Permit t
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
T , I %. DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00015
DATE ISSUED: 1/11/2006
W 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 101 DC -04602
SITE ADDRESS: 07337 SW TECH CENTER DR ZONING: I -P
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: LV Fire Alarm. Job #083 - 18469 - 04.
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: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
MCCORMACK, WILLIAM L + DARLENE T ADT SECURITY SERVICES, INC
7190 SW SANDBURG ST 2815 SW 153RD DR
TIGARD, OR 97223 BEAVERTON, OR 97006
Phone: 503- 624 -2090 Contact #: PRE 503- 469 -7100
FAX 503- 469 -7110
FEES Reg #: L1C 59944
ELE 26- 209CLE
Description Date Amount
[ELPRMT] ELR Permit 1/11/2006 $75.00
[TAX] 8% State Surcha 1/11/2006 $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: Permittee Signature:, �1,
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.
01/11/2006 12:32 FAX 5034697110 ADT SECURITY el 002
/
4.11ectrical Permit Application __. - . - • ', FOR OFFICE USE ONLY - ..'" • •
_ .
City of Tigard Received ./
Date/El : , — /A 1 71 - 1) Pemnit Na.' L ;- i
...---
13125 SW Hall Blvd., Tigaid, OR 97223 Platt Review
Phone; 503,639.4171 Fax: 503 Date/B : Other Permit:
, 4, I AA/ Il
inspection Line: 503.639.4175 W. h'i i' Date Reidy/By MI El See Page 2 for
Internet: www.ci.tigerd.or.us Notified/Method: Supplemental lalurmatinn
lk ANAL I Y 1 21r 1 1: i: ;A l gt ; l i l IARgargagg i anntratt, 0 WPM TWASSM.V.01010%V - ..' , i::. ' • .
2 New construction D Addition/alteration/replacement Please check all that apply:
['Service over 225 amps, corrun'l Dliazardous location
Ej Demolition 0 Other:
,. ['Service over 320 amps - rating LIBuildng over 10,000 sq. A.,
I -1',, ', twitm 1, .
J' ' le gas., , , iw „1-
'i,, IP. !ilatomildwianfaai : agAna` 1 q ' .i. Nalniakidlgt.hui Eif: Pp ;I , t''' " I"' , ,1'4=ii. of 1- and 2-family dwellings 4 or more new residential
D 1- and 2-family dwelling 171 Commercial/industrial El Accessory building ['System over 600 volts nominal units m one structure
['Building over three stories ['Feeders, 400 amps or more
D Multi-family u Master builder El Other:
il ' O ' t: ' 'k -agn i rea t f . ' " Fi l t :.4 I MF '51 '' ' ' & 2; ,.tiq ANIERTRNI% ElOccupant load over 99 persons ['Manufactured structures or
• '.. i'v ' -',I•A Ae , J • ' i • ...la, ks • b , lb. • , .Cie :: , I •• - • ,foirL .;' l U ii.' k •',1!-.,. . ,.. Egress/lighting plan RV park
Job no.: 181_1(pq I, fob site address: Realth facility
- 131 ,SW I -Lek efilferX1 wi EIC)ther:
Submit 2 sets of plans with any of the above.
City/State/ZIP: 1)6 ain IV I be____ 9 --Na5 The above are not applicable to temporary construction service.
PRETIERi .i ''
Suite/bldg./apt. no.: Project name: ka 1 u
Dityer1prion Qty, Fee, Tot.1 ..
Cross street/directions to job site: cJ 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 1
Limited energy, residential 75.00 2
Tax map/parcel no.:
Limited energy, non-residential 75,00 2
P' lk ! a W V. : 746 1 5MARreLe 'r 'llffiriM 'ai Each manufactured or modular
• bi la dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
OM 1
200 amps or less 20.30 _
2
q ., , --/ R ows 14;cousw I v 'h„101,, v ., l i g ,. 201 amps to 400 amps 106,85 _ 2
cilri4. 40 , ',..it.i Lt.:. 1''''t. '''141 , , leJi • • I ■ • 1 ' i'l !IlAti a _ iljn
' - 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 feederslostanotton, alteration, and/or
relocation
Phone: ( ) Fax: ( )
200 amps or less 66.85
1
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
Mititgamoramir4toolNimprusgratutnarvalciovi A, Fee for branch CirCU11.5 With
, , , . ,,, 1. ■ i'.-1 -,e , , 4 , „ 4 ' L • • •••+ • ,,-, 1., - .4n i 1 't service or feeder fee, each
6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: „stexe,, 'Disiiinan „,,,„,it service or feeder fee,
46.85 2
each branch circuit
Address:
Each add branch Circuit 6.65 72
City/Stare/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
PhoD5) 0‘ 1 1C 0 Fax: : ( ) Sign or outline lighting 53.40 _ 2
E-mail: Signal circuli(s) or limited'
', 11Callaffigirlin ' 'Ittlangi fil I energYPaPel' alteration, or
extension, Describe: I Page 2 16,k, 2
Business name; ADT scurry SERVICES, INC.
Addres 23ITSTPFIVR Each additional inspection over allowable in any of the above
s:
aEsuanaht,...QEutzm Per inspection 62.50
City/State/ZIP: (503) 469-7100 Investigation per hour O. hr mim 62.50
—
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
q 'Isr:''":
CCI3 Lie.: 599L1.14_ Electrical Lic,:2 ,.. • eke uprv. Lie scl L. _,,, Subtotal
.
Suprv. Electrician signature, fr re, required: . /4111re Plan review (25% of permit fee)
• /.4. 4 - A A . A . .
State surcharge (2% of permit fee)
Print name: Vey -1 ____.a.ak&./ Date: 1 1 1 0(
TOTAL PERMIT FEE 81 , PC)
Authorized signature: Thh permit application expires if a permit is not obtained within 180
days after It has been accepted at complete
Print name: Date: - Pee methodology set by Tri•County Building Induttry Service Bonrd
I 1 " Number of inspections per permit allowed.
iABuildingTennitskELC-PennitApp.dac 12/03 6 . 1 r C.- , kiZI ild 04 6 I 5T(10/02/CONIAVEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: E:I.R200600016
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1!1
Phone: (503) 639 -4171 40m00f(
Inspection Requests (24 Hrs.): (503) 639 -4175 IL
INSPECTION WORKSHEET FOR DATE: 127 /2006 TIME: 7:01AM PAGE: 112
SITE ADDRESS: 17337 SW 'hi OH CENTER DR CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: R AYTE}; USA
DESCRIPTION: V Fire Alarm. Jr., #083
OWNER: MCCORMACK, WIL „JAM L + DARLENE T, PHONE #: /30 ?). 624,20 90
CONTRACTOR: AD•t SECURITY SEI +'ICES, INC PHONE #: 503.1169.7100
Inspection Request Scheduled For: Date: 2/270006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 'O2738': -t41 60 96.979(3
Corrections /Comments / Instructions:
NAYIN ( 1 ? . F6UL45
'..� 2.n04 dt0 40 O6 S"'
►/ PASS I PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6 Date: tJ 21 61, Phone #: (503) 718- ti'f "�V
111
1