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CITY OF TIGARD ELECTRICAL. PERMIT -
RE5TRICTED ENERGY
F #: ELR96-0197
::OMMUNITY DEVELOPMENT PERMIT HATE issuEn: 06/11/96
13125 SW Hall Blvd.T;gerd,Ornyon 97223.8190 (503)839-4171
PARCEL: IS135DC-00200
1 TE ADDRESS. . . ,. 11825 SW GREENBURG RD #1-C:
SUPDIVISION. . . . : ZONING:C-P
BLOCI•S. . . . . . . . . . . 1-01.. . . . . . . . . . . . . :
Project Description:
A. RESIDE.NTIAL_.__.______ B. COMMERCINL--_______.____.____._____________.__.__ +.._.v
AUDIO & STEREO. . . a AUDIO & STEREO. . : INTERCOM & PAGING. . :
BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. . :
GARAGEOFTENER. . . . : CLOCK. . . . . . . . . , . . MEDICAL. . . . . . . . . . . . r
HVAC. . . . . . . . . . . . . : DATA/TELE COMM. . . NURSE CALLS. . . . . . . . .
VACUUM SYSTEM. . . . a FIRE ALARM. . . . . . : OUTDOOR I_ANDSC LITEa
OTHERS a : HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . :X
INSTRUMENTATION. : OTHER— : : a
T01"AL t OF SYSTEMS: 1
01.,ner: ---------------•---•- ------------------------------------ FEES
CAREER OPPPRTUNITIFS LTD type amount by date recpt
11825 5W GREENBURG RD PRM"I• $ 40. 00 CJS 06/11/96 96-280478
SUITE #1-C 5PCT $ 2. 00 CJS 06/11/96 96-280478
TIGARD OR 9722.3
Phone #:
Contractor:
PDT SECURITY ALARMS s 4;'-:,, 00 'TOTAL
703 NE. HANCOCK
REQUIRED INSPECTIONS
PORTLAND OR 97212 Wall Cover Elect' l Final
Phone fit: 503-284-3265 Elect' 1 Service
Reg #. . : 39944
This permit is issued subject to the regulations contained in the _ _
Tigard Municipal Code, State of Ore. Specialty Codes and all other Fler__.mi.tee Signat�.rre
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started rL -
within 188 days of issuance, or if work is suspended for more C..�C x J5t':Am Ld1-
than AS days, Issued By
INSTALLATION
The installation is being made on property I own which is not intended for
sale, lease, or rent.
OWNER' S SIGNATURES
DATES
--__----CONT RAC;TUR INSTALLATION ONLY-- ------- --
SIGNATURE OF SUPR. ELE:C' N: 00 _ jD P1�c�t�.nDATE:
LICENSE NO: !7
Call fir inspection - 639-4175
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard,OR 97223 I,LRMI I # jF4&96= 7--- — ----- --- —
Phone(503)639-4171
FAX(503)684-7297 DATE ISSUED �- // - �L.
--------------- -------
TDD No. (503)684-2772
CITY OF TIGARD Inspection (503) 639-4175 ISSUED BYL
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF NSTALPATION 1 4. TYPE OF WORK
� - � i c��-
Addr RESIDENTIAL---Restricted Energy Fee . . . . . . . . . 440.00
�,i •3 (FOR ALL SYSTEMS)
City g State Zip Checker oe of Work Involved:
PERMITS ARE NON-TRANSfLRARLE AND NON-REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems
IS NOT STARTED WITHIN 180 DAYS Of 116UANCE OR If WORK IS SUSPENDED FOR
180I)AYS ❑ Burglar Alarm
2. CONTRACTOR APPLICATION ED Garage Door Opener'
❑ Heating,Ventilation and Air Conditioning System'
Contractor__SD1 SECtIR(TY SYSTEMS.INGI ype Vacuum Systems"
703 NE HANCOCK ❑ Other
Address MRTtAND,OR 91212 --
Date -�� COMMERCIAL—Fee for each system . . . . . . . . . S40.00
(SEE OAR 918-260-260)
Property Owner. 1 �� k Tv„ne of Wurk Involved:
C.'CL ❑ Audio and Stereo Systems
Contractor's Board Reg. No.
❑ Boiler Controls
Phone# -- ---....__ ❑ Clock Systems
❑ Data Telecommunication Installations
3. OWNER APPLICATION nn �} 7 ❑ fire Alarm Installation
,tl�,,L �a?� — /rte" ❑ HVAC
Print Owner's Name Phone No ❑ Instrumentation
Address Q Intercom and Paging Systems
❑ Landscape Irrigation Control'
City State Zip ❑ Medica'
This permit Is issued under OAR 918.320•370,This applicant agrees to make only ❑ Nurse Calls
restricted energy installations 11(x1 volt amps or less)under this permit and to do the ❑ Outdoor Landscape Lighting'
followingprotective Signaling
1. Only use electrical licensed persons to do installations where required.(Certain /
residenlial anti other transactions are exempt from licensing.There have ❑ Other-_
asterisksl•).All nihms need licensing).
2. Call for an inspciunn when all of the install:tions under this permit are ready
for inspection at 503(,.19.4175. [] Number of Systems
1. Purchase separate pk for all installations that are not ready for inspection
when the inspector is Inspect under this permit. •No licenses are required. Licenses are required for all other 6rstallations.
4 Assume responsibility for assuring that all corrections required by the inspector
are done,and
5. Assume responsibility for calling fer a final inspection when all of the 5. FEES
corrections are complet . !, r
The•person sign! f this permit must he the applicant or a person a. Enter Fees $ L��)
authorized to h c applicant.pP b. 5% Surcharge(.05 x total above) $ C7
Sig ure TOTAL
Authority if other than applicant
ENERGAP.CHP
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST
BLIP
31 mate Requested_---,?--2— ___AM_— PM _ BLD '
Location � L1.,�,�. �r'� _ --- Suite MEC --------
Contact Person —_ — P'1 .�1� PLM -------- -
Contractor -„e�. j�,�1�— _ Ph � .��,5%f SWR
BUILDING — Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain —
Crawl Drain Inspection Notes: SGN —
Sla ----- - - --- ---- SIT
Post& Beam --`---- - --
Ext Sheath/hear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
-------- -------------------
Fire Sprinkler
Fire Alarm -- - ---- -- - - -- __
Susp'd Ceiling
Roof —
Misc:_ _..---- ----- — - --
Final
PASS PART FAIL ----------------___._-.-----
PLUMBING
Post& Beam -------------- --------
Under Slab
Top Out ------- --------_____�
Water Service
Sanitary Sewer -`
Rain Drairs
Final -- ----- ___ -
PASS PART FAIL
MECHANICAL ---- -
Post& Beam
Rough In
Gas Line - ----- ------
Smoke Dampers
Final ---- - - --
PA FAIL
L CT ICAL ---
forvier-�
Rough In
ir
oltR,ge-erm _-
F inal
PAS`; PART FAIT_
SITE
Backfill/Grading -- - ----- - - -- - -'—
Sanitary Sewer
Storm Drain I J Reinspection fee of$_-___ ,_ _required before next inspection Pay at City Hall, 13125 SW Hall Blvd
BasiB
Catch n
Fire h Basipply Line [ J Please call for reinspection RE __- ( J Unable to inspect-no access
ADA -�
Approach/Sidewalk pat`' b i Inspector_-_ �- -t�_ 4 l Ext
Other - — - - -
Final -
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
— ^— FLECTRICALPERMIT-
CITY OF TIGARD
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2000-002.72
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 119/00
PARCEL: 1 S135DC-00200
SITE ADDRESS: 11825 SW GREENBURG RD 1-A
SUBDIVISION: ZONING: C P
BLOCK: LOT: JURISDICTION: TIG
Proiect Descriution: Burglar Alarm
A.RESIDENTIAL B.COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARRI: X BOILER: LANDSCAPEIIRRIGA.T:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDS,C LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL#OF SYSTEMS:
Owner: � Contractor:
NIC;OLAISEN, JAMES E + ADT SECURITY SER/ICES, INC
DAVIS, MIRIAM G TR 2815 SW 153RD DR
1440 SW TAYLOR BEAVERTON, OR 97006
PORTLAND, OR 97205
Phone. Phone: 503469-7100
Reg #.: LIC 0059944
ELE 26-209CLE
FEES _ Required Inspections
'Type By Date Amount Receipt _ Elect'I Final
PRMT CTR 11/9/00 $15.00 2720000000
5PCT CTR 11/9/00 $600 2720060000
Total $81.00
r _ L
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. Oregor 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 obtai.,copies of these rules or direct questions to OUNC at (503)
246-1987.
Issued by �J2"r� _ _ Permittee Signature�L�
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE _ _ i DATE:-------.
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N _ ^_ ^_ _ DATE:------
LICENSE
ATE:__ __LICENSE NO: --
Call 639-4175 by 7:00 P.M.for an Inspection needed the next business day
Electrical Permit Application
RECFty Pate received: Permitno.: 1,„a Oo �72-
City of Tigard Project/appl.no.: Expiredatc: `
City ofTigord Address: 13125 SIN liall Maud,Tigard,OR 97-2 3 _v. --- p
OjE�Iest,ed: B I-Ltec-ei tno
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.. Payment type:
COMMUNIIr u,
Land use approval:
TYPE 1 ,
U I &2 family dwelling or accessory U Commercial/indusnial U Multi-family U Tenant inlprovcOn'nl
U New construction U Add ition/al leration/re placemetit U Other: U Partial
JOB SITE INFORMATION-
Job
' 1Job address:I - Or 111:If. nit Suitt no.: Tax map/tax lot/account no.:
Lot: I Block: ISijbdivision: ____ •--���-
Pmject name: / r I Description and location of work on pren►ises: &L 4&L
Estimated date of completion/inspection:
SCHEDULECONTRU7014 APPLICATION FEE
job - r - Dcseriprkrn ry. (c'a) rulal non.tI
nsp
Business name: Y perewresenA -single ormuay
-I}=
Address: ) n 1 . rinellingun)LIncludes attached garage.
City: t;Y state: ' ; zIP — service included:
Phone: l Fax �f/ + E-mail: 1000 sq n nr Ic,,
Each additional 507 sq.ft.or portion thereof
CCB no.: f. - - Elec.bus.lic.no:
Limited energy,residential 2
City/metro lic.no.: Limited energy,roan-residential 2
Each manufactured home or r.wduiardwelling
Signature of lupery s ng a betrician(requir Irate Service and/or feeder __
Sup.elect.narru(print) License no: Services or feeders-W!Allatlon,
alteration or relocation:
PROPERTY OWNER 200 snips or less 2
Name(print): 201 amps to 400 amps 2
_ 401 amps to 600 amps 2
Mailing address: _ 601 amps to 1000 amps 2
City: ~- Slate: ZIP' Over 1000 amps or volts 2
Phone: Fax Email: Rcconnectonly I
Owner installation:The installation is being made on property I own 'Ientporary services or feeders-
which is not intended for sale,lease,rent,or exchange according,to
Installatior.,alteration,or relocation:
21 amps or less 2
ORS 447,455,479,670,701. 0 _ _
201 amps to 400 amps 2
Owner's si nature: Date: 401 to 600 ams 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-- —` - [State. ZIP - B Fee for branch circuits without pt:rchase
- -- -- of service or feeder fee,first branch circuit: 2
Plume: Bach additional branch circuit.
PLAN REVIEW(Please check all that apply).- Misr.(.Service or feeder not included).
U S ivitt met 22 m p,-inmvi,ial _j health"m to,dim F&ch pump or irrigation circle - 2
U Service over 320 amps-rating of 1&2 U liar rdous location Each sign or outline lighting 2
famllydwellings U Buildingover 10,00(1 square feet fournr Signal circuit(s)or a limited energy panel Cr
U Sy.tem over600 volts nominal mme residential units in one structure alteration,or extension* 2
U Buil ling over three stories U Feeders,400 amps or more •Descrition: _ -
U Occupant load over 99 persons U Manufactured structures or RV park Itch additional Inspection over the allonable In any of the alcove:
U Egressflightingplan U Other _- Per inspection _ -
Submit %etc of plans with any or the above. Investigation fee _
'lire above are not applicable to temporary construction service. Other —
Permit fee_...................$ �D
Nat ail Jurisdiction,accept creat cards,pleaw call jurisdiction for more information. Notice:This permit application
U Visa U MasterCard expires if a permit is not obtained Plan review(at _` %) $ _
Credit card numbs __ _ - -- - /-1-- within 190 days after it has been State surcharge(8%)....$
card
r•.,pires acc.pted as complete,
TOTAL .......................$
i Name of cardholder i,ihown one t s
-- --— Cardholder sianature Amount 4404615(NDWOM)
Electrical Permit Fees: Limited Energy Fees:
_. TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below:P Restricted Energy Fee........................ ........ $75.00
Number of Inspections per permit allowed
(FOR ALL SYSTEMS)
Service included: Items Co-,t Total
Check Type of Work Involved:
Residential-per unit
1000 sq it or less $14r,15 4 ❑ Audio and Stereo Systems
Each additional 500 sq it or
portion thereof _ $3340 1 ❑ Burglar Alarm
l-imited Energy $75.00
Each Manufd Home or Modular F]Dwelling Service or Feeder $9090 Garage Door Opener'
Services or Feeders U Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less $80.30 2
201 amps to 400 amps $106.85 2 Vacuum Systems'
401 amps to 600 amps $160.60 2 U601 amps to 1000 amps $240.60 2 Other
Over 1000 amps or volts $454.65 2 - -
Reconnect only $66.85 2
Temporary Services orFeeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
installation,aiieratiurr,ur rolwaiion
200 amps or less $6685 2 Fee for each system.............................. ........................ . $7500
201 amps to 400 amps $100.30 _ 2 (SEE OAR 918-260-260)
401 amps to 600 amps $133 75 i _ 2
Over 600 amps to 1000 volts, Check Type of Work Involved:
see"b"above.
❑ Audiu and Stereo Systems
Branch Circuits
New,alteration or extension per panel ❑
a)1lie fee for branch circuits Boller Controls
with purchase of service or
feeder fee. ❑ Clock Systems
Each branch circrit $665 _ 7
b) [tie tee for branch circuits _ ❑ Data Telecommunication Installation
w1thoul purchase of service
or feeder fee. ❑ Fire Alarm Installation
First branch circuit $46.85
Each additional branch circuit $6.65 _ ❑
HVAC
Miscellaneous
(Service or feeder no'included) ❑ Instrumentation
Each pump or Irrigation circle $53.40
Each sign or outline lighting _ $53.40 ❑
Signal circuit(s)or a limited energy Intercom and Paging Systems
panel alteration or extension $75.00
Minor Labels(10) $125.00 ❑ Landscape Irrigation Control'
Each additional Inspection over ❑ Medical
the allowable In any of the above
Per Inspection _ $62.50Nurse Cells
_ ❑
Per hour $6250 `
In Plant $73,75
Outdoor Landscape I_Ighting'
Fees:
❑ Protective Signaling
Enter total of above fees $
----- ❑ --- ----
8%Slate Surcharge $ Other_ _
25%Plar,Review Fee --Number of Systems
See`Pian Review"section on $
frord of application ,T No licenses are required Licenses are required for all other installations
Tota I Balance Due Fees:
El Trust Account# Enter total of above fees $_ _
8%Stale Surcharge $_ -
Total Balance Due $
i\dsts\fmrms\elc•fecs doc 10109/00
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-hour Inspection Line: 639-4175 Business Line: 639-4171 ----- ----
BUP
_Date Requested_ -- Zo _ AM� PM BLD ----- -__ ---
Location_ iI�Z —S�� �-j'��^ � — _ Suite A — MEC
Contact Person _ _ Ph PLM
Contractor — i `— V Ph SWR -
BUILDING Tenant/OwnerELC
Retaining Wall -- — FLRv-c, 2
Footing
Access
Foundation FPS
Fig Dain SGN
Crawl Drain Inspection Notes: ,: ---- ---
Slab& Beam —�C /Lam_ --- --------- SIT ------- --
Ext Sheath/Shear
Int Sheath/Shear -^--�—�-------
F-raming -
Insulation
Drywall Nailing
Firewall - -- ---
Fire Sprinkler
Fire Alarm
Susp'd Ceiling --
Roof
Misc -- -- -- )
Final
PASS PART FAIL _
PLUMBING
Post& Beam `--- ---
Urder Slab
Top Out -- ---
Water Service
Sanitary Sewer � --- --- '------ _-LL}
Rain Drains
Final --
PASS PART FAIL _
MECHANICAL.
Post& Beam --- - ---- -------
Rough in
Gas Line --- ---- - -- ..----- ---
Smoke Dampers
Final --- - -- -
P T FAIL
F1 Ef
Service _
Rough In
UG/Slab
Low Voltage
larm
F
SS_, PART FAIL
Backfill/Grading -.-� -- -- -- `—'---- ---- ---�--
Sanitary Sewer
Storm Drain I Reinspection fee of$ _required before next inspection. Pay at City Hall, 13128 SW Mall Blvd
Catch Basin I ]Please call for reinspection RE: 1-?Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk /
Other Date Inspector—__ Ext
Final �_-
PASS PART —FAIL 00 NOT REMOVE this inspection record firom the job site.