Permit ti..
CITY OF T I G A R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
AzA41 DEVELOPMENT I
O BM SERVICES 2 CES I 00172
(503) 639 -4171 DATE ISSUED: 06/20 200
- 13125
SW
SITE ADDRESS: 11999 SW PACIFIC HY PARCEL: 1S135DD -05106
W
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: Low Voltage wiring for Burglar Alarm. Job #083 - 10917 -82
•
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:
INSTRUMENTATION: OTHER: BURG ALARM X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WEIREX CO INC + ADT SECURITY SERVICES, INC
CCC PROPERTY MANAGEMENT LLC 2815 SW 153RD DR
14001 WILLAMINA CREEK RD BEAVERTON, OR 97006
WILLAMINA, OR 97369
Phone: Phone: 503 -469 -7244
Reg #: LAC 59944
ELE 26- 209CLE
FEES Required Inspections
Type By Date Amount Receipt Elect'l Final
PRMT CTR 06/20/2001 $75.00 2720010000
5PCT CTR 06/20/2001 $6.00 2720010000
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 �77/yL 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: a DATE:
LICENSE NO: <72.(
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
06/20/2001 07:57 FAX 5034897110 ADT SECURITY 0001
•
Electrical Permit t don
� Datereceived :&� / j Permitno,���D/ _ 607 ,;; ;���� City of Tigard Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: .
T1'I'E OF PEIt'4ll'
0 1 & 2 family dwelling or accessory 11•6mmercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other: 0 Partial
JOB SITE INFORMATION
lob address: /Mg/ ,S'(J 2 4 e ,G gyv If Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: II Block: Subdivision: /
Project name: E o f Api‘klak I Description and location of work on premises: Etthdlnk t aJ- rn •
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCI IEDULE '
Job no: # ' - / Z . Fee Max
Business name: ' DT S �C I V I L .G`.i -. Description Qty. (ea.) Total no. 'asp
Address: Z815 S.W. 153R Dr. New resWeatial- single or multi-family per
dwellingmdt Includes attached garage.
City: Be verton CbRt700 . Serriceincludea:
Phone:/.01y(4- 72./.1 Fax L,9 7-J /V I E - nail: 1000 sq. ft. or less 4
CCB no.: fr-cA y(� Elec. bus. lic. no: ,7(Q _ 9 e L Limited additional 500 sq. ft. or portion thereof
` Limit energy, residential 2
City /metro lic. no.: Limited energy, non - residential 2
6 - /? - 01 Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2
Sup. elect. name (print): U License no ' Serrlcesorfeede re — lttststllatlaa,
alteration or relocation:
200 amps or less 2
Name (print): 201 amps to 400 amps 2
• 401 amps to 600 amps 2
Mailing address: ' 601 amps to 1000 amps - 2
City: I State: IMP: Over 1000 amps or volts 2
Phone: I Fax: ' I 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, lease, rent, or exchange according to Installation, alteration, orrelocation:
ORS 447, 455, 479, 670, 701. 200 orlesv 2 •
•
2001 1 amps to 400 amps 2
Owner's signature: Date: 401 to 600 s 2
Branch' circuits - new, alteration,
or extension per panel: •
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
- Phone: Fax: E -mail: of service or feeder fee, first branch circuit: 2 . • Each additional branch circuit:
PLAN REVIEW (Please clteclt all that apply) Misc. (Service or feeder not included):
O Service over 225 amps - commercial O Health-care facility Each pump or irrigation circle • 2
C) Service over 320 amps-rating of 1&2 0 Hazardous location Bach sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension* 1 " 2
0 Building over three stories O Feeders, 400 amps or mom *Description:
O Occupant load over 99 persons Cl Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egresstighting plan O Other Per inspection • I I I I
Submit _ sets of plans with any of the above. . Investigation fee
The above are not applicable to temporary construction service. Other •
Not all ierisr ie9oos accept credit cards, please call Jurisdiction for more information. Notice: This permit application Permit fee $
O Visa Cl MasterCard expires if a permit-is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8%) .... $
ea accepted as complete. TOTAL $
Name of cardholder as shown on credit card
$
Cardholder signature Amount 4464615 (6100/COM)
•
4.2.7
<CITY OF TIGARD BUILDING INSPECTION DIVISION ' MsT
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 1-1,6 AM PM BLD
Location I / f'9 1 Sw n e < r' ` I Suite MEC
Contact Person Ph 4 .16 f 7Z y y PLM
Contractor A- iD 7 Ph SWR
BUILDING Tenant/Owner fie. / r e f_ Y p- ELC
Retaining Wall ELR &e/a/ 7L
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam ,Q
Ext Sheath /Shear U V Y 3 Az r /[/
4 rm —
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler �._� % �/
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
rS /] n �_ /�
Water Service �? j'J ( r yrL
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers /
Final
PASS PART FAIL
roil
Rough In
Ci e
- Fire Alarm
PA SS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date Inspector g Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.