Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
,�,L DEVELOPMENT SERVICES PERMIT #: ELR2004 -00241
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/30/2004
SITE ADDRESS: 09650 SW WASHINGTON SQUARE RD G -15 PARCEL: 1S12600 -00300
SUBDIVISION: WASHINGTON SQUARE 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: 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: Phone: 503 469 - 7244
Reg #: LIC 59944
ELE 26- 209CLE
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 7/30/2004 $75.00 Elect'I Final
[TAX] 8% State Surchar€ 7/30/2004 $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 / /��l S/' Permittee Signature _S.P C'11)
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
07/29/2004 14:32 FAX 5034697110 ADT SECURITY 2001
,, .
Ell trical_nit ADDi ioYn 1 % %y FOR OFFICE USE ONLY
City of Tigard \\-- c ?, T ; ,30 '09' , E6 j �- PermitNO - CL,1
13125 SW Hall Blvd., Tigard, OR 97223 P °`• 7 ( -
GP , F' aa R eview
Phone: 503- 639.4171 Fax: 503.598.1960 \�, OF - „II(' Dat�x Other
Line 503.639.4115 e o�G ------ ,L i Da
Nr Ready/Ey J ®Sae Page 2 for
Inttenek www.ci.tigiuttor us VL: Notified/Method: ' � S lemeotal
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{ il �� ... f1 �1u 14C ..C.. -d. l��• el I F'i. �4 4. +`,� ••
❑ New construction ❑ Addition /alteration/replacement Phase check all that apply:
El Demolition Other over 225 amps, comm'l ❑Hazardous location
' i - ",:'s 4 1 I I 0.-01,: j ?i J q' ..I I III I ' Fi i tl l �1, r s 1: n l % t 'p ,-'1-c over 320 amps- rating ❑ Butldng over 10,000 sq_ ft„ - -._ ..,. _....., l / 1 , f : rk i p of 1- and 2- faintly dwellings d or more new residendal
El 1- and 2 - family dwelling - ._i - Commercial/industrial El Accessory building _....._ ['System over 600 volts nominal utdts m one structure
❑ Multi- family • Master builder [] Other ❑Bul7dmg over three stories El/leviers, 400 amps or mare
❑Occupant load over 99 persons ❑Manufactured structures or
1 ( 1 j. . I1l I III'llfl•:I1' E ... ;I '1'-!;;.. { , -
„ .
;% -- DElgress/lighting Aan RV. park
Job n ,I�1� ' , + Job site atidresa.p S 1 IL:II► I ; / s 2 sets of ❑Healthre facility ❑Other -
City/Sfate/Z1P: , / ` pIatLS with any of the above.
ii The above arc not applicable to temporary construction service.
Suite/bldg./apt- id LP 11 P L, '1, - l II � 1 v 'l1E 'rl '.t
g apt no-: Project name ! i / . ,., r• n .. , a
1 _ _ Aeeertpttoa Qty- Ihd Toms "
Cross street/directions to job site: • New residential single- or multi- family dwelling unit.
Iodudes attached garage.
1,000 sq. ft. or less 145.15 4
SubdiViaion: Lot no.: Ea. add'I 500 sq. R or portion 33.40 1
Ter map/parcel no Limited energy, reside 75.00 2
- 7500 2
energy, non
_ _. " �acb manufaetlued er tsiodulss
�1 a ,+� dwelling service and /or feeder 90.90 2
. " Lit �t 1 i es Servic or feeders installation, alteration, and/or relocation
200 amps or less I , 80.30 ' 2
-
_ -
�; � ; ' ' I 201 to 400 s 106.85 • 2
:1 : ",', ' . It '' i � ' s a�
4 arepa to 60 0 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 I 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
Phone: 7 I . ' • 1 , • • Fax: ( ) relocation
200 amps or lees 66.85 1
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, resat, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2"
Owner Si
.; tuft Date: Branch tlrceita - new, alteratloo, or extension, par panel
Ir C ` I a ' 'i. Ir ,I ,. ' ' I ; 4 I` _ A_ Pee for branch circuits with
. _... ... .: , , .., .. ,.... .. _ ;' .. ., .. .. service or finder fee, each
allSineSs name: brooch circuit 6.65 2
Contact name: B. Fee for branch circuits
without service or feeder fee, 46.65 2
Address: each branch circuit
Each add'l branch circuit 6.65 2
City/Statc/ZlP: Miscellaneous (service or feeder not included)
Phone: ( ) p ax:: ( ) Pump or irrigation circle 53.40 . 2
Phone; E-mail: Sign or outline lighting 53.40 2 -
{{ Signal circuit(s) or limited -
r.__3 4-�:•! I `ii1 1 1 1 . ; i l , Ii i � II -11 1,
1 4 Ii 1I3 .I i o„ l I
r J. i � a } 1 energy panel, alteration, Or
y . .. a..2� 2 t. ,_ , vi -. extension. Describe: 1 Page 2 --i5 co 2
Business name: ADT SECURITY SERVICES, INC.
it _ -
Address: ' II - • Each additional inspection over allowable In any of the above
• , • _ : t t i Per inspection 62.50
City/State/ZIP: (503) 469-7100 Investigation per hour (1 hr mire) 62.50
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
{ i ' ' "r t 1? " I 0; f1'I di• ! � P-'- r I y� ¢
. �, ; (1t, ri, J,i .1 � I �sl ?011, t �Ill��lS gri. ,. 'ih Art�F+�, >'
CCB Lie.: 53194 Electrical Lie.: ,_ •• cLE uprv. Lie.; g- . A _ Subtotal ,Li)
Suprv. Electrician signature, required: :01111NINAMIM Plan review (25% of permit fee)
Print name: Date: D i O State surcharge (8% of permit fee) _�
I - - ` TOTAL PERMIT 1F g I 043
Authorized signature: TWe permit application expires Ira permit ii nor obtained within 180
days aver it bee been accepted as complete
Print name: Date: • Pee methodology set by Tii -County Building Industry Service Board
•• Number of inspections per permit allowed.
s IBuidI°glr'crntitld9LC- PermitApp doe 11/01 440 4615T(10/02/COM/W130
CITY OF TIGARD 24 -Hour
BUILDING Inspection Linn '(503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
B
Received �° Date Requested / I— ��M PM BUP
`
Location / ' 57) 9-- 6 Z' Suite q / MEC
Contact Person ( Ph ( ) - 7 G PLM
Contractor Ph ( SWR
BUILDING Tenant/Owner 9- ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR - v d 1 1
Crawl Drain
Slab Inspection Notes: • SIT
Post & Beam 4 6 0 N L� I.P
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation '
Drywall Nailing -
Fi rewall
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling T
Roof � I
Other: - -- -
Final
PASS PART FAIL i ij •
PLUMBING _ I .
Post & Beam
U
IWAW nder Slab ,
Rough -In
Water Service WAIN lirrallV
.-
Sanitary Sewer •
- Rain Drains ..r"
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final '
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
. Service
Rough -In
UG/Slab f " ' _ �/ 3 55 / �-
�.f
w Vol age }— La / — ci C' C( V/ b - Ls./ ' na` y'Ac'
L..rm 6
` k 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PA -) PART FAIL
SITE ❑ Please call for reinspection RE: fl Unable to inspect — no access
Fire Supply Line c -
ADA 1 •�
Approach/Sidewalk Date 4 � In spector ,% °�'� Ext
Other:
Final DO NOT REMOVE this Inspection ecord from the'job site.
PASS PART FAIL