503 1. Ober Permit:
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TIGARD OR lead
JOB S 14�+ORMATIOdV wivlD LOCw7I�Y O O s»ooa
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job n o-: 83- ..f? .SLU Cl Q e • ' wary. z '1.3
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Suite/bldg./apt. net.: Projxc name: #m 1 _ y9iy c / q ° Savioa or toodrr600
saps or noses.
• Cross ssrea/directions to job sit= FEE SCHEDULE
a.k.a. rQn. I so. I T.rd I •
New residential ingto- or l u111. li day dwelling snit:
Includes attached garage.
SubdiivitiOn: Lot no.: 1.000 sq. ft. et k o 145.15 4
T m c m a p / p a r c e l no.: P m m 1 6 1 5 0 0 s q . or portion 33.40
• DESCRIPTION OF WORK • Limited h A residential
T5.00 2
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residential ( therm aq, $) 75.00 2
/ Services ow feeders iDmllatlon, alteration, and/or relocation
• )P760 OW1R+,It 20O imps or lees 8030 2
Q 'ffiWIV7l' : .
201 cps w400 amps 106.85 2
Mate: Vii _ _. /[ r Cf 40l Stmpu; "ft turipa 160.60 2
601 amps to 1,000 a
Acidly= /� 3 � S L ` , s � � �/ atom 740.60 z
Aid B � 4 �e Oyer 1AOOampaor.vl/3 454.65 �
ado a .�J t�I" 9 "70 ?5' services or feeders Im�ltndo n. alteration, t+nd/or
Phont ( ) Q I Fax: ( ) `+- 200 amps or leas
Owne i b�ioa This . 66. ]
ttrtrltltartian is being made as propdrty that t awe i.4 not 201 a a e to400 snips 10030 2
intended for sale. leas; rant. or tatchange. according to ORS 447. 449, 670. and 701. 401 maps to 599 amps 133.15 2
Owner : tiraatii titertts, rim otter, ar _ old : Q APl� 1CANp Oetc: A Fee for broach circuits rah _
e> treat
: �_' CONTACT ON above =vice or feeler foe
Bntina ss name:
each bomb circuit 666
� B. Foe for binned circuits
COQ ntp0 // ) f G d' n�3�,�e9 -✓vT� first b without ravine or feeder fee, , r '� / that bomb circuit 46.85
` Each len branch circuit 6.65 MEM
Ctb/SmulLIP: or modular
rot waded}
Each mm�rCGscOd ' or roodelei
Phm ez
(97/ )0735 - D d/S Floc : ( ) dvodti� service and/or feeder 9a90 s
E-mail: Reconnect oats 66.85
t'�P a (*Mk 53,40 53.40 2
oaix1 AcI o�ie Sim or oo�,ioe rr tg 53.40 2
Bad trainer ADT sncu1�ITY
Signal a h(s) or limited -
Addle= 2813 SW 133 DR _ crhergy panel, Almaden, Of
otIcasion. Describe 1 POW 2 75.00 2
City/State/ZIP: BRAVERTON OR 97006 Farb addltinoal ... • , . aver aaowsate in of the above
Per gnaws (503)469.,7212 I Fax (303)469 -7114 62 .50
MocetigationIcr bow(' arrwin) 6230
CCS i.ie.: 99944 I Electrical Lic.: 262097,E ( Supra. Lie.: LEA389 gy& plant ptr has
Suprv, Electrician - 73 7s
n f g1�CJl7uC.eO PERMIT FEES �
Subtotal: 75.00
Phut oar= KEN 1KRAUS Date: 7 e ,f.- Platt review OS%of permit tbc)c
Authorized si J
TO
�m TOTAL P permit fee): 9.00
�. _ TAL. PFIth!)T FEE: 84.00
Print name: IC I IOiAUS TIM permit ppilot a o apnea K a ORnn to sot obtained within mo
tom ' °' 4oaaw HSrtLO6 J '' wo�6ts7(1t1m�i?KIWFD
• Nozolorof Awed pd' ��
CITY OF TIGARD
BUILDING EtVISION PERMIT #: ELR2008 -00202
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/14/2008
Phone: (503) 639 - 4171 �*
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/11/2008 TIME: 7:00AM PAGE: 3
SITE ADDRESS: 12562 SW MAIN ST 250 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: I2MG FINANCIAL
DESCRIPTION: Installing (1) protective signal system.
OWNER: TWO G'S REAL ESTATE LLC, PHONE #:
CONTRACTOR: ADT SECURITY SERVICES, INC PHONE #: 503-469-7212
Inspection Request Scheduled For: Date: 9/11/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 075379-01 503-469-7212 N
Corrections/Comments/Instructions:
No QccPs,c
[Q c c t-e
G-1 be 2-1 `i of
,x) PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ?" / Phone #: (503) 718-