Permit CITY OF TIGARD ELECTRICAL PERMIT -
All% RESTRICTED ENERGY
� DEVELOPMENT SERVICES PERMIT #: ELR2000 -00313
'�I I- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/19/00
SITE ADDRESS: 07000 SW SANDBURG ST PARCEL: 2S101 DD -00100
SUBDIVISION: ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Burglar 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: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PAPE' PROPERTIES + ADT SECURITY SERVICES, INC
PAPE', TERRANCE/TOOKE, DIAN + 2815 SW 153RD DR
PAPE', SHIRLEY N BEAVERTON, OR 97006
EUGENE, OR 97440
Phone: Phone: 503469 -7100
Reg #: LIC 0059944
ELE 26- 209CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 12/19/00 $75.00 2720000000 Elect'l Final
5PCT CTR 12/19/00 $6.00 2720000000
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. GZ {
Issued by . Permittee Signature m
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
•
Electrical Permit Application
���� v.v Datereceived: P ermit no. a pat, X3/
tlasf , q
A.
;� ,,� City of Tigard !� t t � Pro ject/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, 01 9�7: a�" Date issued: By: I Receiptno.
Fax: (503) 598 60 p�� O�V�`��
Land use approval: CO ���1 Case file no.: Payment type:
M�'�
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ■ Commercial/industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction .' • ddition/alteration /replacement ❑ Other: • ❑ Partial
JOB SITE INFORMATION
Job address: 7 � 6 OJ ,, I IA / / , Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: Subdivision: a
Project name: in gningifferMel Description and location of work on premises: Imr /,/�flp . A
Estimated date of c + mpletion/inspection:
- -- • - ._ - _ _ -,.. --
._,,._.. _ -- -.� •GOA�FR-A, r11 '1'LIEA�hI(�N' '= ------ - -- - -_.- -- . .- - _ - �` - IEEE 'SCI'IEI)ULC_"`
Job no: 3 -- 0 3`71 0 -0-2.----- Fee Max
Business e S ECURITY SERVICES, INC. Description Qty. (ea.) Total no. imp
Address: 2815 S.W. 153rd DR. New residential - single or multi-family per
DEAVERTON, OR J700C dwellingtmit .Includesattachedgarage.. •
City: 15 0' 1 ) 469_71(X) I S tate: I ZIP: Serviceincluded:
Phone: 563- E1•(A -7/ OU I Fax:5b.3 bi - //bE - mail: 1000 sq. ft. or less 4
CCB no.: 5 I Elec. bus. lic. no: cl -2O �G lx i Each additional 500 sq. ft. or portion thereof
Limited energy, residential 2
• City /metro lie. n0.: / / Limited energy, non- residential 2
)/ f V6 Each manufactured home or modular dwelling •
Signatu of supervising el= ttician equired) Date % %%% Service and/or feeder 2
Sup. elect name (print): S License no 31 3 .' . Services or feeders- installation,
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): (, R r k e i ( , 1 4 Q 201 amps to 400 amps 2
401 amps to 600 amps • 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone:Sp3- 1 - '1 /d Fax: IE -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 illation , alteration, orrelocation:
20 amps or less 2
20
ORS 447, 455, 479, 670, 701. 201 1 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENG IN EER 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
of service or feeder fee, first branch circuit: 2
Phone: Fax: E - mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
❑ Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle 2
O Service over 320 amps -rating of 1&2 ❑ Hazardous location Each sign or outline lighting 2
family dwellings O Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, G 00
IS O System over 600 volts nominal more residential units in one structure alteration, or extension* I I✓ 2
❑ Building over three stories O Feeders, 400 amps or more *Description:
❑ Occupant load over 99 persons O Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan ❑ 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
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
Permit fee $ 15.00
0 Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ _•
Credit card number: I I within 180 days after it has been State surcharge (8 %) $ • • e
Expires p accepted as complete. TOTAL $ .
Name of cardholder as shown on credit card
$ •
Cardholder signature Amount 440-4615 (6✓00/COM)
Electrical Permit Fees: Limited Energy Fees: - .
• Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
/� Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total si, Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 _ 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 _ 1 ❑ Burglar Alarm •
Limited Energy $75.00 _
Each Manufd Home or Modular 1=1 Garage Door Opener
Dwelling Service or Feeder $90.90 2
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System*
Installation, alteration, or relocation
200 amps or less $80.30 2
201 amps to 400 amps $106.85 2 ❑ Vacuum Systems
401 amps to 600 amps $160.60 2 ❑
601 amps to 1000 amps $240.60 2 Other
Over 1000 amps or volts $454.65 _ 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation
200 amps or less $66.85 2 Fee for each system $75.00
201 amps to 400 amps $100.30 2 (SEE OAR 918 -260 -260)
401 amps to 600 amps $133.75 2
Over 600 amps to 1000 volts, Check Type of Work Involved:
see "b" above. ❑
Branch Circuits • Audio and Stereo Systems
New, alteration or extension per panel ❑
a) The fee for branch circuits Boiler Controls
with purchase of service or
feeder fee. ❑ Clock Systems
Each branch circuit $6.65 2
b) The fee for branch circuits pi Data Telecommunication Installation
without purchase of service
or feeder fee. ❑ Fire Alarm Installation
First branch circuit $46.85
Each additional branch circuit $6.65 ❑
HVAC
•
Miscellaneous
(Service or feeder not included) • ❑ Instrumentation
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension I $75.00
Minor Labels (10) $125.00 ❑ Landscape Irrigation Control
Each additional inspection over ❑ Medical
the allowable in any of the above
•
Per inspection $62.50
Per hour $62.50 ❑ Nurse Calls
In Plant $73.75 ❑
Outdoor Landscape Lighting
Fees:
❑ Protective Signaling
Enter total of above fees $
n Other
8% State Surcharge $
Number of Systems
25% Plan Review Fee
See "Plan Review" section on $
front of of application. ' No licenses are required Licenses are required for all other installations
.
Total Balance Due • $ ' ei
F ees:
El Trust Account # Enter total of above fees $ .
8% State Surcharge $
Total Balance Due $
•
•
i:\dsts \forms \elc- fees.doc 10/09/00
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Busines's Line: 639 -4171
OUP,
Date Requested ?� AM PM BLD
Location -7000 54 4" Sa = �y � [� Suit E C
�'"� MEC
Person 4►-1C .r Ph 5v3 —Jf 3 /G PLM
Contractor AD'r Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR t --3 / 3
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab V r74-- SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Drywall on
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm )
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out •
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam •
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
C1 FCT If="Qb-- Service
Rough In
UG /S - .
ow Volta. -
Fir larm
in
ASS 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 l.Z, - 277 - -alp Inspector Ext
Final .
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.