Permit . a
•
CITY F, T I G D RESTRICTED ENERGY
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR2001 -00263
.`,��I 13125 SW Hall Blvd., Tislard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/25/01
SITE ADDRESS: 09646 SW WASHINGTON SQUARE RD G -14 PARCEL: 1S126C0-01107
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Proiect Description: Tenant Improvement - CCTV
Job No.083- 14035 -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:
INSTRUMENTATION: OTHER: CCTV. X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PPR WASHINGTON SQUARE LLC ADT SECURITY SERVICES, INC
BY THE MACERICH COMPANY 2815 SW 153RD DR
9585 SW WASHINGTON SQ. RD. BEAVERTON, OR 97006
PORTLAND, OR 97223
Phone: Phone: 503- 469 -7244
Reg #: LIC 59944
ELE 26- 209CLE
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 10/25/01 $75.00 2720010000 Wall Cover
5PCT CTR 10/25/01 $6.00 2720010000 Elect'I Final
Total $81.00
This Pen 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by (- Permittee Signature INlac Qp.d
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
10/23/2001 14:10 FAX 5034697110 ADT SECURITY 0001
Electrical Permit Application
Date received: Per :e4 Roo /-oo 263
e.:� ",.t rt
Tigard 1 = � City of Tigd
b 11Vv Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, OR 97 Date issued: By: I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 OCT 2 3 2001 Case file no.: Payment type:
Land use approval:
I .MUNI uEYEIOPMCNT
TYPE OF PERMIT
O 1 & 2 family dwelling or accessory 7I Commercial/industrial ❑ Multi- family ❑ Tenant improvement
Cl New construction ❑ Addition/alteration/replacement Cl Other: ❑ Partial
JOB SITE INFORMATION • y'
Job address: 94 S() ask , K Si. Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: jSubdivis n:
Project name: Skit's s a I Description and location of work on premises: (jGTV
Estimated date of completion/inspection: •
CONTRACTOR APPLICATION FEE SCHEDULE '
• Job no: OR 3-1 .0/ Fee MAX
Business name: rs Description Qty. (ea) Total no. insp
Address: ZBIS SW 151rd New residential -single or multi- family per
/ dwellingunit. Includes attached garage.
City: State: OR, i • . Serriceincluded:
PhoneSo l{61.7100 Fax .iggs X E -mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
CCU no.: s� 4,/ / Limit
I Elec. bus. lie. no: 26 209CLF q" p
Limited energy, residential 2
City/metro 'c. no.: Limited energy, non- residential 2
a - A _ , •. 10-27-01 Each manufactured home or modular dwelling
Signa - 7o supervising e ctrician (required) Date Service and/or feeder 2
Sup. elect. name (print): License no: Services or feeders— installation,
alteration or relocation:
• PROPERTY OWNER 200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps . 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: " Date: 401 to 600 am .s 2
ENGINEER Branchclrcuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail:
Each'addjljonal branch circuit:
' . PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
•
❑ Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps - rating of I &2 ❑ Hazardous location Each signor outline lighting 2 -
family dwellings ❑ Building over 10 ,000 square feet four or Signal circuit(s) or a limited energy panel, I ��
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2
O Building over three stories ❑ Feeders, 400 amps or more *Description:
❑ Occupant load over 99 persons Cl Manufactured structures or RV park Each additional inspection over the allowable In any of the above
❑ Egress/lighting plan ❑ Other. Per inspection I 1
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all Jurisdictions accept credit cards, please call Jurisdiction for more information. Notice: This permit application Permit fee $ 75.
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: I / within 180 days after it has been State surcharge (8 %) $ •
Name of cardholder as shown on credit card
Expires as complete. TOTAL $ O
Cardholder signature Amount
440-4615 (6/00/COM)
- 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 96 '449 1.(_)f , Sc R D Suite MEC
Contact Person Ph 4 46 , q 7a- I PLM
Contractor Ph S
it�1/
BUILDING Tenant/Owner E - -
Retaining Wall EL •t s. -
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
*1.Z
Post & Beam
Rough In
Gas Line -
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service.
Rough In
UG /Slab � C,
(y/
Low Voltage
Fire Alarm
PART FAIL .
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
Other oach /Sidewalk Date /02-1 — tO/ Inspector , y�d Grt Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.