Permit ,
•
C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00437 •
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/27/2007
PARCEL: 2S112AD - 00900
SITE ADDRESS: 14800 SW SEQUOIA PKWY ZONING: I -P
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: HOME DEPOT
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Project Description: Burglar alarm low voltage.
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: BURGLAR AL X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
HD DEVELOPMENT OF MARYLAND, INC ADT SECURITY SERVICES, INC
POBOX 105842 2815 SW 153RD DR
ATLANTA, GA 30348 BEAVERTON, OR 97006
Phone: Contact #: PRI 503 469 - 7100
FAX 503 469 - 7114
FEES Reg #: ELE 26- 209CLE
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LIC 59944
Description Date Amount SUP 389LEA
[ELPRMT] ELR Permit 11/27/2007 $75.00
[TAX] 8% State Surcha 11/27/2007 $6.00 REQUIRED ITEMS AND REPORTS
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 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: 077 q(rh'c
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.
Nov 28 07 01:38p Stephanie P . • 503489 p.1
■ 1 cEl . „,..
Electrical Permit Application FOR OFFICE USE, ONLY
NOV il 2 6 EZ! a7 9 4 Per mit t: _ 2001 - 5 S l 31 ] i l h•d Tigrd, OR 97223 IJtlwrPrnnit;
Phone: 503,63 Fax: 503.5 !1.1 J� Y r It •'
Ins action Linc: 503.639.4175 Vr 1 1` +.• •. udy;lfy: )"roc / BI See t'e4c.2 [Cr
TIGARO p , 'ilMclhod. i l'u pplementalInformation
lnlc+avcK: wv w.ti) nrd�r.gov r• IL II I 'r r _
TYPE OF woiu •• � ..., ,. ' PLAN REVIEW •
• i ihease check all Ant apply ( .ubmit a set• of punts *Ikons checked t+elow):
0 New construct CI Addition /alteration /replacement 0 S.' vice or feeder 400 ornpri DIM= C auilding ova duce store+.
L] Demolition 0 Other, whwra the available fault currant Q Marima and bualyands.
• CATEGORY •OF CONS"1`ROCTJON: • • • •. . W:eecdt 1 0.000 mom at 150 volta or ❑ Floating buitdinya,
• lean to wound, or exv.ods 14.000 ❑ Common' al -tie agricultural
0 l- and 2- family dwelling ID Cc,mrncrcial /industrial ❑ Aveestory building amps fee nli ° u r BntnlInaom. buildings.
Q Hire pump. Q Imlallation of 73 KVA or
❑ Multi- i'nmily ❑ Mastcr builder (] Other Inner arstel derived
❑ L'merY}r,cy syslaln. P Y system.
JOB SITE .INRORp7AT1O' • AND LOCATION ❑ Addition of new motor toadof 0 "A'•,•')i ", "1- 2 ". "1 - 3'.
wow or room occupancy.
Job no.: 113 - Ph 74'41 site addic .s: /, Sea SE () d OAR ❑ Six or wore resideutcil unit;. ❑ Recreational vehicle NAB+
❑ l lcahh•care. facilities. (] heap %Y voltage for mart uc,ri
City /Statc/LiP: TiGARD 1712 9 702 o2.� ❑ 1Licii ftn1S tue.i1wnd. [x10 volts nominal.
Suite/bldg./apt. no.: Project name: Alm 0
r ❑ Service or feeder 000 snips or =m:.
FEE SCHEDULE •
Cross sire ct/dircctions to job situ: r,n FLY T'a°1 .12'
New residential single- or multi - family dwelling unit.
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Includes attached garage. '
Lot n.: 1,000 sq. ft, or kss ' 145.15 a 4
SubdlVisiun: T f _ t, La, add'l 500 Fp, rt. or portion 33.40 -
1 -
Tar, maprr:uccl no.; �L imilt d energy. re idrntial 75.00 2
DESCRIPTION OF WORK . • ' with above :. IL)
- L energy, multifamily 75.00 2
. h�idemial (with afx„t. do. t1.) I ,
.1"....., �J� Scrvici•S or feeders installation, a lteration, Pn&or relocation
200 maps or 103 _ 80.30 -' 2
• ❑ PROPERTY OWNER : . 0 , TENA - NT .. • 201 anrps to 400 amps - 106.85 2
4)1 ami)s to 600 anips 160.60 2
Name: 4 01 antps to 1,000 amps I 240,60 2 _
• Address: Over 1.000 amps or volts I 1 454.65 • 2
_ I Temporary se viaara or feeders installation, alteration, and /or
ityiStot e/'liP: relocatio .
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Phone: ( ) Pax: ( ) 200 amps or lees I 66.1(5 I i
r' 201 amps to 400 amps 100.30 2
p wner installition: This 4151/Illation is being made on property that I own which is not 401 to 594 a 133.75 2
I intended for sale, lease, runt, or exchange, according to ORS 447, 44 (170, and 71}1, `�° ° 'p"
Branch circuits - new, alteration, or extension, per panel
Owner signature; Date; _. A. Fcc for branch circuits wits
APPLICANT ANT! ® CONTACT PERSON: • above service or fecdcr fee, 6.65 2
each branch circuit
'
Business mune: 73. Foe for branch cintuits
withou[ service. or fetch t'ec• 46.85 2
Contact name : ' first branch circuit
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Each add'I brunch circuit I 6.65 i 2
Address:
Miscellunmus (service or feeder not in
City /State /'LIP; [ rnanutactund or modular 90.90 2
• dwelling, service und'or feeds
Phone: .03 ) .4 f_ -ya / _ Fax: ; ( ) Rcconnts t only - 66,85 2
E-mail; t
Ytunp or irrigation circle 53.40 2 V
• CONTRACTOR . • • . • ' • .: . • • : .. . • Sign ar outline lighting I 53.40 2 I
1 rS tgualcirctut(a)tolimiteti-
Business name' ADT SECURiTY mazy pitr,ol, alteration, or
C %LtRlsiun. Describe: I Page 2 75,00 2
Address: 2815 SW 153 DR
C t yiStatc /Z1P_ BE AVF.RTON OR 97006 Koch additional Inspection over aUuwable in aav o above
Yet inspection 6 .50
Phonc; (503) 449-7100 --- rc: (503) 464 -7114 inveKligat.ion per hour 11 hr min) 62.50
CCI3 Lic.: 59944 Electrical Lie.; 2(,- 209CL 1 Suprv. Lie,: LEA:189 Industrial plant per hour 73.75
___ --L__• LLE(TRICAL PERMIT FEES S . `1 uprv. Electr signature, required: , , ` � a.l- z -r.2%) Subtotal; 75,00
q Plan review (25 %of permit fee);
P iu
Print nne: KEN KRAUS I /late: // o-c6 0 7 Su (1(%ofptTn 1'cc): 6.00
�1c
Authorized signature: y ( 2 .» t�C,� TOTALPI'RMI'I'FEE: xi3O0
/ )'b{s permit appl ic exp)rce i[ u permit n nqt obtrin¢rf witMn mu
-
i print name: KEN KRAUS Date: /� / - �p 7 da after it law been accepted Ire complete.
iii/ • dumber of innpaxiin,er allowed Der permiL
l:•B Penal/ A ay> due .)51: ?t;x, .41L46:'T(I I/C,,JCONtAv ; t
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CITY OF TIGARD
BUILDING DIVISION ' PERMIT #: ELR2007 -00437
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/27/2007
Phone: (503) 639- 4171i�y��, �
Inspection Requests (24 Hrs.): (503) 639 -4175 !4
INSPECTION WORKSHEET FOR DATE: 5/14/2008 TIME: 7:04AM PAGE: 40
SITE ADDRESS: 14800 SW SEQUOIA PKWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HOME DEPOT
DESCRIPTION: Burglar alarm low voltage.
OWNER: HD DEVELOPMENT OF MARYLAND, INC, PHONE #:
CONTRACTOR: ADT SECURITY SERVICES, INC PHONE #: 503 -469-7100
Inspection Request Scheduled For: Date: 5/14/2008 Pour Time:
Code # Inspection Description Confirm-# Contact # Message
135 Low voltage 06984' 503 469-7212 N
Corrections/Comments/Instructions:
\',,,
/11\
1 �, PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G-# • 0 I L Date: 6'J 1 q10 Phone #: (503) 718- Z `V