Permit ELECTRICAL PERMIT -
CITY TIGARD RESTRICTED ENERGY
4 11114' 4, r DEVELOPMENT SERVICES PERMIT #: ELR2001 -00244
• `.I I - 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/2/01
SITE ADDRESS: 10101 SW WASHINGTON SQUARE RD PARCEL: 1S135BA-01802
SUBDIVISION: OAKBURG ZONING: C -G
BLOCK: LOT: 025 JURISDICTION: TIG
Project Description: Burglar Alarm installation.
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 SQUARE TOO LLC ADT SECURITY SERVICES, INC
BY MACERICH COMPANY 2815 SW 153RD DR
ATTN: JANET FISHER, ASSET MGMT BEAVERTON, OR 97006
SANTA MONICA, CA 90407
Phone: Phone: 503 - 469 -7244
Reg #: LAC 59944
ELE 26- 209CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
5PCT CTR 10/2/01 $6.00 2720010000 Elect'l Final
PRMT CTR 10/2/01 $75.00 2720010000
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 952-001-00;0. You may obtain copies of these rules or direct questions to OUNC at (503)
246-1 c 7 O r�-/
Issued by r •�Gc,�� Permittee Signature
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
10/01/2001 11:49 FAX 5034697110 ADT SECURITY 21001 /001
1
Electrical PermitAp 1 ' - «-. on I
AI
Date received: FIN° Permit no.: / j . -62-
_ City of Tigard �� Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard : ' ' 7223 Date issued: By• gt , Recei .t no.:
Phone: (503) 639 - 4171
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: .
TYPE OF PER 11IT
❑ 1 & 2 family dwelling or accessory likeommercial/industrial ❑ Multi - family ❑ Tenant impro' ement
D New construction ❑ Addition/alteration/replacement D Other: D Partial
limimmimiriliailailluzziamilliiimmmi
I
/ 6/0/ _ Sit) ps . F� Bldg. no.: Suite no.: Tax map /tax lot/account nc :
Lot: I Block I Subdivi n:
Project name: SikAk of Amu.' i.w 'Description and location of work on premises: —" to r .} \ J- the
Estimated date of conk. letion/ins • ection: l
CONTRACTOR API'LICATIOIN FEE SCIIEI)1 LE —
dobno: 0 :!• J3g3Q•6l Fee Max
Business name: ' 6 C(.:unty 3CrviLGti Description Qty. (ea.) Total no. Imp
Address: 2515 S.W. 153RD llL New residential -Single oromlti- faarilyper
dwelling unit Includes attached garage.
v
B erton, C 70q
City: at P: Servlcelndaded: .
Phone:ji / .gyt{ IFax: Wig- 74/0 I E -mail: 1000 sq. ft. or less 4
: � ! (4/./ti Elec. bus. lic. no: (tL Locheddnio or portion thereof
CCB no. /m . O 1 . n0.: � no: (.767—,.).e- 1,imited energy, residential 2
CI
tY Limited energy, non - residential 2
, ( s L ��� .10-1-411 Each manufactured home or modular dwelling
- Si of supervis l ectrrcmn ( wed) Dace Servlce and/orfeeder 2
Sop. elect. name (print): (A License no
' Senlces orfeeders— installation,
alteration or relocation:
200 amps or less ° 2
Name (print): 201 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: IFax: E-mail: I 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, alteraHon , 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 2
Branch ciraarlts - new, alteration, .
- -- - - -- — — nrpstend Fee for branch circuits with p nap'rp'ort . _ __ r ase of
_ '
- -
Milne: - - - - -- uch —
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
Phone: Fax: E -mail: of service or feeder fee, first branch circuit 2
• Each additional branch circuit —1--
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not lncluded): •
Cl Service over 225 amps- commercial Cl Health-care facility Each pump or irrigation circle • 2
❑ Service over 320 amps- rating of 1&2 ❑ Hazardous location Each signor outline lighting 2
family dwellings Cl 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 ' 2
Cl Building over three stories Cl Feeders, 400 amps or more *Description:
Q Occupant load over 99 persons Cl Manufactured structures or RV park Each additional inspection over the allowable in any of the at me:
O Egress/lighting plan Cl Other. Per inspection 1 I l
Submit — sets of plans with any of the above. . Investigation fee
The above are not applicable to temporary construction service. Other
� �.+ 1
Not all Jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ _ T�
O Visa Cl 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 accepted as complete. TOTAL $ _
Name of cardholder as shown on credit card
$
Cardholder signature Amount 40-4615 (6/00/COM)
CITY OF TIOARD 24-Hour _ , L
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested —' 7 AM PM BUP
Location / h lb( wR`-S @-. Q - t Suite MEC
Contact Person Ph ( ) I 9 7.. PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
ELR
Ftg Drain �� O ��
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation I� � S�
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
'Final •
K
PASS PART FAIL i
PLUMBING /
Post & Beam • /.
Under Slab
Rough -In \ �
Water Service \/
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
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
F�\ larm
tOMU$111 PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE [] Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA r�
Approach/Sidewalk D ate 2 ` 0 `-' — G / Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the ob site.
PASS PART FAIL