Permit " A CITY OF T IGARD ELECTRICAL PERMIT-
RESTRICTED ENERGY
1 rt, DEVELOPMENT SERVICES PERMIT #: ELR2001 -00067
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: ,3/19/01
SITE ADDRESS: 15230 SW SEQUOIA PKWY 120 PARCEL: 2S112DA -00300
SUBDIVISION: ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG.
Protect Description: Burglar System .
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:
PACIFIC REALTY ASSOCIATES PROTECTION ONE ALARM MONITORIN
15350 SW SEQUOIA PKWY #300 -WMI 15500 SW 72ND AVE
PORTLAND, OR 97224 PORTLAND, OR 97224
Phone: Phone: 624 -0244
Reg #: ELE 34- 428CCLE
LIC 116325
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 3/19/01 $75.00 2720010000 Wall Cover
5PCT CTR 3/19/01 $6.00 2720010000 Elect I Final EXPIRED
Total $81.00 "C /5 ( /
0 3
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. • 2 TIONHOregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rule 14 ., , - -e forth OAR
952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or /q = lions • • 1 at (503) h
246 -1987. _ /
to
Issued by l Permittee Signatu • _
• OWNER INSTALLATION ONLY {b
The installation is being made on property I own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: DATE:
0
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE: b
LICENSE NO:
t 41.
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
•
t CITY OF T IGARD ELECTRICALPERMIT -
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR2001 -00067
I- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/19/01
SITE ADDRESS: 15230 SW SEQUOIA PKWY 120 PARCEL: 2S112DA -00300
SUBDIVISION: ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Burglar System
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:
PACIFIC REALTY ASSOCIATES PROTECTION ONE ALARM MONITORIN
15350 SW SEQUOIA PKWY #300 -WMI 15500 SW 72ND AVE
PORTLAND, OR 97224 PORTLAND, OR 97224
Phone: Phone: 624 -0244
Reg #: ELE 34- 428CCLE
LIC 116325
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 3/19/01 $75.00 2720010000 Wall Cover
Elect'I Final
5PCT CTR 3/19/01 $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. t TIO_ Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rule, , e forth OAR
952- 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or /q : lions • • . IC at (503)
246 -1987.
Issued by f_ Permittee Signatu - Z
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
,l
L
r- Electrical Permit Application
A Date received: 3' e7 D( Permit no.: a 00 / — 06QlP7
d.rep a � �, • •
_), j, i 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:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory .0•ommercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other: 0 Partial
JOB SITE INFORMATION
Job address: /5JO $ w , -4,�, A9, ;l Z
Bldg. no.: Suite no.) Tax map /tax lot/account no.:
Lot: I Block: s ubdivision:
Project name: 7 Q Description and location of work on premises: _14.2,zi_Al, / a
Estimated date of s mpletion/inspection: , __ , ! 00
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: .6p,2S9 _ Fee Business name Description Qty. (ea.) Total no. insp
y, � R New residential - single or multi- family per
Address: S o _) /Ja�P 04.0._e_ �7- e9 C) dwelling twit. Includes attached garage.
City: , I Sta l e 1 lP:9 7, 2 s./ Serviceincluded:
Phone: 63-q-074-4.4 I Fax:,j 9 - '2 /OQ I E -mail: 1000 sq. ft. or less 4
CCB no.: / /63,�zi' I Elec. bus. lic. no: 3 V -i.1 c r'z Each additional 500 sq. ft. or portion thereof
Limited energy, residential 2
City /metro lic. 0.: Limited energy, non- residential 2
, j.40 — --. /9 e / Each manufactured home or modular dwelling
gnat of supervising 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): 7 j iv, 201 amps to 400 amps 2
•
/ �p qc�e� 401 amps to 600 amps 2
Mailing a ss: ,5 2 o c" I l „ / ` t 0 / 601 amps to 1000 amps 2
City: /2 I State *' I P: ' 7' a 7 Over 1000 amps or volts 2
Phone: �� 0 cb7 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, or relocation:
200 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
ENGINEER 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):
0 Service over 225 amps- commercial 0 Health -care facility Each pump or irrigation circle 2
O Service over 320 amps- rating of I &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,
0 System over600 volts nominal more residential units in one structure alteration, or extension* 2
O Building over three stories 0 Feeders. 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable In any of the above:
O Egress/lightingplan 0 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 f �Q
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ ��'
0 Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ /. G `a
Expires accepted as complete. TOTAL $ g” 4 e"
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440-4615 (6/00/COM)
r
Electrical Permit Fees: Limited Energy Fees: -
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4. 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 Manuf'd Home or Modular n 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 ❑ Vacuum Systems
201 amps to 400 amps $106.85 2
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 Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918-260 -260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts, ❑
see "b" above. Audio and Stereo Systems
Branch Circuits ❑ Boiler Controls
New, alteration or extension per panel
a) The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder fee.
Each branch circuit $6.65 2 n Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service n Fire Alarm Installation
or feeder fee.
First branch circuit $46.85 ❑ HVAC
Each additional branch circuit $6.65
Miscellaneous ❑ Instrumentation
(Service or feeder not included) •
Each pump or irrigation circle $53.40 0 Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 ❑ Landscape Irrigation Control'
Minor Labels (10) $125.00
❑ Medical
Each additional inspection over
the allowable in any of the above ❑ Nurse Calls
Per inspection $62.50
Per hour $62.50 ❑
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 $ No licenses are required. Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $
Enter total of above fees $
❑ Trust Account # 8% State Surcharge $
Total Balance Due $
i:\dsts \forms \elc- fees.doc 10/09/00
BUP - Building Permit ELC - Electrical Permit
4 Inspection Description Date Passed By 4 Inspection Description Date Passed By
_ Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough - 4n
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing - 4 Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry/Reinforcement
Framing
' MFG - Structure set -up MEC - Mechanical Permit
Insulation
Drywall nailing Inspection Description Date Passed By
Suspended ceiling Post/beam mechanical
Gas line
Engineered soils Mechanical rough -in
Welding_ Lab Final Fire damper
_ Concrete Lab Final Duct work
Bolting Lab Final Smoke detector
Fireproofing Lab Final Mechanical final
Structural observation
•
Final inspection —
PLM - Plumbing Permit
• 4 Inspection Description Date. Passed By _
BUP - Fire Protection System Permit — Plumbing underslab
Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in Plumbing top -out
Sprinkler final RP/backflow preventer
Fire alarm final Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer •
4 Inspection Description Date Passed By — Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin/Manhole SWR - Sewer Permit
Engineered soils 4 Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
•
INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC, SIT PERMITS