Permit CITY O TI GARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
�,L r . � y � DEVELOPMENT SERVICES PERMIT #: ELR2003 -00322
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/16/03
SITE ADDRESS: 15230 SW SEQUOIA PKWY 190 PARCEL: 2S112DA -00300
SUBDIVISION: ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Installation of 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:
INSTRUMENTATION: OTHER: BURG ALRM X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES A & E SAFE & ALARM CO
15350 SW SEQUOIA PKWY #300 -WMI PO BOX 179
PORTLAND, OR 97224 MCMINNVILLE, OR 97128
Phone: Phone: 503 472 - 6439
Reg #: ELE 36 -34CLE
LIC 65198
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 10/16/03 $75.00 Elea! Final
[TAX] 8% State Tax 10/16/03 $6.00
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 throuc
Issued by Permittee Signature �,/ %4/ e �TronJ
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 Q/✓ DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Sent By: AE SAFE AND ALARM; , 5034723570; _ • •Oct -14 -03 1 Page 1/1 .
Electrical PermitApplicatian : (71--•F-J t: l t;s1. :. ()Ni .N.
•
-' Date received: ' ty /9 p_3 Perm no, 0200 .032
• c, ►,L' � 1' ; i City of Tigard no.:
_ : J � E ® ,Projcct/itppl. rio. Expire date:
C'Ery o f :near," h , Address: 13125 SW Hatt Blvd, T Z i '
Date issued:
Phone: (503) 6394171 .
Fax; (503) 598.1960 OCT "14 2003 Case file no.: ARM] Payment type:
Land use approval: • CITY OP TIGAAD • . .
T's '£' t:)F P111111
U.1 & 2 family dwelling or :accessory Li Commercialiindustrial 0 Multi - family O Tenant improvement
0 New construction ..
. CI Addition /alteration /replacement 0 Other: O Partial • •
.1t)li St INl t)R:11A I'ION:
•
Job address: a • • : , ,_ , p _Bldg. no.: ' ■ Suite no.: il Tes,vt map/tax lot /account no.; • • •
Lot: 'Block: Su.divisio / r .
Project. name: 1 ,, ( Description and location of work on premises: e dia ,
Estimated date ofcompletio inspection: — ad• 11 , �
'• ( t.) \1 14,kt. :l'Oli A,l'l't.lC TION 1.1.:1. sin EU)I. i is
Job no: I i• at.i ' � A' - S A-FE 4 4 ' RM co Fig Max •
•
Business name: j - • _ I y "/ "' r t> ptimn Qt'. , (�) load nu.iaap
yr ring Omuta-family pp
'� Z Newresidethtfal- -single r
Address:
/ 7 ! 1 , d., elUnguniLlrieladea attached garage.
City. Al: . 1 .1...te.... Sale: J ell ZIP: Senketnduded: . • . •
Pll. n n 17, 2 - - Fai V 7 9 - - mail :, avg , • - x , R. or leas 4
C:CB no.: . Elec. bus. lit:. no; .• fa
' :, kgti<mai S00 3 ; 1 . fir portion thereof `
Limited energy. residential 2
City /Intro lic. no.: /D i p 1 /
Limited erkryl9, non-residential . • 2
, .
/ ' /Q ../....3 TJ 1 ash ntanufacturod henna or modular•dwrlling
• ignature of supervising a ectriciaa (re 1 Fred) -- • Date Service and/or Seeder 2
Sup. elect sunne (print); L, a •r't , t ' - License no: /, . 4/1f Set orfeedera— tmilallednn, •
alteration or relocation;
f'ttOl'1':I2"I t ?11'NEi` 200 a mps or t ea s . 2 • Name (print): e/41 4.0 _ 201 ;imps to 400 WITS . 2 .
Mailing address: 1,6 3L(J f , . 401 amps to 600 amps 2
_ i! sot tuil w _t t>tw gun 2
City
� 41 I State: LIP: 9' 7,..2,•9 9 Over 1000 amps or volts:. 2
Phone: lF&ix: I E-mail: Reconnect only — 1
Owner installation: The installation is being made on property 1 own Temporary services orf eders
which is nol intended for sale, lease, rent, or exchange according to iasmllatlon,aiteratlon . arreiocadmt:
ORS 447, ° 455 479.670 701. 201) amps or less �W S _ 2
201 amps to 400 amps , � 2
Owner's signature: Date: 401 to 600 ants .. 2
IN( i I NI: FR Branch circuits - nen, alteration,
Name: or extension per punt:: ..
•
r , „� �� A. fee for branch circuits with purchase of
Address; service or feeder, fee. each brunch circuit - . 2 •
City: I State: I ZIP: B. Fee for branch circuits without purchase
Phone: F .x: l lnait: of service or feeder fle, first brunch circuit " 2
IiaCh odditirmsi brands srcuit
MAN Rf:VlF - (Please. check all that apple) Misr .(Serriceorfeedrf not Included):
• O Service- over 225 • amps•connuesttiid U Healt -air facility ( Each pump or irrigation ;.irate . „ „ 2
C] Service over 321) an:p».raling of F &2 '. C.I Han:tniotu location Erich sign or outline lighting 2
family dweliintpi 1.3 Building over 10.000 square feet four or Signal circuitis) or a limited energy panel, 7 -
' O System over 600 volts nominal : more residential units in one strutsnre abet:ntion, or extension °. / I 75' - r7 2
Q Building over three stories : LI Feeders, 400 amps or pore *Description;
[] Oesuri:fnt load over 99 persons : t:] Mauufatarirtxt structures or RV park Each oddltlanalinspection over the allowable ha any of the nbore:'
D ECuessilh htinu Plan U C)ther. , Per intlructicrr j ( l i
Submit _ sells of plans with any of the above. lmestiguuitin fee
..__.
e above are not app�tblle to temporary construction service. Other _...- .....
Th
Permit fee $ •_, 5 .-N - J
•
a nt. ; it jurixdir:liotnr accept credit enrds, plcnrc cull iriri;utit:non f more llil,'1rn mica- Notic This pemitt application r
-craw. sa u ha _ expires if a permit is not "obtained PL•t re vi e w (at _ °/n) $ f/ ' G '- t 1 „
wad n u:,. '' e_ ° :,a, •�' -' ° j• _ T �' within 180 day, after it bas been S tate surcharge (8 %) $ �., �y
/ taprres TOTAL $ fJ
.. ... - .accepted au complete.
Name ou r as shown on credit card ,j
$ (/"� .
Cardholder signritare unuru ,i)
■ •
440.4s (MSWOM)
CITY OF TIGARD 24-Hour
BUILDING Inspection Liner(50#639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
//
/5,2,5o SW y)o,kf wy /70 BUP
Received Date Requested M / AM PM BUP
Location('') 1 S 3 S • . c, - L-2 Suite < 30a MEC
Contact Person Ph ( ) `' 7 a — "3 ? PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR 3 -- C3 a �--
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 L
Susp'd Ceiling
Roof
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
ire Alar �►
'� PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SI ' Li Please call for r- inspectio RE: 0 Unable to inspect — no access
Fire Supply Line
ADA / •
Approach/Sidewalk Date l C> a d 3 Inspect . / Ext
Other:
Final DO NOT REMOVE this Inspection recor from the • site.
PASS PART FAIL