Permit CITY OF TIGARD ELECTRICAL ENERGY
-
- RESTRICTED ENERGY
� DEVELOPMENT SERVICES PERMIT #: ELR2002 -00003
13125 S W Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/8/02
SITE ADDRESS: 13560 SW PACIFIC HIGHWAY STARBUCKS PARCEL: 2S102CC -00500
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: CCTV add -ons. Job No. 083 - 14003 -02
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: CCTV. X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
STARBUCKS COFFEE COMPANY ADT SECURITY SERVICES, INC
2401 UTAHAVES 2815 SW 153RD DR
SEATTLE, WA 98134 BEAVERTON, OR 97006
Phone: 206- 318 -1575 Phone: 503 - 469 -7244
Reg #: LIC 59944
ELE 26- 209CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 1/8/02 $75.00 2720020000 Elect'l Final
5PCT CTR 1/8/02 $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 -0 1.< through OAR 95 - I -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
• 246- d 987.
b y / / � , � Signature L.4 /i / 9 . i �
Issu d by ,I P erm itt ee e i 442/
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
01/07/2002 14:37 FAX 5034697110 ADT SECURITY Z001/002
•
- Electrical Permit Application
RECEIVED Datereceived: / 7 Did Permit no.: Zig A –p .3
7 4' 7 City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigagd, QR67223,
Phone: (503) 639 -4171 ��qN / Z002 Date issued: By: Receiptno.:
Fax: (503) 598 -1960 an OF TICARD Case file no.: Payment type:
Land use approval: BUILDING DIVISION
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory lilf Commercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration /replacement 0 Other. ❑ Partial
JOB SITE INFORI1A'fION I
Job address: /3500 SGt) tae/ , c. I/wr Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: (Block: (Subdivision:
Project name: „Via - bucks !-.ogee (Description and location of work on premises: new Tl/ 4X /- avt
Estimated date of completion/inspection: •
CONTRACTOR APPLICATION FEE SCIIEDU,E '
Job no: / ;t - o/q - az Fee Max
Business name: Aar S «VrI Description Qty. (ea.) Total no.Insp
New residential -single ormulti -famlly per
Address:
2815 . u) 153rd 1 ') dwelWtguidt bteludesattaeltedgarage.
City: Reamer II (State: Opt I ZIP: 97406 SeMalacluded:
Phone$ .1161.'7/ 01 Fax .4 .7)6E -mail: 1000 sq. ft. or less - 4
Fach additional 500 sq, ft. or portion thereof
CCB no.: 1744 I Elec. bus. lic. no: Z6•2 9CLE Eachad tgy, residential 2
City /me lic. no.: Limited energy, non- residential 2
,% 4 i - 7-02 Each manufactured home or modular dwelling
Signa re of supervi in electrician (required) Date Service and/or feeder 2
Sup. elect. name (print): License no: Services or feeders– installation,
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): 201 amps to 400 amps 2
Mailing address: 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: I State: I ZIP: 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 amps or less 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: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Mtsc . (Service or feeder not Included):
O Service over 225 amps- commercial 0 Health-care facility Each pump or irrigation circle 2
O Service over 320 amps - rating of 1 &2 0 Hazardous location Each sign or outline lighting 2 -
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, I ��
Cl System over 600 volts nominal more residential units in one structure alteration,orextension• 2
O Building over three stories- 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons O Manufactured structures or RV park Fach additional Inspection over the allowable In any of the above:
0 Egress/lightingplan O Other. Per inspection I I i I
Submit _ sets of plans with any of the above. - Investigation fee c
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more infocmatlao. Notice: This permit application Permit fee $ 4 7S .w
0 Visa 0 MasterCard expires if a permit is not obtained Plan review (at — %) $
Credit card number: I / within 180 days after it has been State surcharge (8%) $ •
Expires accepted as complete. TOTAL $ W . t0
Name of cardholder as shown on credit card
$
Cardholder signature Amount
440-4615 (6r00K:OM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested /0//e0 / AM PM BUP
Location / 3 SG 0 Pa644(1.e. Suite MEC
Contact Person (^TL Ph ( ) PLM
Contractor - - • _ '(d .■ l � i Ph ) SWR
BUILDING Tenant/Owner / ELC
Footing
Foundation ELC
Access: �j - 0 d O 0
Ftg Drain ELR O�
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling r - _ • • AWL 9J 1 L/ i wit /J■ i
Roof
Other:
Final
PASS PART FAIL
PLUMBING _ -PA
Post & Beam l
Under Slab ;k1 ar •
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 {��
w volt 5 7'% /-
Fi larm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
E 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA D �T� /6 0 Inspector LGo r1 11 Ext
Other:
Approach/Sidewalk ) P l ' Y
V
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL