Permit 114 v CITY OF TIOAR O 6 L ECTRICAL RESTRICTED ENERGY PERMIT
°' COMMUNITY DEVELOPMENT PERMIT #: ELR2006 - 00268
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/7/2006
PARCEL: 2S 113AC - 00103
SITE ADDRESS: 07216 SW DURHAM RD 200 ZONING: I -
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG
Project Description: Burglar alarm Job No. 18932 - 4
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:
PACIFIC REALTY ASSOCIATES ADT SECURITY SERVICES, INC
15350 SW SEQUOIA PKWY #300 -WMI 2815 SW 153RD DR
PORTLAND, OR 97224 BEAVERTON, OR 97006
Phone: Contact #: PRI 503 469 - 7100
FAX 503 469 - 7110
FEES Reg #: ELE 26- 209CLE
LIC 59944
Description Date Amount
[ELPRMT] ELR Permit 11/7/2006 $75.00
[TAX] 8% State Surchar€ 11/7/2006 $6.00 REQUIRED ITEMS AND REPORTS
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 t 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 99 or 1. 0.33 344.
Issue By: k ` ' / Permittee Signatur� 0'12 �; ni / ,-
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.
Nov 07 06 10:58a Stephanie Pate 503.469 p.1
. ' Electrical Permit Application FOR OFFICE USE ONLY
City of 'I<'R arfi
,A �. Received h/
06 Direai : // 7. xq , Pcnmt N(,• gL�pOG -(70 v?lv�_
13125 SW I loll Blvd., Tigard, OR � I'41n Review I}rrr.;ly:
Phone: 503,639.417! Pax: 503.5')8.1 OOO Other PCrrtlPermit ry � _
Inspection Line: 503.639.417 I 2 0 � ► -'�'� Dame Ite;al . ley; !�n 14 See Page 2 fur
Internet: wv.w•ei,tigard.or.us OfIIGA 1Vutific 'Madr>l �f ' Nu pplcmena111hfermalion
.. : A ' I '' - ' ' IC. PLAN' REVIEW
❑ New construction Yj Addition /alteration/replacement P1c:1Se cheek all that apply:
llettlolition Other: i ❑Sersice over 225 Amps, comm'l ❑hazardous location
['Service over 32(1 amps •• rating ❑Buildn over 10,000 so. ft.•
CATEGORY :O. :• :CONSTRUCTION . • .,:.`•; • •.. of I - and 2 - funny dwellings 4 or morencW residential
0 I - and 2- family dwelling g Cornmeroial /indutttrial 0 Accessory building ❑SY:item over 600 volts nominal units in ono structure
CI Multi I:Imily ❑ Master builder 0 Other; ❑l3uihlmg ova three stories ['Feeders. 400 amps or more
JOB •ti17 INFORMATION AND LOCATION ❑Occupant load ova 59 persons ['Manufactured structures or
•
Q�7 a ❑F.l +rt :satlightittg plan RV park
J ob n /�' 93 .. Job site address: � ❑1l :atilt -cttto facility DOktvr
� / r ' s� �xf Submit 2 KIN Of plans with any o f the above.
City/Slaw/ZIP: - / 7� 4a i ne ?7a.2 The above arc not applicable to temporary construction Service.
J
Suite /bldg. /:rpt, no, :7f�Dd Project name. f z = FEE* SCIi1 Utq,F, ..
Dencripnoo Oh. Fee, A nna
Cross street/directions to job site. Now residential single- or multi - family dwelling unit.
Includes attached 1414rsgc.
I .I!00 sd. ft. or Tess I t45.15
-
Subdivision Lut no.: Gat. add'1 Sa{► , L. sir portion 33,4C , 4
- T - 1
Tax lrlap /parcc } no,: - f Limited energy, residential 75.00 , 2
- I Limited energy, non - residential I 75.00 I 2
--" DESCRIPTION.
� » OF • 'WORl ..,_1 �
". la h manufactured or modular
iL � i ! / 7 dwelling, service :utcVor feeder _ 90.90 2
/� L ' _ Services or feeders installation, Alteration, and/or relocation
I 200 amens or less V • 80,30
•
Q PROPERTY OWNER + • : • " L ❑ TENANT - . 201 amps to 400 amps 106.05 2
40 I. amp;sto6(1():imps IG O.(�0 2
— - Name: J
_ 601 amps to 1.000 amps , 240,60 I 7 M
Address: Over 1,000 amps or volts 454.65 2
-Y
Reconnect only
t~ity /SSatc /LIP: Temporary Temporary services or feeders installation, f ti alteration, artd.or 2
Phone: ( - � y )
-
Fax: ( ) relocation
700 amps or less 65,85 III
Owner installation: This installation is being made on property that I own which is not 201 snips to 40o amps )00.30
intended for sale, lease, rent, or exchange, according t1 ORS 447. 449, 670, and 701.
' 401 amps to title) amps 133.75
Owner signature: Date. ' . Branch circuits - new, liberation. or extension, per panel `
•
El APPt.I(:i1,N•I' .. I. CONTACT PER i ,.: A. a !sir branch circuits with
service or 1coder fee. each 2
Business name;
_ branch circuit _ 6.65
B. Fee for branch cireuits
Cont -. name: j ,. .'ltirou! service or ti><aiu' tic,
Address: first bran circ `'G• 2
_ _
Full add'1 branch circuit I 6.65
City /StateZIP: Miscellaneous (service or fee not included)
Phone: ���� r 1 ( ) Pump or irrigation circle I 53.40 � 2
c -p3) 5 7 7 Kix:: -
E -mail:
Sign or outline lighting 53.40 2
I Signal circuits) Or limited -
CONTRACTOR .. energy panel, ahtrttion, ev / _ oc
Business mime: AO'f Security Services • CJiltSls Describe. / Ir:tgc2 2
•
Address; 2815 SW I53 "' Dr, E�nddition:rt inspection O'tr allowable in any of the abuvt
Per inspection 62.5
City /State /Z1P: Beaverton OR 97006 I
_ InvoilisraUOn per hour (I le nun) , 62.50
Phone: (503) 469 -7100 I, Fox: (503) 469 - 7114 Industrial td ;rot per hour I _ 71,75 I
• ' 1LLG.CTRI<.:Al, PERMIT Flil;'S" • .
CCB Lic.. 59944 Electrical Lic.: 26- 209CLE Suprv. Lie.: I_EA389 " -
Stibtotia
Suprv. Electrician signature. required: ,( �`
�� Plan review (25% of permit fco)
- Print name: A--2_- 4 Date:: /r -7 e.. Slate v;;lt,'tft;c(311 or permit fee) S. 0°
� un TOTAL PERMIT FEE gt o
Authorized signature: r
/ %�"��(/r "l'hiN Permit application expires I u permit is nut obtained within ISO
— day's after it has been aCCrptrd AS Complete
Print name; N 4rA (Jr Date + Fe e Metlufdnlnty sat by Tri- Comity ftinkling Industry Service Itoprtl
/ •- t' umb.:i or,IL'prclrrm: per permit snowed 1. ltlme`.Yon. tto I2.93 ( \ / // / �/ . I. ' - k. 11
Dec 11 06 09:17a Stephanie Pate __
503469 p.1
Building Division
` ` v Request for Permit Action or Refund; °R' ..t °
1 Ci _ of Tigard l
TO: CITY OF TIGARD DEC 1 1 2006
CITY Permit System Administrator 111 Y iy�
13125 SW Hall Blvd., Tigard, OR 97223
Phone: ������
Phone: 503.718.2430 Fax: 503.598.1960
FROM: I I Owner ❑ Applicant ® Contractor 0 City Staff
(check one)
Name: ADT Security Services
(Business or individual) _ V .-. 1 D Mailing Address : 2815 SW 153 =d Dr
/02./ 6 Ci ty /StateiZip: Beaverton OR 97006 -
Phone No.: 503- 469 -7100
•
PLEASE TAKE ACTION FOR THE ITEMS) CHECIap (+r):
® CANCEL PERMIT APPLICATION. a -4 ,7,, //e/f.,,2ciot ® REFUND PERMIT FEES.
❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit). s � ax 6, te y 9
Pomit #:
eZ e 0.20 [ p - Oo2 6e .5e6 wk
Site Address or Parcel #: D 74,2 /6 , ,e( gy)..x- g°( a) _.
Proj ect Name:
-
Subdivision Name: _ Lot #:
EXP ANATION: C -, Y -16 "`
/ .of t6_____ 7 r.• . - _
6
sip nturc: Z7 � -� Date: /c
Stephanie Pate 5 -0�' 969_ 7‘y,.
Print Name: _
, • nd Polia
i. Mc Building Official may authorize the refund of:
a) any fee which was ‘ r roncottsly paid or collected.
b) not rttorc than 80 percent of the palnit lee for issued permits prior to any incpation requests,
el not more than 80 perc nt of plan review fw when an application is canceled before any plun review effort has been expended.
2. Refunds will be returned to the original Payer in the same method in which payment was received.
FOR OFFICE USE ONLY
Ric to S,n Admin: D e ' -/) - 7 Bype L Rte to 131de Admin: Date / / //,/ By -i �
Rts
end Processed: Date , By Invoice Processed: Date 7 B y
Permit Canceled: Date By 'T/24.4 Parcel Ta Added: Date By
//
Receipt #4,55p1. Date p& Method s7 Amount S F"/.
l:\ BuildingWonnsltegPemtitAelion- dg.duo Rev 10/17/05 25, al �� . kO epQ ,_- 6e , Gry --4pNij