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Permit CITY O F TIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY :alit DEVELOPMENT SERVICES PERMIT #: ELR2000 -00147 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/14/00 SITE ADDRESS: 09508 SW WASHINGTON SQUARE RD Or PARCEL: 1 S126C0 -01107 SUBDIVISION: ZONING: C -G BLOCK: LOT: JURISDICTION: TIG Project Description: Installation of protective signaling. Job No. 083 - 11838 -01 A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATAITELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: : HVAC: PROTECTIVE SIGNAL: X INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: PPR WASHINGTON SQUARE LLC ADT SECURITY SERVICES, INC 9585 SW WASHINGTON SQ RD 2815 SW 153RD DR TIGARD, OR 97223 BEAVERTON, OR 97006 Phone: Phone: 503469 -7100 Reg #: LAC 0059944 ELE 26209CLE FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT DEB 6/14/00 $60.00 0002953 Elect'l Final 5PCT DEB 6/14/00 $4.80 0002953 Total $64.80 �� ®0 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 require ollow rules adopted by the Oregon Utility Notification Center. Those rules are set forth 'n OAR 95 - 01 -0010 throb h OAR 9 - 001 -1080. You may obtain copies of these rules or direct , question o OUNC at (503) 6 -1987. / I ued by ,,I; / - /jam. /' 44' I f i Permittee Signature j,' _ ! � i i ,� �._1� 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 03/17/00 FRI 12:15 FAX 503 598 1960 503 598 CITY OF TIGARD la 003 CITY dF TIGARD 13125 SW HALL BLVD. Electrical Permit Applicati,q t #• a Plan c # TIGARD OR 97223 R /� e+ �1 Recd By �V �� �� �/" 'u � 10 Date R c'd 6, -/ 3 -eC Phone (503) 639 -4171, x304 N. . ' Date to P.E. Inspection (503) 639-4175 �* Date to DST Fax (503) 598 -1960 Print of Type J .ski-\. Permit # Incomplete or illegible will not be acc Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Ok$01/itj 6,76 E¢i/lher Number of Ins tions per Name (or name of business) ,j�G'it. �, L P� p permit allowed ervlce included: Items Cost Sum 4- Address • 4a. Reslderrtlal - per unit City /State/Zip / A S AS4. see 470,-7013 1000 sq. ft. or less $ 117.75 Each additional 500 sq. ft. or 4 Commercial ❑ Residential © portion thereof $ 26 75 1 Limited Energy 1 $ 60.00 $60.00 Each Manufd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder (Prior to permit Issuance, applicants must provide contractor license $ 72.75 2 Information for COT data. base), 4b. Services or Feeders on, Electrical Contractor ADT Security Services, Inc. In 200 a ampsor ess n'orrelocation Address 2815 SW 153rd Dr . 201 amps to 400 amps $ 64.25 2 City RP AVP rt - nn State $ 85.50 2 OR Zi 9 7006 401 amps to 600 amps $ 128.50 2 Phone No. _ 601 amps Job No. t 5� 01 to 1000 amps $ 192.50 2 Over 1000 amps or volts $ 363.75 2 Reconnect only $ 53.50 2 Elec. Cont. Lice. No. 26- 209CLE Exp.Date 10/2000 V 4c.Tem OR State CCB Reg. No. 59944 Exp.Date 5/07/01 Installation, al Or ocaton COT Business Tax or Metro No xp.Date 200 amps or less $ 53.50 2 Signature of Supr. Elec'n 201 amps to 400 amps $ 80.25 2 i ,�i�. 401 amps to 600 amps $ 100.00 2 n � � � Over 600 amps to 1000 volts. License No. Exp.Date see "b" above. 3 rS Phone No. 4d. Branch Circuits New, alteration or extension per panel 2b. For owner installations: a ) The fee for branch circuits with purchase of service or Print Owner's Name f f ee. Each branch circuit $ 5.35 2 Address b) The fee for branch circuits City State Zip without purchase of service Phone No. or feeder fee. First branch circuit $ 37.50 made on property Each additional branch circuit $ 5.35 The installation is being P party I own which is not 4e. Miscellaneous intended for sale, lease or rent. (Service or feeder not included) Owner's Signature Each pump or irrigation circle $ 42.75 Each sign or outline lighting $ 42.75 Signal circuit(s) or a limited energy 3. Plan Review section (if required):* panel, alteration or extension $ 60.00 Minor Labels (10) $ 100.00 Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over 4 or more residential units in one structure the allowable In any of the above Service and feeder 225 amps or more Per Inspection $ 50.00 System over 600 volts nominal Per hour $ 50.00 Classified area or structure containin s In Plant $ 59.00 described in N.E.C. Chapter 5 g Peaal °ccupanq as 5. Fees: . ` Submit 2 sets of plans with application where any of the above apply. 5a8E Enter total of above fees $ 6 n _ nn Surcharge (.08 X total fees) Not required for temporary construction services. S $ /i . 80 Subtotal NOTICE 6b. Enter 25% of fine ba for Plan Review if required (Sec. 3) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal S 64:80 'S NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR .- WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # \T ANY TIME AFTER WORK IS COMMENCED Total balance Due $ 64.80 ,dsLs forms \electric doc CITY OF TIGARD BUILDING INSPECTION DIVISION ` • MST 24 -Hour. Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 7- AM PM BLD Location 0 - 5-0( 5 w WG SGt 5 Suite e1 - I MEC Contact Person Ph if G 7 7 L g y PLM Contractor Hy-r Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR (" /`{ 7 Footing Access: • Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing • Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS 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 T FAIL ELECTRICAL ervice Rough In • UG /Slab Low Voltage Fire Alarm 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 einspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date Inspector Ext Final PASS PART FAIL O NOT REMOVE this inspection record from the job site.