Permit ". ---. `' CITY OF TIGARD ELECTRICALPERMIT -
RESTRICTED ENERGY
A 1 DEVELOPMENT SERVICES PERMIT #: ELR2001 -00149
-41 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 05/23/2001
SITE ADDRESS: 09689 SW WASHINGTON SQUARE RD C -8 PARCEL: 1 S126C0 -01107
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:
INSTRUMENTATION: OTHER: BURG ALARM 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 #: L1C 59944
ELE 26- 209CLE
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 05/23/2001 $75.00 2720010000 Wall Cover
5PCT CTR 05/23/2001 $6.00 2720010000 Low Voltage Inspection
Elect'I Final
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987. -
Issued by � - ,/ Permittee Signature (ni 19p �) ,2
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 ( ( L ,0 ( H i i f /yL DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
•
05/22/2001 14:02 FAX 503 469 7110 ADT SECURITY 1j001
rI
;
iip,, Electrical Permit Application
Date received: S a? Q / Permit no.: k LK �t / _ jj
s;� i I City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: R eceipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 ' Case file no.: Payment type:
Land use approval:
TYPE OF I'ER:YIIT
D 1 & 2 family dwelling or accessory 1 ommercial/industrial 0 Multi- family 0 Tenant improvement
❑ New construction 0 Addition/alteration /replacement O Other: 0 Partial
.10B SITE INFORMATION
Job address: qt; 89 Et.,) [,Jott[Att. 4- $ R ; 0;i Blde no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: I Subd ision: 9 . L— )
Project name: 13rookS +ae+ie; * /3/ I Description and location of work on premises: diaN. may, r✓\
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: •1_3- // 223 - r Fee Max
Business name: ' b 1 Security SCI VIUCS - Description , Qty. (en.) Total no. insp
Address:
2 815 S.W. 153R mily ' Dr. New residential - single or multi- fa per
dwelling unit. Includes attached garage.
City: Beaverton, (Rat�7OG IP: Service included:
Phone:Li /pg - 7u L., I Fax. -J( E-mail: 1000 sq. ft. or less 4
ioiUy I ,Q , e e PL. Each additional 500 sq. ft. or portion thereof
CCB no.: Elec. bus. tic. no: ���rl Limited energy, residential . 2
City /metro lie. no.: Limited energy, non- residential 2
ZZ Q/ Each manufactured home or modular dwelling
S ature of,s ervising electrician ( uired) Date Service and/or feeder 2
Sup. elect name (print): (A License no Services or feeders— installation,
alteration or relocation:
200 maps or less 2
26 l amps to 400 amps 2
Name (print): (o., Lot i' 1<rs>�tr' S(- /47-64/0 401 amps to 600 amps 2
_ Mailing address: 601 amps to 1000 amps 2
City: '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, or relocation:
200 amps or less 2
ORS 447, 455, 479, 670, 701. 201 201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 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
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E Each additional branch circuit:
• PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
O Service over 225umps-commercial O Health -care facility Each pump or irrigation circle - 2
O Service over 320 amps - rating of 1&2 0 Hazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel.
O System over 600 volts nominal more residential units in one structure alteration, or extension* 1 ..-�T3 2
O Building over three stories 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons O Manufactured structures or RV park Each additional Inspection over the allowable In any of the above:
O Egress/lightingplan 0 Other. Per inspection 1 i 1 1
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other r� L]�
Not all Jurisdi jurisdiction accept credit cards, please call juristion for more Information. Notice: This permit application Permit fee $ T
O Visa O MasterCard expires if a permit-is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8%) $
Expires TOTAL as complete. TOTAL $
_
Name of cardholder as shown on cedit card
$
Cardholder signature Amount 440 -4615 (6100 /COM)
•
Z Z �
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hover Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 7-5 AM PM BLD
Location 9 p 7 56a Lvxs C- 5// .- Suite MEC
Contact Person J `� Ph 0 c , Zf r PLM
Contractor , / `` Ph SWR
BUILDING Tenant/Owner grog /Cs/ h L ELC
Retaining Wall ELR
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 . /7 /
V s�o n� ri /`�/ � S �?/!
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
PASS PART FAIL -
C,CTRIC
Service
Rough In
•
UG /Slab
Low Voltage •
Fire Alarm .
Fil.
W O 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 3
Inspector E xt
Approach /Sidewalk Dat J / It
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site. •