Permit •
rr .
CITY T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
I DEVELOPMENT SERVICES PERMIT #: E 8 /2006 - 00210
�I DATE ISSUED: 9/8/2006
- 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171
PARCEL: 25101 DC -04601
SITE ADDRESS: 07409 SW TECH CENTER DR 150 ZONING: I -P
SUBDIVISION: TECH CENTER BUSINESS PARK LOT: 002 JURISDICTION: TIG
Project Description: Security 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: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WATUMULL PROPERTIES CORP H S I SECURITY SYSTEMS INC
621 SW MORRISON SUITE 800 3424 NE 35TH AVE
PORTLAND, OR 97205 PORTLAND, OR 97212
Phone: 503- 223 -3171 Contact #: PRI 503- 287 -4604
FAA 505 . P.S7 - l 3 75
FEES Reg #: ELE 26 -755C
LIC 42140
Description Date Amount SUP 3778S
[ELPRMT] ELR Permit 9/8/2006 $75.00
[TAX] 8% State Surcha 9/8/2006 $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: i th eiz iteit 2/ Permittee Signature: )— Q� dJ C fjy�
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.
Sep -06 -2006 11:32 PM HSI SECURITY SYSTEM 5032871345 1/3
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• electrical Permit A t tioh' .' , F . , .
t •—� pA i FOR OFFICE USE .ONLY { :• °. -
City of Tigard Received
: / e t/W 1 � I ' 0C4 — G _ •
13125 SW Hall Blvd., Tigard, OR 97223 SL t. :1 2006 Plan Rovi'
Phone: 503.639.4171 Fax: 503.598.1960 4 r > s , r i' ' , D� : Other Permit:
Inspection Line: 503.639.4175 • ■ �i ' Date Ready/By: VI Sec Page 2 for
Internet: www.ci.tigard.or,us tall 1 J-. .. a-1 .-"r •— Notified/Method: � Supplemental information
MATT :.�. l fl :':'i.•':C' :�41r7. Ta:') , �iF� '•= ✓ � .5.� �r J.i.4., -,,' _ .u j' • "— .,yu:.. • ki U • , ,•! . •
MA TTt q .P li >= J.k t - 'g 1 �t 14 .. - EE ' ' t3h ' T vo i21C r:.i'm:az,' is f 'd, 7, t ' � , . fr, -7 „ ,A. > . T �,. / .f., i . S� • r .., ., •
.,, . .. _. r� �Yg.fr t ,rfr.. � .'} ,dr'I.PYjiAiY:R`GV[.-•iV ue,.., x
..+u - .. •+' 1 � '•= ' '4 , ;_i. �.: r, �. , .,. . -.. _ .. ���.:.: J;>�- St .a , . ,.�x.�z f�`.:Y.�L. •.:. . . . .. . . ._ - . {1 �: ,' _: .. �
.. . ...,. _.. . r... •,. _ ,. .1•,9.3 ,; ,�. :.•...:i � 'i:. , y .
❑ New construction El Addition/alteration/replacement Please check all that apply:
ID Demolition
® Other. Tenant Improvment ['Service over 225 amps, come! ❑Hazardous location
_ . i; „p,,, , „�_ .., /u;•� . x . ,,_ , . { `. ❑ Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft ,
. ,V' :.-F:? '; 71 . ;. . 1 -r` T GOIL1s?:0,17 CONY RV • p7 F S "a ,� ,, , .
..�•.a.•� .a . .,, -,. � : .� � . .:: _ t�il i� �k ._j.,.,, . :,<,.,c��: � of 1 -and 2- family dwellings 4 or more new residential
❑ 1 - and 2- family dwelling ® Commercial/industrial El Accessory building ❑ System over 600 volts nominal units in one structure
El Multi - family I: Master builder ❑ Other OBuilding over three stories 0 Feeders, 400 amps or more
f':a• •! q rr2 ' t i , ����,,,: ,,: F 1 K ,ti , �. ❑ Occupant load over 99 persons
• El Manufactured structures or
: c:J ]3;S1'rC��iV1CO�t11�1e>. � Ol '- 1 `+ -- r , : !•.y: , : RV park
..._ - _ �:: ,.c :.. k... _ �<:,.:�•, ,;'x .... , s .. ), DE plan P
Job no.: Job site address: 7409 SW Ave., suite 150 ['Health facility ❑Other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: Tigard, OR 97223 T6- e h '- C1.. D 2 , The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: Project name: am "Y 1 � „` � ;- ” , ^ e '
S Medical .,:fwi�{ ; ���t.. W' L:< i��',F�F:':��cEI�D�iT�>..t<,. �,r;,;�,.3�x �>;::i:°
De criptloo I Qty. I Fee. I Total i
Cross street/directions to job Site: 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
Tax map /parcel no.:
Limited energy, residential 75.00 2
;_rr.0 ` ^'.r ;• ° - '�... �?'iti i '�{C `; t '.Y % ", "'7�•a a) '• ., <. .. Limited energy, non- residential 75.00 2
',' t x•. ,', ;�1': � %.` `'- )i . t...:_, .:_. , . �,,F.bY, b1A(S� _,n + .";: . - 3, 7, ' v r:,s' , i)' i't' Ea ch manufactured or modular
Security System
dwelling, service and/or feeder 90.90 2
. Services or feeders installation, alteration, and /or relocation
200 amps or loss 80.30 2
_ iiit ,,-; y.r ••-F' yt , v ;
;;;t T 201 amps to 400 amps 106.85 2
r :. '�; ,
0 :.. R.OPL'`I2�`iX�.��:�� ,
I�•''R,.: - i � ?,�:? i ®i• � , _ r � y 5 P� ` i..:F P P
`` "" "'O 'i "" 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
Phone: ( ) I Fax: ( ) relocation
200 amps or less 66.85 l
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
!Y'. Yy ;, •' ' ,-c •r.K'� �: •;t . 'fit. -' . � . ,:. � .,�,,• :,;;
r• ` ,'f , ti 'C'" 3 JW,; , {",f ` g(`ii:li PER" x r� :� ^zit A. Fee for branch circuits with
.�.... ..:. _._.:.:.:_... .._i1. �'7 ... •• '� ._bn• T1.. '' .._a.,•�r_. l: service or feeder fee. each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: iv/thou/service or feeder fee,
first branch circuit 46.85 2
Address: Each edd'l branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax:: ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
s :i' 1' c.y , a@i'- .t',v;.:i:- 'CO aRA' j,,, v. i ; - i ,y y �,t: _ Vic , �3r•'-z rU ration, or
"V't i'ill'LS -.• .._ ._.' r'_ la 'Y:�.'}i.l' ?.- 3�'.R'y,:,��:. t -'..7 .KAV•404�•'Y_ ..S •�k': "�I- • l V� 'O/P anel, alteration ' .. ., .: 11.5.' - i -T_ ./:.:.. �. __.n �'�._'.1'. �
ene extension. Describe: Security Page 2 2
Business name: HSI Security Systems, Imc. System
Address: 3424 NE 35 Ave. Each additional inspection over allowable in any of the above
Per inspection 62.50 _
City/State/ZIP: Portland, OR 97212 Investigation per hour(I hr min) 62.50
Phone: (503) 287 -4604 Fax: (503) 287 -1345 industrial plant per hour 73.75
CCB Lic.: 42140 I Electrical Lic.• 26 -755 I Su . Lic.: 3778S Subtotal 75 -- -
Suprv. Electrician signature, required: / . / Plan review (25% of permit fee)
I State surcharge (8% of per fee) b
Print name: f [10'0 gtjotp5v 7 Date: 9-6 -06
�
n TOTAL PERMIT FEE . DD
- Authorized signature: � yY % This permit application expires if a permit is not obt within ISO
� days after it has been accepted as complete
Print name: al l - -' 0,j' 7 H4 // Date: 9 • Fee methodology set by Tri County Building Industry Service Board
•• Number of inspections per permit allowed.
is 5iruildulgWemits \ELC- PezmitApp.doe 12/03 440- 461ST(I(R}2tOMAVEB
CITY OF TIGARD A .
BUILDING DIVISION PERMIT #: ELR2006-00210
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/8/2006
Phone: (503) 639 -4171 MOia Inspection Requests (24 Hrs.): (503) 639 -4175 F ''
INSPECTION WORKSHEET FOR DATE: 9/14 /2006 TIME: 7:00AM PAGE: 17
SITE ADDRESS: 07409 SW TECH CENTER DR 150- CLASS OF WORK:
SUBDIVISION: TECH CENTER BUSINESS PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: SAM MEDICAL
DESCRIPTION: Security low voltage.
OWNER: WATUMULL PROPERTIES CORP, PHONE #: 503 -2 -3171
CONTRACTOR: H S I SECURITY SYSTEMS INC PHONE #: 503-297 -4604
Inspection Request Scheduled For: Date: 9/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
' . - - --e 036540 -01 503 -936 -1070 Y
I99 Fll'Ob
Cor - _ • II - II / I - ructions: W. _ . =; 0
6 L 20 6 4 - 00 38 7
C7f4TV Qvig
TA PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G' . KM vt Date: Phone #: (503) 718- P'Yb•