Permit •
jilh CITY OF T I G A R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
�& DEVELOPMENT SERVICES PERMIT #: ELR2002 -00151
''" r ' l I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/9/02
SITE ADDRESS: 06640 SW REDWOOD LN 2ND FL PARCEL: 2S112DA -01300
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 001 JURISDICTION: TIG
Project Description: Low voltage: Addition to Security Alarm.
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: SEC. ALARM X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES ACTION TECHNOLOGY SYSTEMS
15350 SW SEQUOIA PKWY #300 -WMI 835 SE 17TH AVE
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: Phone: 231 -1992
Reg #: LIC 79136
ELE 26- 775CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 8/9/02 $75.00 2720020000 Elect'l Final
5PCT CTR 8/9/02 $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. ��pp�" ,,//
Issued by ^� L cc�'C f J Permittee Signature (;'7'i a 1 ` 7 �"
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: e)'1 C i DATE:
LICENSE NO: c p-6.9 —'17 5 C L
•
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
AUG -05 -2002 13:20 ACTION TECHNOLOGY SYSTEMS 503 231 1402 P.01
Electrical Permuit Application
Dale receivcd &-c v
• - � d � Permit -
it ao.: a - J�D/S/
. : 1 City `.� ib"" P rojec d app l . no.: Expire date:
1i.., � Ca of T
CityofTigard Address: 13125 SW Hall Blvd, Tigard. OR 97223 - Date issued: Phone: (503) 639 -4171 � B y `
Fax: (503) 598 -1960 g '4 Case file no.: Payment type:
•
Land use approval:
TYPE 01 I'LRiiIIT
❑ 1 & 2 family dwelling or accessory IR Commercial/industrial ❑ Multi - family 11 Tenant improvement
O New construction O Addition/alteration/replacement CI Other: 0 Partial
JOft SI l L INFORM VIM:NI
Job address: 6640 SW Redwood Dr. Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: Block: 'Subdivision:
Project name:Portland Clinic I Description and location of work on premises: Additions to ecurl y arm
Estimated date of completion/inspection:
CONTRA(1Ott :1PPLJ(: 'ION FEE SCI1F1)11.L
Job no: '
Fee Max
Business name: Action Technolo S stems Description QtY•: Total _Imp
Address: 835 SE 17th Ave.
NEW r �' 4i " or
City: Portland I State: OR I ZIP: 97214 s
Phone503- 231 -19921 Fax: 231-14021E-mail: 1000sq. R or less 4
L b— I / )ULE • F� addi l 500 tiona sq. ft. or portion thereof
am no.: 7 � Elec. bus, lie. no: _
City /metro lic. no.:29U9 L BY. rcsidartial 2
_ Limited energy, nonresidential 2
8-05-02 Each manufactured home or odular dwelling
Signature o supervising elecutcianfre�quired) Date Service and/or fader 2
Sup. elect. name (print): Steve Kirkland u no: 5 /tJJLk, Servieerorfeelters Installation,,
alteration orndocattom
PROP F:ItIT OWNFIt 200 amps or leas 2
Name (print): 201 amps to 400 amps 2
Mailing address: 401 amps l0 600 amps 2
601 amps to 1000 amps 2
City: State: 7 : Over 1000 amps or volts 2 -
Phone: Fax: E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary tertian or feeders - . -
which is not intended for sale, lease, rent. or exchange according to IoemttdioaalatvtMoa,orreirrodioo:
ORS 447, 455, 479.670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's • • y.: • - -- — Date: 401 to 600 amps 2
I:N G I N F F: R Branch detamts -new, alteration,
• areztension per papa
Name: k Foe for branch circuits with purchase of
Address: service or feeder fee. each branch circuit 2
City: ( State; J ZIP: B. Fee for lnan:harcmta without pu :base
Phone: Fax: 13 of savior or feeder fee, fast branch circuit 2
Each additional breach circuit
P 12F1'1F:%' check :111111;11 Apply) Misc. (Service orfeeder not includedk
D Service over 22S amps- wmmaciat • [] Health- eanefaritity Each pumperinigation cask 2
o Service over 320 amps-rating of 18.2 0 Hazardous location Emit sign or outline lighting 2
familydwellmgs U Bn,iMibg over 10 000 square feet fear or Signal arwil(s) or a limited energy panel. 1
O System over 600 volts nominal more residential units in one structure alteration, or extensions 2
D Buildtug over three stories a Feeders. 400 maps or more s
O Occupant load over 99 persons CI Manufactured sanctums or 1W park Deseription
Each over the allowable In any Olive shore:
Cl Egress/lighting plan Q Other: _ Per inspection I I I I
Submit i sets of plans with any of dze above. Investigation fee
The above are not applicable to temporary emart ucdon service. Other
Not a0 jwlelenom accept credit cards, please call jatiadrrim for mote Notice: This P� application it Permit fee $ ti • • f 15�i U O Visa O MaseerCard expires if a permit is not obtained Pl r eview (a ,_ %) $ 0 (,- UU
credit card ®b¢ 14 10/ /05 _G within 180 days after it has been State surcharge (8%) $
•
N crud accepted as complete. TOTAL........... _._..._. -. $ 6 .5 • / /
■ maw= amount , . S is (&COCOM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested � - 7 AM PM BUP
Location qn (1 Suite MEC
Contact Person Ph ( ) 0 -31-19q_ PLM
Contractor P ( ) SWR
BUILDING Tenant/Owner o -?]G/ ELI — 06 / .s /
Footing EL — 0 l S oZ
Foundation Access: �
Ftg Drain /Lad rfs ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear _
Ina Sheath /Shear � o
e
Framing te
Insulation
Drywall Nailing _ .7 - - / Vf a ()S re 71
Firewall (
Fire Sprinkler 4 � � � � 1i C
Fire Alarm /A ) 711, SAC o
Susp'd Ceiling / / ?'
Roof , ad
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
Low Voltage
Fire Alarm
��� ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
• ���-- PART FAIL
SITE Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
•
ADA
Approach/Sidewalk Date c / p� O Inspector .rte_ _ Ext
Other: /
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL