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Permit C ITY OF TIGARD RD ELECTRICAL RESTRICTED ENERGY PERMIT A DEVELOPMENT SERVICES PERMIT #: ELR2005 -00343 AA I I 13125 SW Hall Blvd., Tigard, O R 9722 503 - 639 -4171 DATE ISSUED: 10/13/2005 PARCEL: 1S135BA-00102 SITE ADDRESS: 10124 SW WASHINGTON SQUARE RD A -7,8 ZONING: C -G SUBDIVISION: WASHINGTON SQUARE TOO LOT: 001 JURISDICTION: TIG Project Description: Burglar alarm low voltage. 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: X OUTDOOR LANDSC LITE: OTHER: : HVAC: PROTECTIVE SIGNAL: 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 Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 10/13/200E $75.00 [TAX] 8% State Surchart 10/13/200E $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 -00 -0100. You may obtain copies of these rules or direct questions to OUN at 503 - 246699. Issued By: 0117/ Permittee Signature /,� � ryy ,/ ��, Ao 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 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. El ectrical Permit Application FOR OFFICE USE ONLY City of Tigard RECEIVE ®• Re Date/B e eiv l D p Permit No.: .? 13125 SW Hall Blvd., Tigard, OR 97223 L 1 .5 — O D �J /:'".A-.•114,',110. „ Plan Review Phone: 503.639.4171 Fax. 503.598. 1 ' � Date/B : Omer Permit: Inspection Line: 503.639.4175 U I 1 3 2005 _ .: •i Date Ready/By: Jos. El See Page 2 for Internet: www.ci.tigard.or.us Notified/Me�thod: Supplementallnformadon tl % '' i } �y 't ^` r s1' y '".� vtg l 11 L> } ��'t :4 T 'Ji vt F .h.� K, - '%.S.47e L: 51 't` f i'" rr • w +4 ,'veld ":4' :' ' "•' .1 r1 4 :t 1.- • �.. e.:.ia =2 F. � X11 < .? 2 ,1.'i I1y.J�",1._` _'yir" fu8j 1 1 ` ' . , New construction r • • • Itio • teratio t replacement Please check all that apply: f ❑ Demolition ID Other: OService over 225 amps, comm'l ❑Hazardous location a rer �-c r r t F r Y� , `, .� F a ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., L,�.� .,: : . li , ©� ,1� 14 ,, �fk p,%'�? i v,.ICi of 1- and 2- family dwellings 4 or more new residential ❑ 1- and 2- family dwelling I'I Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ['Building over three stories ❑Feeders, 400 amps or more ❑ Multi family 0 Master builder ❑Other Fa_. ... ;n, z. : Ott �. , ,, ; ,� �{ ❑Occupant load over 99 persons ❑Manufactured structures or r Dr a u � °a � tm 0 1 0 € m r ' E ess/li tin l an RV park _ t 3 l , ._,. ' ,, � ° v, Y:: rw"_A' -t~r�M i6,: �f'..7 ❑ gr 8h g P Job no/454,1A DHealth-care facility ❑Other: �� /ate Job site address16 /a� �'� � N 6 � n� - If , Submit 2 sets of plans with any of the above. City/State/ZIP: / /G Ai J oA q 7,,,1 A 3 The above are not applicable to temporary construction service. ' Suite/bldg. /apt. no �j/ / /��/��/ O ms s S .; . = ' 'e ` „ L.�/� /� // � I � v .J ' • E ;. �? a . �;ia.; G] �1,;�, , i.1 �I� .�? � L�'. , , r - �� Project name: . �.. •` Descripdon Qty. Fee. Total •• Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: I Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 , 1�+ .�- w` *� 'r �a w = ,t ;fie) v� a �x e Limited energy, non - residential 75 00 2 EZ71.+ +..: 6 :rI' - ' ; �,'_ir `'� e 5 �au1d, tt ':.� v [ "'ra ! r Each manufactured or modular 6 u /2 f� �'(�K / n 4 , ` A , ^ �.' 1 1 dwelling, service and/or feeder 90.90 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80 30 2 P � "'3,..w ' a T 1 to m 7 `-" 2.. ' , � [ + c� . — fin 201 a ; rpt - 1 -Ar s. .I � F 1 : y = : ic. '. , .s � ; q •? amps to 400 amps 106.85 2 401 amps to 600 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 66.85 2 City/ State/ZIP: Temporary services or feeders Installation, alteration, and/or Phone: ( ) I Fax: ( ) relocation 200 amps or less 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 1 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel ~ } � f Est ` v 's iWi rti s ; 'f' i , 1 5 `' �.'=T P c{� ` t ` A. Fee for branch circuits with y- x.41:.- �.,,i L,c r_._., :1L 2, � ? �;- �31.1: L:? .: r , service or feeder fee, each Business name: branch circuit 6 65 2 Contact name: B. Fee for branch circuits without service or feeder fee, 46.85 2 Address: each branch circuit - Each add'I branch circuit 6.65 2 City/State/ZIP: Miscellaneous (service or feeder not Included) Pump or irrigation circle 53.40 Phone: 2 ( ) I Fax: ( ) Sign or outline lighting 53.40 2 E-mail: Signal circuit(s) or limited - ' y, . [ �-� s 4�ai' r 4 'k� x7 14 '+xri• 9 1 " "r 0 4 ,d ,� - A ay ,s r ,.r. S . k _3 �t •titi ifi ,x / �;� R C�4 a t � __.��" ::i..N� � -. F', >gi - . , I). i ?.,1 .. energy Panel, alteration, or extension. Describe: I Page 2 15.06 2 Business name: ADT SECURITY SERVICES, INC. Address: 2815 S.W. 153rd DR. Each additional inspection over allowable in any of the above RFAVFRTON, OR 97Q(1R Per inspection 62 50 City/State/ZIP: (503) 469 -7100 Investigation per hour (1 hr thin) 62.50 Phone: ( ) I Fax: ( g -7//O Industrial plant per hour �y� 73.75 1-+(/ Y'f late_ 4_L'7J0. g �4H a ]Iedffill9„, ?r'?3 CCB Lic.: 59 144 I Electrical Lic.: „loci eke ) Suprv. Lic.: g9 LEA Subtotal Suprv. Electrician signature, required: - /' - _. ` Plan review (25% of permit fee) Print name: v l. Date� / a� � State surcharge (8% of permit fee) b. bo / TOTAL PERMIT FEE O i . DO Authorized signature: This permit application expires If a permit is not obtained within 180 days after It has been accepted as complete Print name: Date: • Fee methodology set by Tri -County Building Industry Service Board •• Number of inspections per permit allowed. i'\Buiiding\Pemuts\BLC- PemitApp doc 12/03 440- 4615T(10/02/COM/WEB CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2005 -00343 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/13/2005 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639-4175 WORKSHEET FOR DATE: 10/27/2005 TIME: 7:16AM PAGE: 113 SITE ADD" ESS: 10124 SW WASHINGTON SQUARE RD A-7,8 CLASS OF WORK: SUBDIVI ON: WASHINGTON SQUARE TOO LOT #: 001 TYPE OF USE: PROJECT NA : FED EXIKINKOS DESCRIPTIO . Burglar alarm low voltage. OWNER: HINGTON SQUARE LLC, PHONE #: CONTRACTOR: ADT CURITY SERVICES, INC PHONE #: 503-469-7244 Inspection Request Scheduled Fo • Date: 10/27/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 019429 -01 503-469-7212 N Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 66 Ise /..‘ Date: 1 O Phone #: (503) 718- Lig