Permit ELECTRICAL PfRMIT-
CITY TIGARD RESTRICTED ENERGY
°mark DEVELOPMENT SERVICES PERMIT #: ELR2000 -00251
^` " '- -- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/30/00
SITE ADDRESS: 09477 SW WASHINGTON SQUARE RD PARCEL: 1S126C0 -01403
SUBDIVISION: ZONING: C -G
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: : X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PPR WASHINGTON SQUARE LLC SECURITY LINK FROM AMERITECH
P.O. BOX 21545 12119 NE 99TH STREET
SEATTLE, WA 98111 SUITE 2094
VANOCUVER, WA 98682
Phone: Phone: 360- 25393113
Reg #: LIC 55060
ELE 26- 514CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 10/30/00 $75.00 2720000000 Elect'I Final
5PCT CTR 10/30/00 $6.00 2720000000
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 e set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules i • •uestions to 0 ' -t
246 -1987.
Issued by Permittee Signature / N
/ '_/ %� % � " i; ,/
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Received: 10/17/00 9:52AM; 503 598 1960 -> SECURITYLINK; Page 2
. 10/17/00 TUE 09:44 FAX 503 598 1960 CITY OF TIGARD x1002
e.
•
•
Electrical Permit Application
Date received: Permit no.: �'� Zip - 6 DOS /
j;' City o f Tig Pro J ect/a PP
,. “1- I no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: , Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 'Case file no.: Payment type:
Land use approval:
O I & 2 family dwelling or accessory Commercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction ❑ Addition/alteration/replacement 0 Other: 0 Partial
JOB SITE INFORMATION
Job address: Q."gS Sic) as inF yt Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: ' Subdivision: Sla ' 'eV
Project name: I Description and location of work on premises: Tns 7,( R L.vt �,Qp� /•� /a..rj x
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCHEDU.E
Job no: ., , (p, -7 Fee Max
� ,atn. ` � Description Qty. (ea.) Total no. insp
Ig
Business name: ,,Q.,* ‹P oi L i1 k New residentW-single or multi - family per
Address: ID ill NF (9.944-- s w _ S d 09 y dwelling mgt. Includes attached garage.
City:I /(A,h C nutbe_ I Statej )f{- Z IP: igg(o $a Service included:
<e. t. j 1000 sq. ft- or less 4
Phone 0 • - - ' / ,� F7o7S3 - /y7 E-mail- . /e L nCC 'r' Each additional 500 sq. ft. or portion thereof
CCB no.: C/3O0SS'Q(e O Elec. bus. lic. no: a )( y _ j j q G L6 Limited energy, residential 2
City /metro lic. no.: S 4 5 0 2 70/ V" Limited energy, non- residential / 7(Lk' ?,511 2
gnature of supervising electrician (required) Dam Services or feeders installation,
Sup. elect_ name (print): - r • C. Chas ' License no • gy alteration or relocation:
PROPERTY OWNER 200 amps or less 2
201 amps to 400 amps 2
Name (print): Z �,� p S 401 amps to 600 amps 2
Mailing address: q(, j 1,0 . woj nuA Hill La. tn. e.- - 601 amps to 1000 amps 2
c/
City' Tv t/ i I State: / /t t� I ZIP:7510 3 �y Over 1000 amps or volts 2
Phone: Temporary services or feeders -
__ 1
y I Fax: I E-mail: Reconnect only
_
Owner installation: The installation is being made on property I own Installation, alteration, orrelocation:
which is not intended for sale, lease, rent, or exchange according to 200 amps or less 2
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2
Owner's signature:
Date: 401 to 600 am s 2
Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
B Fee for branch circuits without purchase
City: I State: ZIP: of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): Each outline lighting 2
Each pump or irrigation circle
, ❑ Service over 225 amps- commercial '❑ Health-care facility - hsignoroti _ 2
O Service over 320 amps -rating of 1 &2 CI Hazardous location Signal panel,
family dwellings O Building over 10,000 square feet four or g 2
O System over 600 volts nominal more residential units in one structure alteration, or extension*
❑ Building over three stories • 0 Feeders, 400 amps or more *Description: -
0 Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan O Other: Per inspection I I j
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other . -
Permit fee $ �S• Ov
Not all jurisdictions accept credit cards, please call jurisdiction for mote information. Notice: This permit application Plan review (a[ _ %) $
❑ Visa ❑ MasterCard expires if a permit is not obtained State surcharge (8%) $
Credit card number: / / within 180 days after it has been
Ex accepted as complete. TOTAL $
• Name of cardholder as shown on credit card $
Cardholder signature Amount 440-4615 (6/0O/COM)
/, - /Zc-,
CITY OF TIGARD BUILDING INSPECTION DIVISION . MST
24 -Hour I pection Line: 639 -4175 • Business. Line: 6394171
BUP '
Date Requested l � -" —6-6 AM PM BLD
Location 9A-- `)(g) Suite MEC
Contact Person Ph SR'— 3730 PLM
Contractor ply L 560 (F// - go 9z_ SWR
BUILDING Tenant/Owner ELC
Retaining Wall O —
ELR � 0 0,0 2 S7
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: (� n'` SGN
Slab `3Z /'r ` � �� SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler / itJ 4-
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final EG7 PAS S PART FAIL /
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
� Ft F rTRI A �
Service
Rough In
U -•
ow Voltag =
Fire -
F' , -
• AS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA J
& zD
Approach /Sidewalk D // ` 2'- Inspector
Other Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.