Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
PERMIT #: ELR2006 -00147
i DEVELOPMENT SERVICES DATE ISSUED: 6/7/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S135BD -00200
SITE ADDRESS: 09785 SW SHADY LN ZONING: C -
SUBDIVISION: 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:
STAN NORED ADT SECURITY SERVICES, INC
16500 NW GARFIELD AVE 2815 SW 153RD DR
CORVALLIS, OR 97330 BEAVERTON, OR 97006
Phone: 503- 689 -1702 Contact #: PRI 503- 469 -7100
FAX 503- 469 -7110
FEES Reg #: ELE 26- 209CLE
LIC 59944
Description Date Amount
[ELPRMT] ELR Permit 6/7/2006 $75.00
[TAX] 8% State Surcha 6/7/2006 $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.
Issued By: CoJ ;cam Permiftee Signature:
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.
',..,
Electrical Permit Apvkigtt INIED , FOR OFFICE USE ONLY
City of Tigard
A Received ' _
Date/B : A 'W - mr■ .. lb Al( ; '
IZI2
13125 SW Hall Blvd., Tigard, OR 97223 11 N 'I 2006 Plan Review
Phone: 503.639.4171 Fax: 503.598.196W‘' 4 . I '''iii•illii Date/13 : Other Permit
O TIG .--- Date Ready/By: :
Inspection Line: 503.639.4175 AR II -R AP- '`a 1
CTY F El See Page 2 for
Internet: www.ci.tigard.or.us I IVISI • I. Notified/Method: I Supplemental Information
BUILD D , . ,;-,,,, „,.-- „ : ,, 47 Vii 4,- tt , 4ALIk 'F. :4VS1 1 12k -- - - v I' '-'?.",-; ' • .
-,- '4', y., ia.; -.; .rYPq , ',W9 11 ,- 1',•;• c.-ciii.;.,4q,:ikc i*,.'..2 '.,--,.,.....,q... . •',... ' , '
IE - construction 0 Addition/alteration/replacement Please check all that apply:
['Service over 225 amps, cornm'l ['Hazardous location
0 Demolition 0 Other:
OService over 320 amps - rating IDBuildng over 10,000 sq. ft.,
ci F'e ncoille - O o*Tuuciier
tTi;' of 1- and 2-family dwellings 4 or more new residential
.,,,, ., ., ,.,-.-•:.,..,, 7: ..e...;::."1 - ` . ''
El 1- and 2-family dwelling aerimmercial/industrial 0 Accessory building ['System over 600 volts nominal units in one structure
OBuilding over three stories oFeeders, 400 amps or more
0 Multi-family 0 Master builder 0 Other:
ElOccupant load over 99 persons ['Manufactured structures or
, JOB•SITE.INFORMATION, AND '.s.'A .1, : !,. - ” 0Egress/lighting plan RV park
gg '' ' . — 0Health-care facility ['Other:
Job no.: .20„2../ 3 -/ Job site address: q7g /e )4 4( c ,,,, ,r ,....,
Submit 2 sets of plans with any of the above.
City/State/ZIP: (-- a . 917.2-a2_3 The above are not applicable to temporary construction service.
i,. -7- , t'iltE t tetiltitit,C.,•:......':'
Suite/bldg./apt. no.: Project name:/e )4 r i 1 - ..-=., ''-:!=. , -.^..,.-a:: .., . - .,..,..L...... . ,.... --, .. -,.. ,
Description I Qty. I Fee. I Total 1 ••
Cross street/directions to job site: "/./2. 74,-*--~-- New residential single- or multi-family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
Tax map/parcel no.: •
Limited energy, non-residential 75.00 2
,•-•;,: '..e.c. c -,: • .1
I ., , I . ,....;,' . , .,,: : -DESCRIMON , OF Wow( ; ..:, :.-: ,.:,,::-_.: ,=.,:_:. ,.,:,;::,:: Each manufactured or modular
•
/4/6-176rU deer/1-'2;-, dwelling, service and/or feeder 90.90
2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
1 ..,. • . -,-,-,. • • - • . • , - • +,, . 201 amps to 400 amps 106.85 2
[I OWNER:" z ' • )• ; e " •"'e:- e' • - - - ; Ll'TENANT: ..".:•' ..,
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
in :4ikreAivt .' .:' -''' Iii . A PERSON - .' ' 'P :.,.-: A. Fee for branch circuits with
service or feeder fee, each
6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: 4219--_X without service or feeder fee,
46.85 2
each branch circuit
Address:
Each addl branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (503) 96,-.... 7. Fax: : ( ) Sign or outline lighting 53.40 2
E-mail: Signal circuit(s) or limited
e ,-_ e" " , .'.: : ::•;.:i i :: . : ,:"".-:',; cor4*- ;;:,,,,•'..-..,,: .7l ■,y energy panel, alteration, or
extension. Describe: I Page 2 16 Db 2 • Business name: ADT SECURITY SERVICES, INC.
Address: 2815 S.W. 153rd DR. Each additional inspection over allowable in any of the above
RFAVFRTON, OR 51700R Per inspection 62.50
City/State/ZIP: (503) 469-7100 Investigation per hour (I hr min) 62.50
Industrial plant per hour 73.75
Phone: ( ) Fax: ( ) •:, "'"",, ..- {. i V,LECTRICAt PERIATti",ePttsi7:
CCB Lic.: 59 el (41.4 Electrical Lic.: ..2oci eke uprv. Lic.: g9 back Subtotal
Suprv. Electrician signature, required: Plan review (25% of permit fee)
11/14. i .4 State surcharge (8% of permit fee)
-if.„, 4
to. OD
Print name: v 1.,
Date: ,67 .6.
TOTAL PERMIT FEE gi • Do
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri-County Building Industry Service Board
" Number of inspections per permit allowed.
i: \Building \Permits \ELC-FerrnitApp.doe 12/03 440-4615T(10/07JCOM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR200& -00147
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/7/2006
Phone: (503) 639 -4171 Ara m°
Inspection Requests (24 Hrs.): (503) 639 -4175 F 'I �
INSPECTION WORKSHEET FOR DATE: 9/20/2006 TIME: 7 :01AM PAGE: 59
SITE ADDRESS: 09785 SW SHADY LN CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: RAINBOW PARK
DESCRIPTION: Burglar Alarm.
OWNER: NORED, STAN PHONE #: 503-689-1707
CONTRACTOR: ADT SECURITY SERVICES, INC PHONE #: 503-469 -7100
Inspection Request Scheduled For: Date: 9/20/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
195 Misc. inspection 036831 -01 503-968 -7230 N
19 9 W44 -'
Corrections /Comments/ Instructions:
It PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: , v �v ` Date: Q 2 W Phone #: (503) 718 - 24