Permit vir
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
l� DEVELOPMENT SERVICES PERMIT #: ELR2005 - 00387
..� I ° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/2/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09339 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Burglar alarm. Janeville. Job #083 - 19090 - 01.
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:
WASHINGTON SQUARE LLC ADT SECURITY SERVICES, INC
BY THE MACERICH COMPANY 2815 SW 153RD DR
9585 SW WASHINGTON SQUARE RD BEAVERTON, OR 97006
TIGARD, OR 97223
Phone: 503- 639 -8865 Phone: 503- 469 -7244
Reg #: LIC 59944
ELE 26- 209CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 11/2/2005 $75.00
[TAX] 8% State Surcha 11/2/2005 $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 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: fie, �
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.
11/02/2005 10:19 FAX 5034697110 ADT SECURITY IJ001
Ck lectrical P • - I I A t 11 • ._ �� i _ X E 1 i j I ii!:, ` r FOR OFFICE USE ONLY
` V crewed
13125 SW Hall BUd., Tiger. , C JR`972 Dates : _ v
NO „, Plan Review
Phone: 503.639,4 71 Fax: 303.598.1960 C� NO ''d 0 5 Date/By: Other Permit:
Inspection Line: 5 .639.417 :i I I Z f u J .�_ 1/. °`I / I� Date Ready/By: !uric El See Page 2 for
Internet: www.ci.tig r.lis ' ' I .. b - II Notified/Method: Supplemental Information •' i ti ''� ;ti ?;
f . �'.J i1 • , 4 _. 1 I l 1' {' F h `, y i ii ri�f� ��v�a 11�i fil / F eg'[ ��'{ � } ( y ..i r "-', it Lein , "v -, l u �,'r °.:.': .
?:.. Y .._.,� t ,!. ;',='- 1 :4:2:31:1�.ri - 1 .. ' . ;,..di . > .... t.1J--Ptirv..kir2:(giti L baic�L'_�L;ttik-0.11r_lir`i 1... .i !F . , I. , , � • .. , i' • . ..
1- ew construction ❑ Addition /alteration/replacement Please check all that apply:
❑Service over225 amps, comm'1
• Demolition El Other mp ['Hazardous location
.� ['Service over 320 amps - rating ❑ Buildng over l 0,000 sq. ft.,
I - !u, 1 ; ,:. li . +jr IT 7 - ifi " lti �` ',4A 1 ai:< %1 411 4 �1 ' 1N,!'t 4.19 ". i1 a' 4 Y q
„ 41 - . i . FA..; Jic . .' �; 5 ti;, : ! -: ,.3.N...1r ., J _s_,1?,.- 11L4_t1a62. >.1eal .11. 1, o l - and 2 -famil dwellin 4 or more new residential
❑ 1 - and 2 family dwelling 7l< ommercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories OFeeders, 400 amps or more
❑ Multi faintly El Master builder ❑ Other:
['Occupant load over 99 persons OManufactured structures or
?yg rl,ll er i�'w xt / l i g19 . iii ; -F d I' R r3 r1''2+ o tlUi iii iY tlii5; (r r xP , r "'F is, i ', RV park
' / _ '.,.� .'...';r >, _, _ . , _„ t .., :-� i..z'?! /x. L! : *: -1' -:.�., a's t, ❑Egress /lighting plan P
Job no. :C3. l9o8t. Job site address: 95 SW bt.) a e»,,�l�ii ❑Health -care facility ❑Other: s7
Submit . sets of plans with any of the above.
City/State/ZIP: 6L 9 7,2 The above are not applicable to temporary construction service.
WL [/ 1 7 V � . j 'u 'a�'tt`(f l:�r A �� 31 Q i P)1 1 ti t u'' ;tt.'
Suite/bldg. /apt. no.: Project name: 9,itnth. ..�... 1�• +L r� . ,, . . „
Description Qty. Fee. Total ••
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'! 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
� 11 Limited energy, non - residential 75.00 2
al Itf; '''' g'' " 1 r-- 't : I P 1 7� `' ?!(0- j A 'W 't ;Y-, r� f i g � `�+ r r Each manufactured or modular
Bilt_dia.LS1101) dwelling, service and/or feeder 90.90 2
Services or feeders Installation, alteration, and/or relocation
200 amps or less 80.30 2
i�l t , �s- e� r i .• f 7 l �nv r � a r 1 y � i t w 'p f ,i 201 amps to 400 amps 106 85 2
3 ,,, y ; K r � �1 131��21 . , T6 �,Vi lu ;' r� ''t.'t � (,�` :.If A '# rs' f9f�_' s i t , r 4 l; 4` f �' : I. . 4. P
t ,d$. .!i _L 11 A: t .z. < [irk,_e_. : : :._.�� �;:, � +x .,_e. i,. Ifl, ., 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: ( ) Fax: ( ) _relocation
_ 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 snips 100.30 1 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
. t 44
, _ ,. + L 7 ` S tr ), ' 7.7,..A`% , :--:".:2._ -, ,, ._i� t l - y 5- . d - , 5 q � _ . . " ri� l '� l l '� � , '
' ,ta ,7 2�T YL ,7, . , ° � l A. Fee for branch cir with
Business name: service or feeder fee, each 6.65 2
branch circuit _
Contact name: t /i B. Fee for branch circuits
"� without service or r feeder fee, 46.65 2
Address; �VI . each branch circuit
Each add'! branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not Included)
, ` Pump or irrigation circle 53.40 2
Phone: ` I )1 11 • ,9..t. Fax: : ( ) Sign or outline lighting 53.40 2
E -mail:
Signal circuit(s) or limited.
i _ „''0 ' IbT.'T i L Ih . r:Si - :. '_ ,- '. i ,2 . .,69hs i j... + a l s ;, _� � , ..t;. ;P;1 !'.._il t _ .,i'.:�ilt �,.' ]k .:S''t gy nel, ation, or
F "" - e pa Descnb
Business name: ADT SECURITY SERVICES, INC. � Page 2 15 . Di) 2
Address: Eac a inspec over allowable in any of the above
BE.A1LERT()N, nit g7nnR Per inspection 62.50
City/State/ZIP: (503) 469 -7100 Investigation per hour (1 hr min) 62.50
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
CCB Lic.: - 'l;� . . : ∎ii ibgi �lalti, i �t'r W f i� .i. ii-MW ,- .1- :�,,
F9Gi Electr Lic.:j� cte )uprv. Lic.: g c i LEA Subtotal iS.6
Suprv. Electrician signature, required: _ 4 ; _ . Plan review (25% of permit fee)
Print name: 14th F--1 ,: S Date: C
1 Q (8% State surcharge (8 of permit fee) b. pp
V t
'` 6 U TOTAL PERMIT FEE $+ . Do
Authorized signature: This permit application expires If a permit Is not obtained within ISO
days after It has been accepted as complete
Print name: Date: • Fee methodology set by Tri -County Building Industry Service Board
•• Number of inspections perpetmit allowed.
i:\Buildiog\Pertnits\ LC- PennitApp doe 12103 440- 4613T(10 /O2ICOM/W13.8
CITY OF TIGARD
' BUILDING DIVISION PERMIT #: ELR2005-00387
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 111212005
Phone: (503) 639 -4171 Ake
Inspection Requests (24 Hrs.): (503) 639 -4175 I I—
INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7:12AM • PAGE: 166
SITE ADDRESS: 09339 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: JANEVILLE.
DESCRIPTION: Burglar alarm. Janeville. Job #083-19090.01.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503- 639 -8865
CONTRACTOR: ADT SECURITY SERVICES, INC PHONE #: 503 - 469 -7244
Inspection Request Scheduled For: Date: 11/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 021026 -01 603-469 -7212 N
c‘ AL.
Corrections /Comments /Instructions:
PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: e2 V" Date: ti • Itt' 05 -- Phone #: (503) 718- 2A 46.