Permit •
- CITY OF TIGARD RESTRICTED ENERGY
r� DEVELOPMENT SERVICES PERMIT #: ELR2002 -00160
• ^ � I II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/21/02
SITE ADDRESS: 09779 SW WASHINGTON SQUARE RD D -11 PARCEL: 1S126C0-01107
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: Job #083 - 15630 -01 Install burglar alarm.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPEIIRRIGAT:
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 #: LIC 59944
ELE 26- 209CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 8/21/02 $75.00 2720020000 Elect'l Final
5PCT CTR 8/21/02 $6.00 2720020000
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 pA
/ L
.64 a ( Permittee Signature (j1 Gc.-10_
OWNER INSTALLATION ONLY
The installation Is being made on property I own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: L.^ DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: rr) (z lap,/ ,/�/ DATE:
LICENSE NO: , TLE 3 85 0 ''
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
,. Electrical PermitApplication�
FILE ( f i // �, received_ I j Date , � o g Penult no.-.9 ' .0, e. � ,
iii...' . •I I ' City of Tigard Projcct/appl. no.: Expire date:
City ofTlgard Address: 13125 SW Hall Blvd, Tigard, . OR 97
Phone: (503) 639 -4171 itiUB" 1 t 2 Date issued: >3y =� Receipt no.:
Far (503) 598 -1960 �•� / Ii cLy�, d ll4�?1;41a•g Case file no.: Payment type:
� approval: Bhp DWG DM
0 Land use
T1(Pl? OF PERMIT IT
O 1 & 2 family dwelling or accessory VI Commercial/industrial 0 Multi - family 0 Tenant improvement
O Now construction 0 Addition /alteratiott/replacemeni O Odi 0 Partial •
JOB SITE !NFORM,177ON
Job address: (j 79) wasially mou RD, Bldg. no.: S ' : no.1)11 'ax map /tax lot/account no.:
Lot: Block: 'Subdivision: •
Project name: K -r ,i /07 'Description and location of work on p .• - - we4 ,ALA ttuv
Estimated date of completion(, :. ., . on
CONTRACTOR APPLICATION FEE SCHEDULE '
Job no: o 3 - 15630•01 Fee Max
Business name: AO7 SecOrrFy NeweesldEt - rinp Description
l9per Qty. (ea') Total no. imp
Address: 28 IS &j) 153rd '
C ty : atage. 12 S t a te: ORI ZIP:* eivog s ' '
Phan +e .4 1•7i O r01 Faxon 1•7E-mail: . 1000 sq. R. or less • 4 •
Each additional 500 ft. or portion thereof
CCB no.: VIII/ I Elea bus. lic. no: Z6 2eyfeL Limited ,residexidal p° 2 -
erlLRgy
City/metro no.:
Limited , Limitarmy, ted army, we .
,® 2 w
S• i 6' 0 elt manufar�redhome or modular dwelling
Si a prvis ectri� (required) Date - Service and/or feeder 2
Sup. decc name Orin* . , VS License noi LE ;Sa r S Wentorreeders— installation,
alteration or Mardian:
PROPERTY O�V1NE1t 200 amps erless 2
•
Name (print): 20t amps to 400 amps 2
Mailing address: 401 amps to 600 amps 2
601 amps to 1000 amps . 2.
City' I State: I ZIP: Over 1000 amps or volts _ 2 '
Phone: I Fax: I E -mail: Reconneetonly 1
Owner installation The installation is being made on property I own Temporary vicesor feeders
alteration, elocadon:
which is not intended for sale, lease, tent, or exchange according to
ORS 447, 455, 479. 670, 701. 200 or less 2
201 amps to 400 amps 2
Owner's signature: • Date: . 401 to 600 amps 2
ENGINEER Briouti elrcuits- um, alteration,
or =tendon per panel:
Name: A Pee forbranch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee far branch circuits without purchase
Phone; Fax: $.�i]• of service or feeder fee, first branch circuit: 2 •
a d d i t i o n a l
Mbc (Service er feeder not indaded): •
0 Service over 215 amps-commercial 0 Health-are facility Each pump or irrigation circle • 2
O Service over 320 amps - raring of l&2 O Hazardous location Each sign or outline lighting 2 -
family dwellings Bujldigg 10.0(X) square feet fburor Slgnaldrcail(a)ora limited energy panel, x
O System over 600 volts nominal • more residential units in one alntUure alter'ation,orestetrsioni I /S 75 2
O building over three stories 0 Feeders. 400 amps or mote •Description:
O Occupant load over 99 persons ❑ Manufactured structures or RV part Each additional inspection over the allowable In any of the above^
O 13gsess/Iightiag O Other Pe 14sq►oction
Submit _ sets of plans with any of the above. • Investigation fee 1 ` , I
The above are not applicable to temporary construction service. Oilier
-
Nm iof�lonsdl mom ap aeeir cm*, please toll judraiowo
c roe more of roadW, Nod= This permit application Permit fee $ ?S .
O Visa O MasterCard expires if a permit is not obtained Plan review (at %) $
C'ed1 "ard number. - 1 1 within 180 days after it has been State surcharge (8%) $
Name of �uotder as shown on credit card
X01 accepted as complete. TOTAL $ W
S
■ Cardholder slenamre Amami
440.4615 (6 00/C0K
T00Ij 1t.LIua035 ,LQV 0TTL696COS rV,3 CO:90 Z00Z /6T/90
CITY OF TIGARD 24- 1(our,
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION 4 Business Line: (503) 639 -4171 MST •
BUP
Received Date Requested 9 y AM PM BUP
Location Q' Sw 6t.14i4 sI Ad Suite 0-1/ MEC
Contact Person Ph ( ) 4 14' 7 Z 9 X PLM
Contractor \` Yoj S - Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR G Z /4 D
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall �c C c v
Fire Sprinkler ��� �� i 0� �
Fire Alarm E,v/i L 'PM 64 vl I
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL �` `�- I S� � * , , ^ PLUMBING l � l�(J
Post & Beam , O ` G ` 1 „� ` �� ■
Under Slab I v 1
Rough -In Y� N §S
Water Service 1`1
Sanitary Sewer
Rain Drains
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
( LECTRI
Service
Rough -In
UG b
.Low VJtaa
1- re Alarm
cEincio Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date �� Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from t ob site.
PASS PART FAIL