7319 SW KABLE LANE STE 500 a w
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7319 SW KABLE LANE
"'SUITE 500
CITY OF TI GA ''D ELECTRICAL ENER -
� RESTRICTEDENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2001-00110
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 04/13/2001
SITE ADDRESS: 07319 SW KABI_E LN 500 PARCEL: 2S112AC-01500
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I-L
BLOCK: LOT: 022 JURISDICTION: TIG
Nroiect Description: Installation of protective signaling, CCT✓and Card Access.
Job#083-13353-01102103.
A.RESIDENTIAL _ B.COMMERCIAL _
AUDIO & STEREO: AUDIO& STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT-
GARAGE OPENER: CLOG(: MEDICAL:
HVAC: DATA/TELE COMM: NUk-SE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR 1.AN'JSC OTE:
OTHER: HVAC: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER: X
TOTAL#OF SYSTEMS: 3
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: Phone: 503-469-7244
Reg #: LIC 59944
ELE 26-209CLE
_ FEES required Inspection;:
Type By Date Amount Receipt Low Voltage Inspection
PRtv1T CTR 04/13/2001 $225.00 2720010000 Elect'I Final
5PC1 CTR 04/13/2001 $18.00 2720010000
Total $243.00
III
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is Suspended for more than 180 days. ATTENTION Oregon law
requires you to follow rules adopted by thp Oregon Utility Notification Center. Those rules are set forth in OAP
952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246-1987 0.11`2 l
Issued by 1� &. �; _ permittee Signature n.)1.1� i
OWNER INSTALLATION ONLY
TN, installation is being made on property I own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: DATE:
COMTRACTOR INSTALLATION ONLY
SIGNATURE OF SIJPR. FLEC'N DATE: _
LICENSE NO:
Call 639-4175 by 7:00 P.M. for an inspection needed the next bi,siness day
Electrical Permit Application
Catereceived:r- L 0 Permit no.�2X�6)6)1
City of Tigard Project/appl.no.: i:.xpiredate:
Cirvof7igard Address: 13125 SW Hall Ilivd,Tig:ud,OR 97223 pate issued: By: Receipt no.:
I'M0 y"(503) 639-4171 ^ --
i� Fax: (503) 598-1960 Case tileno.: Fayrnenttype:
c� l aA use approval:
t
U I &2 family dwelling or accesson• �ommercial/industrial U Mulli-faintly U"Tenant improvement
J New construction U Additit n/alteration/rehlarrmrnt LJ Other:. U Partial
JOB SITFJINFORMATION
Joh address:' 73 R Bldg.no.: Suite map/tax lot/account no.: _—
Lot: illoc Isubdivisiow _
Project namcV _ I Description and location of work on premises:
Estimated date of completion/inspection: t,
i
Job no: Z- o1bt�Gr1 1 gee Max
Business name: u�� `�� n�� --_—--— Description tpy. (ea) T,rtal nu.htsp
— Nevv residential-single o:multi-Inmily per
Address: 'w•T 53— r. dwellingunit.locludcsattnrlrcd, mage.
City: Beaverton. Ofat ($IP: — Service included:
Phone: - i;ax: (� - E-mail: l(NlOsq frwless _ - -�--
Each additional 500 sq.ft.or po, h thereof
CCB no.: ,-q Elec,bIIS.IIs.no: Limited energy,reside-itial 2
r-i / eUo lic.n Limited energy,non residential 2
Each manufacturrJ home or modular dwelling,
r ure f31i rvtsin electnciaR(re uirrj) Datc Service and/orF:eder 2
Sup.elect.name(print) (�` License ta, _ - Services orf eders-Installation,
alteration of relocatiun:
200 amps or less _ 2
Name(print): 201 amps to 400 amps 2
- - 401 amps to 6(x)amps 2
Mailing address: - - - _-- 601 amps to 1000 amps
City: Slate: LIP: Ovcr IOW amps or volts 2-
Phone: I E-mail: Reconneclonl -- - I
Owner installation:The installation is being made on property I own aemporary services orfeeders-
which is not intended for sale,lease,rent,or exchange according to installation,alteratiagorrelocation:
ORS 447,455,479,670,701. 200 amps or less -
201 amps to 400 amus 2
Owner's si nature: Date: _ 401 to 600 amps -- _— 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: 7.1P: B. Fee for branch rircuits without purchase
- of service or feeder fee,first branch circuit: 2
Phone f:tx: h-mai!: - - --
::ash additional branch circuit
Misc.(Service or feeder not Included):
•Service over 225 amps-couunwciA U I1,;dth care facility Each pump or irrigation circle
•Sen+ceover 320 amps-rating oft&2 Ll llazaiduusiocation Each signor outline lighting _2
family dwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel. —
U System over 600 volts nominal more residential units to one structure alteration,or extension* _ ^ _ 2
U Building over three stories O Feeders,400 amps or mote *Description:
U Occupant load over 99 persons O Manufactured structures or RV park Flach additional Inspection over the allonnhle In any of the above:
U Egress/lighthlgplan U Other -- Per inspection —T----
- l
Submit—_sMs of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. other
Not all jurisdictions accept credit cards,please call)uc diction for in--r information. Notice:This permit application Permit fee.....................$
O Visa b 44ssterCard expires if a permit is not obtained Plan review(at __ `9n) $ —
Ctedit card nurnber: _ within 180 days after it has been Slate surcharge(8%)....$ � /S
xpirer accepted as complete. TOTAL .......................$
Name o/cardholder ex shown an c it c Js
Cardholder sidnatute - Amount 4404615(6MWOM)
i
Electrical Permit Fees: Limited Energy Fees:
TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee...................................................... $75.00
Number of Inspections per permit allowed) (FOR ALL SYSTEMS)
Service included: Items Cost Total y Check Type of Work Involved:
Residential-,per unit
1000 sq ft or less $145.15 4 ❑ Audio and Stereo Systems
11 Each additional 500 sq it or
portion thereof _ $33.40 1 ❑ Burglar Alarm
Limited Energy $7500 — —`
Each Manufd Home or Modular ❑ Garage Door Opener`
L elling Service or Feeder $9090 _ 2
Services or Feeders u Healing,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less —_ $80.30r
201 amps to 400 amps $10685 _ 2 L Vacuum Systems'
401 amps to 600 amps $16060 2
— -----
601 amps l0 1000 amps $740.60 _ 2
Over 1000 amps ,r volts _ _ $454 65 ____ 2 -- --- - --- --
Reconnect only —� $66.85 -_ —_ 2
temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation,alteration,or relocation
200 amps or less $66.8: 2 Fee for each system.......................................................... $75.00
201 amps to 400 amps ,—_ $100.30 2 (SEE OAR 918.260-260)
401 amps to 600 amps $133.75
`— -
Over 600 amps l0 1000 vette, CheckType of Work Involved:
sh Circuityee"b"above.
❑ Audio and Stereo Systems
Branc
New,aire..ar ^or extension per panel
a)The fee for branch circuits Boller Controls
with purchase of service or
feeder lee. L� Clock Systems
Eact. ranch circuit $6.65
b)The fee for branch circuits — �— ❑ Data Telecom munI.,ation Installation
without purchase of servlet.
or feeder foe. ❑ Fire Alarm Installation
First branch circuit
Each additional branch circuit ---- $665 L
HVAC
Miscellaneous
(Service o-feeder not included) C� Instrumentation
Each pump or irrigation circle - $53.40
Each sign or outline lighting $53.40 _ l� Intercom and Paging Systems
Signal circult(s)or a.limited energy
panel,alteration or extension __ $75.00 _
Minor Label;(10) —_� $125.00 — ❑ Landscape Irrigation Control'
Each additional Inspection over Medical
the allowable in any of the above
°er inspecti,m $62.50 _. ❑
Per hoar ---- $6250
1 Nurse Calls
In Plant - --- $73 75--- ❑
Outdoor Landscape Lighting`
Fees:
X--?�Pfotective Signaling
Enter total of above fees $
--------_ ❑,/ Other��1� 5��t;'�r� v(-„1-------
8%State Surcharge $ —
25%Plan Review Fee Number of Systems
See"Plan Review'section nn $
front of application No licenses are required. Licenses aro required for all other Installations
Total Balance Due $ Fees:
Enter total of above fees >k �
CJ Trust Account# _ i�
- vv
8%State Surcharge $
nZl
Tofil Balance Due
i:ldstslfomts\elc fees.doc I0/09100
OF TIGARD BUILDING INSPECTION DIVISION TMST
24-Hour Inspection Line: 639-4175 Busii,ess Line: Ki9-4171 --
BUP
— —Date Requested_ �� AM _PM _ BLD
Location—. � c �i SuiteM C -
Contact Person --,— ���'' `'''= Ph _ PLM _
Contractor — l� T _— - _ Ph — SWR __-
BUILDING Tenant/Owner Eb -
Retaining Wall — ELR -�Cin -d U
Footing Access:
Foundation EPS _
Ftq Drain SGN
Crawl Drain Inspection Notes: -
Slab -- ----- --- --- --- --- - ---- --- SIT
Post& Beam
Ext Sheath/Shear
Int Sheath/Shear -
Framing ----._.-
InsulationDrywall Nailing -
r-,-ewall
Fire Sprinkler _.-_--
Fire A.,irm
Susp'd C,9iiing _---------_-- - --- -----------
Roof
Misc --- ----- - -------- ----- --- --- - --
Final -----J -
PASS PART FAIL ------- - -----_-�___._____ - ----._ _ -----__�.
PLUMBING
Post& Beam ---- --�-
Under Slab
Top Ou,
Water Service
Sanitary Sewer ----- -- -�------ -- - - -- ---�--
Rair Drains
Final --
PASS_ PART FAIL.
MECHANICAL - - ----_�__--__�v_ -- _-- -- -- --
Post& Beam
Rough
�- ------------ -- -----. - -._--_-
Rough In
Gas Line - ----- - --�
Smoke hampers IZ7
Final ----- - -- -(:ftfft=MLT FAIL,
ELECTRICA ----- ---- - -- — ----
Rough In
UG/Slab
Low Voltage
Fire Alarm
PAIS RT FAIL - _ -_-- -_-__ ---
Backfill/Grading - ------ ----- -- - - -------
Sanitary Sewer
Storm Drain [ ] Reinspection fee of$ _ required before next inspectio Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for re nUnable to insspection RE _- _-_ __ [ J pect- no access
ADA
Approach/Sidewalk Date ZInspecJ. EXtOther ��— -
Final
PASS PART FAIL 00 NOT REMOVE this inspection record from the job site.
CITY OF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd.,Tigard,OR 97223(503)639.4171 ELECFRICAL PERMIT
RESTRICTED ENERGY
PERMIT #: EL-R98-0275
DATE ISSUED: 09/2'9/98
PARCEL: 2SI12AC--01000
SITE ADDRESS. . . :07319 SW KABLE LN #500
SUBDIVISION. . . . : ZONING: I-L
Bl._.00K. . . . . . . . . . : LOT. . . . . . . . . . . . . JURISDICTN: TIG
Project Description : Data telecaBounicat ions system
A. RESIDEN-rint----------- B.
AUDIO & STEREO. . . : AUDIO & STEREO. . , INTERCOM & PAGING_ :
BURGLAR ALARM. . . . : BOILER. . . . . . . . . . .. LANDSCAPE/IRRIGAl'. . :
GARAGE OPENER. . . . : CLOCK. . . . . . . . . . . : ME D I CAL... . . . . . . . . . . . .
HVAC. . . . . . . . . . . . . . DATA/TELE COMM. . : X NURSE CALLS. . . . . . . . :
VACUUM SYSTEM. . . . - FIRE FiLARM. . . . . . : OUTDOOR LANDSC LITE -
OTHER: HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . -
INSTRUMENTATION. : OTHER. . :
TOTAL # OF SYSTEMS: I
Owner: FEES
AMERI SERVE type amount by date recpt
731.9 SW KABLE LANE PRMT $ 40. 00 B 09/29/98 98-309585
TIGARD OR 97224 SPOT $ fi0 B 09/29/98 98--309585
Phone #: 800-737-4423
Contractor:
$ 42. 00 TOTAI
REQUIRED INSPECTIONS ------
Ceiling Cover Low Voltage Insp
Phone #: W'-J. 1 Cover Elect' 1. Final
Reg #. . :
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore, 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 rule adopted by the
Oregon Litilit yNot fication Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of
these rules or J ct lie tion t WK at (503)246-1987.
Issued by r,e r in i t t e e 5 i g n a t 1.1
INSTnt-L.Al-1014
Ttie installation is being made on ryroperty I own which is not intended for
sale, lease, or rent.
OWNER' S SIGNATURE, DATE:
INSTALLATION ONLY--------------------------------
SIGNATURE OF SUPR. ELI ECIN: DATE
LICENSE NO-.•++++++++++++++-++-+++++++++++++++.+-+++++++++++++-1 ................V..............4-+++4-
Call 639--4175 by 7:00 P. M. for an inspection needed -I-Jie next business day
.........................4-++4-+4 4-+-1......I....................F++4..........V4+++ 4-+1-44+ I-
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by: &I //,
13125 SW}TALL BLVD Date Recd: Z
TIGARD CR 97223 PRINT OR TYPE
V-503-639-4171 X304 Permit# a �-42.
F - 503-6194-7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:_
WILL NOT BE ACCEPTED
Name of Development Project _TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Restricted Energy Fee..................................... .. $40.09
(FOR ALL SYSTEMS)
JOB Street Address Ste#
ADDRESS 7v� ( �� .� LJ KA I3L6 -50(' Check Type of Work Involved
City/Stat a1C 7_ip �Phon;lt Audio and Stereo Systems
j 1C Ets�c '
Nam r ''/4%'? F-1 Burglar Alarm
, -See t/C ❑ Garage Door Opener-
OWNER ailing Address
19 - KA AR-C- Elrleatlny,'!ontilatlon and Air Conditioning System'
City/State zip Phone#
kfA 2 2 t pct )3 7 N7acuum Systems-
Namb
j «.S �� Other
1,<�'7<<1,v,�,/
CONTRACTOR Mailing Address
L,U1 ysiv-Zex u R,�J. .00 _ �<: .., TYPE OF WORK INVOLVED -COMMERCIAL ONLY
(Prior to issuance a City/State 2i5 Phone# Fee for each system.............................................. $40.00
copy of all licenses I n/(- US ��`�� & - 7/C-)�S '/ YG// (SEE OAR 918-260-260)
are required if Oregon Contr. E rd Lic.# Exp Date
expired in C.O T Check Type of Work Involved:
data base). Electrical Contr.Lic.# Exp.Date ❑
Audio and Stereo Systems
C.O.T.or Metro Lic.# Exp.Date
Boiler Controls
Owner's Name
Clock Systems
OWNER - Mailing Address
APPLICANT Date Telecommunication Installation
City/State Zip Phone# yt❑
Fire Alarm Installation
This permit is Issued under OAE 918-320-370.This applicant agree: to ❑
make only restricted energy installations(100 volt amps or'ass)under this HVAC
permit and to do the following ❑
Instrumentation
1. Only use electrical licensed persons to do installations where rbquired.
Certain residential and other transactions are exempt from licensing. ❑ Intercom and Paging Systems
These have asterisks('/ All others need licensing;
Landscape Irrigation Control*
2. Call for Inspections whr•r instaliati,)n under this permit are ready for
inspection at 503-539 5; J' Medical
3 Purchase seoarate permits for all installations that are not ready for an Nurse Calls
inspection when the inspector is out to inspect under this permit;
4. Assume responsibility for assuring that all corrections required by the Outdoor Landscape Lighting'
inspector are done,and; O
Protective Signaling
5. Assume responsibility for calling for a final inspection when all of the
corrections are completed. Other
Permits are non-transferable and non-refundable and expire if work is not
started within 180 days of Issuance or if work is suspended for 150 days —,---,—Number of Systems
The person .;3 ing for this permit must be the applicant or a person No licenses are required. Licenses are required for all other Installations
authorized to bind the applicant.
FEES
ENTER FEES S
Signature
5%SURCHARGE(.05 X TOTAL ABOVE)
U
Authority if other than Applicant TOTAL s.—, "
{� `
I idstsvesele doc 7197 — �G
CITY OF TE L_�:UT51M_ PERMIT
DEVELOPMENT SERVICES ^FRMIT it: El C97-0696
13125 SW Hall Blvd., Tigard,OR 97223 (503)6394111 DATE ISSUED: i 0/;;0/' 7
Pr-)RCE,. : "-,M. 121,1C--01 100
if; : „4ir,5i':3 a1N I-'44E.ji_L-. Lk 4_`04.,
:,L1LtDi1JICTON'. , . . ::Fr,`N` 0 MgEU; AC'RF' TP11r.TC
rl_i7C;N,. . I . , . , . . . LOT. . . , , . . :iii,'""1 URICDICTim- TI(:,
c::�; s:.9.•i p t :i.r,n Installing a presanent 43 sq, ft, wall sign
.Rl•`^TDENTIAI_ LJNI-f.
tOOO GF OR LESS. . . . : 0 0 00 aimp. . . . . . . .. 0 FUME`/IRRI0nTTnN. .
7"()rl? C3D1) ;... IZ0SF'. . . . 0 12'0 400 iAmC 7.0 OUT L..TNI-- LT
TMIT71) ENERGY. . . . . : 0 401 E,OO amp. . . . . . . : 0 SIGNAL/PANEL.. . . . . . . .
�,'ItJF_ fJa,-I, "7)k)C"F'1)" . . ez ',01 + ml� - 1i"14IO v �t t:<�. rSTNCJR l.(�C►F-L. ( 10) , . .
^rPVICF/r"FEDER CTRCUITr__...._......_ -.__.._ADD11.. INSPECTIONS-.-
_'0 � I:;, . . . . . 0 W/^Ef?VTCE OR r"1770F1). 0 PEP TNSPECTTON, •, . . . 0
4i; 400 �Irlp. . . . . . 0 1st W/O Sr2'JC OR 1"17R. a 0 PER f-OUR. . , . . . . . . . f'
t01 . . 0 rf) ADD' ;.- DpNrll r;IRC: 0 TI`I . . . . . . C
r.711 ,. . . . . : 0 __.._..__._. REV IE'W CECTION-----
1 a'rG1O+ aml)/Vr.�I1;. „ . . . el ) �{ RC'ri LJr+IT";. . . . , > GOO VOLT NOMINAL.
0 SVC/r-DR > A'F'C nMP!7;. AREA/,('=EC GCC
type azmoi.(t)t by date "eCi.
15PrT $ c'. 00 D 10/ 16/94 9,7--4001?0
1,11.11. TI LIG1?T 51G-N CO ? 4.7 00 TOM-
"i NE 1)ROnDWAY
REDU T RE"D I NC;>',rr-r+ `-
Lmr) OR ?7,217, Ce i. I. ir)g Cover, flee, i. :.,,,l .
WiAIA "-Ov„, rIp i;" 1 Fier,-,i
it, „ OOOr-.41
ueroit is issued subject to the regulations contained in the Tiga-d Municipal Code, State of Oregon Specialty Codas and all other
applicable laws, Al work rill be done in acerordorce with approved p',ars. This persit will expire if word is rot started withir
deyy of issuanct, or if wort, is suspended for fort than IN days. ATTFEWION: Oregon law requires you to follow the rules adopted
t'he Cs-egon Utilit P;ntificatior, Center. Those rules are tet fort" ii 7r 952-N I-Nlt V`rrggS 000 W-N1-1997. You eay obtain z.
,f these 'ules nr direct questions to OUNC by calling 15031246-1997.
d �
—OWNER TAL.LnTTON ONLY--
',^ 4' :i.17 Y 1 i m U 1R.ti rl r., 1) `".�"'..i}l�^r't: 'y I ci r., W4h C'I--, i . i fl'1:•C'P i 0
IiaI".R" r M1IGNATUQF
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Plarick/Rec. #
Permit tt` C L
Phone ;503) 639-4171 Date Issued 1 0
FAX (503) 684-7297 Issued by d-A
CITY OF TIGARD TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development L ` ',Y ' ' �"� __ Number of Inspections per permit allowed —
Address ��� ll� f�A��t� Service included Items Cost(ea) Sum
h' 4
City/State/Zip�1 � �1 4e. Residential-per unit --
�. 1000 xq if or less $11000
C t� int�h r Each additional 560 sq It or I
Name (or name 0 usiness)� 1 ,J 1't`1 r,1N V11 ��•C�`- portion thereof $2500
Limited Energy $2500
Commercial Fff Residential LJ Fach Manurd Nome or Mod-alar 2
Dwelling Service or Feed°r W 00
29. Contractor installation only: 4b.Services or Feeders
r _ Insiallalion aNwition,or relocation
-- c 7
Electrical Contractor( ,� �J ;c a!",*or lose $60 00 2
201 stripe to 400 stripe $8C 00
Add r s F,L y ✓✓✓rrr !!!� --.7 401 amps to 806 amps $1000 2
City Stat fp -1? 3 S._ 801 amps to 1000 amps *1180 00 2
-)vat 1000 amns or volts $340 00 2
Phone No. �t --
'� r Reronne t only $5000
Contractor's License No._ l'tC! -
Contractor's Board Reg. No._L,, 4c. Temporary Services or Feeders 2
I rr ialialron alteration,or relocation
Signature of Stir. Elec'n��'�- I C�U 200 amps or less $S()00 —
` 201 amps to 400 amps � 575 OC
License No.� _ Phone o. .�_ 401 amps to 800 amps $160 00 —
Over(300 amps to 1000 Mona
2b. For owner installations: see.h.abp1e
4d.Branch Circuits
Print Owner's Name Now,a8erabon or extension psi panel
Address a)The tee for',)ranch c—ults with
-- purchaso or owvkl /Ndor A". 1
City ._, State__ Zip Earh brarrh circuit $5 00 _—
Phone No. _ b)Toe fee lot branch circuits without
The installation is being made on property I own which is purehaae or Service or d+ader 010o.
Fnst —
branch circtnt E3500 2
not intended for sale, lease or rent. Each additional branch circuit $500
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
Each pump or irrglalron circle $4000
r ''
3. Plan Review section (if required): Each sign or or,h,ne lighting $40 00
Signal cimuit(s)or a limited energy f
Please check ap f ropriate item and enter fee in section 5B. panel aneraho.n or extension Soo 00 _
_4 or more residential units in one strueture Minor Lnbels(10) _—+ $10000 _
Service and fowler 225 amps or more 41. Each additional inspection ove'
Systont over 600 wits nominal the allowable in any of the above
C!_assifiod area or structure amtaining special occupancy per inspect.on _ $3500 _
as described in N E C Chapter 5 Per hour $5500
In Plant $5500
Submit 2 sets of plane with application where any of the above
apply. Not requ;red for temporary construction services. 5. Fees: L
5a. Enter totai of above loos $
NOTICE 5/Surcharge(05 X Ictal fees) $
Subtotal $
PERMITS BECOME VOID IF WORK OR CCNSTRUCTION 5b. Enter 25%of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF Plan Rewow if required(Sec 3) $ —
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED El Trust Account 0 $
Balance Due $ „_ f
■-N."dev Wt-pm
CITY OF T'IGARD MECHANICAL
P, RMIT
DEVELOPMENT SERVICES PERMIT #, .E. . . . . : MEC98-0467
3125 SW H311 Blvd., Tigard,OR 97223(503)639.4171
DATE. ISSUED: 11/05/98
P,ARCEL: 2SI- 12AC-11711000
E31TE ADDRESS. . . : Q1731-9 SW KABLE ST #51710 ZONING: 1-1.
SUBDIVISION. . . . :
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . JURISDICTION: TIG
CLASS OF—WORK. . :qTR
F: WORK. . :OTR FLOOR FURN. . . . : 0 EVAP, COOLERS: 0
TYPE OF' USE. . . . :COM UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GRP,. . :B VENTS W/O OPIPIL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . . 0 BOILERS/COMPRESSORS HOODS. . . . . . . :* 0
FUEL 0-3 HF'. . . . : I DOMES. TNCTN: 0
E E —15 HF'. . . . : 0 COMML. INCIN, 0
MAX INPIUT: 0 BTU 15-30 HI='. . . . : 0 REPAIR UNITS: 0
FIRE DAMPERS?. . : N 30-50 Hr,. . . . : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 50+ 11P,. . . . : 0 CLO DRYERS. . : 0
NO. OF UNITS----------- AIR HANDLING UNITS OTHER UNITS. : 0
FURN ( 100K BTU: 0 10000 Cfm : I GAS OUTLETS. : 0
TURN ) =100K BTU: 0 > 10000 cfm: 0
Remark Add A/C unit and A/C handling unit.
Owner-: FEES
AMERT SEPVE type a In 0 Unt by date 1--ecpt
25. 00 DEP ll,/05/98 98310601:`,
7319 SW KABLE LANE PRMT $
'TIGARD OR 97224 P,LCK 6. 25 DEB I1/05/98 98-3110607.
5PCT $ 1 . 25 DEB 11/05/98 98-310603
Phone #:
Contia—tor:
'rEMP, CONTROL MECHANICAL SERVIC
zy800 N CHANNEL AVE
P,0 BOX 11065 1; 32. 50 TOTAL
OR 97211
;"'hone #. 285-9851.
Reg #. . .- 103165 REQUIRED INSPIECTIONS
This permit is issued subject to the regulations contained in the Meehan iral I n s p
Tigard Municipal Code, State of Ore. Specialty Codes and all other Di.lct Inspectior
applicable laws. All work will be done in accordance with Final Inspection
approved pans. This permit will expire if work is not started
within 180 days 1,f issuance, or 4 work is suspended for more
than 180 days. ATTENTIOW Ore5an law requires you to follow rules
adopted by the Oregon llti',,�y Notifi,-ation rtnt-,,r. Those rules are
set forth in OAR 952-KI-00I0 through LX;R 952-00I-MOO. You may
obtain copies of these rules or dire':: questions to OK by calling
(903)?46-9187.
tt,)n_ 14A_ Permittee Signati.tre:
++-1.++++4 4++++++++•+++++..++++4-++4.......4.......4................. ..............4-+
C& 11 639-4175 by 7i00 p. m. for inspections needed the next bij,. iness day
++-++++4•...................4................4..............F+++++++ %++++++.+++++++++-++
Plan Check#f b C
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential DateRec'd-_
TIGARD, OR 97223 Date to P E.lO'34 C�
(503) 639-4171, x304 Date to DST 7,
YP Permit# r
Print or T e
Called
Incomplete or illegible applications will not be accepted
e vel U tolect. Description
1'abie to Mechanical Code
' �y _- QTY PRICE AMT
LLL---��L
Job Street SulteN A) Permit Fee e� -0- -0- 10.00
Address �7�Add
, �Ye 0
Bldgs# may/stat p 1 ) Furnace to 100,000 BTU 600
ir,-,Iuding duds&vents _
ie(or a of businesal 2.) Furnace 100,000 BTU+ 7 50
Owner � G e c , � �, including ducts 8 vents
i g A rens -(�- 3.) Floor Furnace 5.00
inciuding vent
( tat ^ hone 4.) Suspended heater,wall heater G 00
or flour mounted heater_N - - -
Na a(or nama of business) 5.) Vent not Included in appliance permit 3.0C
OccupantI� are / 6.) Boiler or comp,heat pump,air Gond. 6.00
(Jl/ to 3 HP;absorb unit to 100K r _
•1' /State zip hw �^- 7.) Boiler or comp,heat pump,air Gond. 1100
AX3-15 HP;absorb unit to 500K BTU"
Contractor r o 9) Boiler or comp,heat pump,air Gond 15 00
Mi X40 15-30 HP absorb unit.5-1 mil BTU'_ --- -
Prior to permit f j rS�' - 9.) Boder or comp,heat pump air Gond. 22.50
issuance,a copy ,' (/ U r� 30-50 HP,absorb unit 1-1.75mil BTU"'of all licenses 1 10.) Boller or comp,heat pump,air Gond. 3750
are required if 9VLO� "7 �/� >50 HP,absorb unit 1 75 mil BT_IJ" _
expired in COT R0.5 n '�''(-J''pppn�GBoard Lic 0 11 ) Air handling unit to '0,000 CFM 4 50 6
database ,� 1� �----- �� - ✓�_.
Architect hoTe Y / 12.) Air handling unit 'S0
10,000 CTM+ _
Or Mailing Ad res ,f 13.) Non portable evaporate cooler 4 FO 7I
Engineer rt S may' ���� Pone 14) Vent fan connected to a single dud 3 00
_ !}
Describe work Now O Addition Alteration O Repair - 15.1 Ventilation system not included 4.50
to be done Residential O Non-residential in appliance permit
Additional Description of wr rl, —� v� 15.) Hood served by mechanical exhaust 4 50
t
17.) Domestic Incinerators 7 50 --
i
Existing use of 18.) Commercial or irdustnal 3000
budding or property (� / - type incinerator
19.) Reowr units 4 50
Proposed use of � 20) Wood stove 450
budding )r property ' __ �� __
21 ) Clothes dryer,etc. 4.50
i
Type of fuel-oil U natural gas O LPG G aiedriN 22.) Other units - 450 —
I hereby acknowledge that I have read this application,Niat the information 23) Gas piping one to four outlets 2c 0
given is correct that I am the owner or authorized age,.,1
the owner,that plans submitted are in compliance with Oreg9n State law:: 2.4) More than 4-per outlet(each) -50
Date
Signature of Owner/Agent -�� 'SUBTOTAL
r.
1 jm' �. I Z 5°h SURCHARGE
Contact Po n Name Phone PLAN REVIEW 25%OF SUBTOTAL ''c'�>.
r� Required for all commercial permits onlynt gv a3'rL±
�.�-.�� TOTAL ��_" 7't •:yt"� t I
'Minimum permit fs+e is$25+5%s surcharge
"Residential A/C requires site plan showing placement of unit
I.Vnechprmt.doc rev 411;:/05
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TEMP"CONTROL PROJECT WORKSHEET
503)265.6139 JOB NOP/00
/ ^
MECHANICAL SERVICE COPPORATION FAX(503)735.3690 (/0 O (//
a LINC 9orvlcrrA Conrracror f D
3836 N.BALLAST PO BOX 11209 PORTLAND.OREGON 97211 PAGE NO. `�►l
JOBMDATE
�SC4 v '° 14319.E
JO A�GRESS /
1
-4-31 1 1� C,vcw 1 �qA.�, amu. s=Lo
SUBJECT
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CITY OF TIGARD
DEVELOPMENT SERVICES BUILDING PERMIT
PERMIT #. . . . . . . :,� B(JF-9A---0475
13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 DATE ISSUED:
P,AF,ICEI-.- 2S 1 12AC-01000
SITE ADDRESS. . 071319 SW KABLE ST #500
SUBDIVISION. . . . : ZONING: I -L
BLOCK. . . . . . . . . . o LOT. . . . . . . . . . . . . Jt.JRlr3DT(--'T ION:TIG
REISSUE: FLOOR AREPS---------------- EXTERIDR WAI.J.- (-.ONSTRL.ICTION-
C:LA5S OF WORK. :FP19 FIRST. . . . . 0 'if N. 9: E: 14:
TYPE OF USE. . . -COM SECOND. . . : 0 sf PI ROTECT OFIEN I INIGS
':'YP,E OF ('ONS-T. -ON 0 s f N: 9: E: W:
OIXUPIANCY GRP,. ;B TOTAL------- 0 s ROOF CONST: FIRE RET":' :
OCCUPIANCY LOAD: 0 BASEMENT. : 0 s AREA SEP,. RATED:
STOR. : 0 I-IT- 0 ft GARAGE. . . : 0 5f 0(_'CU SEP. RATED:
B5MT'l - ME7Z" . REDD SETBACKS- REQUI
Fl_.00R LOAD. . . . - 0 p s f I-E FT- 0 ft RGHT. 0 ft F I R SF.,KL..Y SMOK DE .r
DWELLING UNITS: 0 FRNT: 0 ft REAR- 0 ft FIR AL.RM- HNL)ICP' ACC :
BEDRMS: 0 BATHS 0 IMF, SURFACE: 0 PIRO C'DPR: VIA RV I NG: 0
VALUE. $ : 8000
Pemarks : Add sprinkler system.
caner: FEES
AMERI SERVE type amoi.t-nt by date rec:pt
7,319 SW KABL-1- LANE FIRE 111 27. 40 DRA 11 /04/98 98--310557
TIGARD IR 97-224 V,RMT $ 68. 50 GEO 11 /12/98
.)8-310745
F)r,r"-r $ 43 GEO 11 /12/98 98--310745
Phone #: 800-737--4423
(;contractor: --------
DELTA FIRE INC
P'. O. BOX 4010
TIJAI_ATIN OR 97062
Phone $ 99. 3:3 TGTAL
Req 000641
ACTIONS or INSPIECTIONS--
This permit is issued subject to the regulations cnntained in the Sprinkler- Roi,trifi
iigard Municipa.' Code, State of Ore. Specialty Codes and all other Sprinkler Final
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 fol'oot the
rules adopted by the Oregon Utility Notification Center. ThosF
rules are set forth in OAR 952-001-010 through OAR W, -00101987.
You many obtain a copy of these rules or direct questions to OUNC
by calling (91)246-1987.
'0
Signat i.tre Issued By.
Per m i t;t e e wg_
4 4-4.+4.+4-+4-4-++A-+++++++I-+4- +++++++++-+-+-+++++++++++++++++++++++++.++.t++++++++++++++
Call 639-4175 by 7:00 p. m. for- in inspection needed the np)(t bi-tsinec s; day
4 4-++++++t++.-+h+++4.4-+-+4++++++++++.4-1-+-+-+++++-44-+1-+4-4-++++4++++++++++ ; +4-+++++++++++
"* Fire Protection Permit Application
�� Plan Che
CNt°Y OF TIGARD Commercial or Residential Recd By,-fA.`.e E
13125 SW HALL BLVD. Date Rec'd/-%'�'�
TIGARD, OR 97223 Print or Type Date to P.E.
(503) 639-4171, x. 304 Incomplete or illegible applications will not be accepted Date to DST
Permit#
Called
Job Name of Development/Project Type of System (Complete A or B as applicable)
kN
Address Address -- ---
r� A.) Sprinkler Wet Dry ❑
dame Standpipes
Owner Mailing Address Additional Hazard Group
City/State Zip Phone Information Dersity
ame Design Area
Foccupant Mailing Address ^ K. Factor
`t
City/State ,Zip Phone A.1) Sprinkler Project Valuation 111
Contracto
1
Contractor Name B.) Fire Alarm
(Sprinkler or 't fl Lj. V\ Uk
Alarm Company) Mailing Address Submittal Shall Include Battery Calculations YES(]
Prior to permit �N- '? -!VI-)
issuance,a City/State Zip Phone Individual Component YES❑
copy - i Cut Sheets
of all license4 (. CSV -2 c: ( B.1) Fire Alarm Project Valuation $
are required if State Const.Cont. Board Lic.# Exp. Date
expired in COT
database ---
��� Project Valuation Subtotal (A & B)
� or $
Name Permit fee based on valuation $ , J
Architect Mailing Address _ (see chart on back)
5% Surcharge $
3 ,
City/State Zip Phone
� FLS Plan Review 40% of Permit $
Describe work A.)New O Addition Alteration 0 Repair O TOTAL $
to be done:
B.) Modification to sprinkler heads only
1. 1-10 heads=No plans required Plans required: Submit three sets of plans, including a vicinity map and
2. 11+=Plan review required the location of the nearest hydrant.
I hereby acknowledg!that I have read this application,that tire information given s
_ Number of sprinkler heads correct.that I am the owner or authorized agent or the owner,and that plans submitted
Additional Description of Work.
are in compliance r nth Oregon State laws
Signature of g Date
A.)In Existing Building New Building ❑ .� —
Building Contact Person Na Phone
Data e•1 Commercil!,;Rr' Residential ❑ \ �� f Mf ear 531 ,�?[� _ 0
FOR OFFICE USE ONLY:
No of stories Plat# Map/TL#:
Sq. Ft:
Notes
Occupancy Class Type of Construction
l firesupr.dnc
CITY OF TIGARD
BUILDING PERMIT FEES
TOTAL
STATE BUILDING
VALUATION OF PERMIT F.L.S. TAX PERMIT
PROJECT FEES (40%) (5%) FEES
1-1500 25.00 10.00 125 36.25
1,501-1600 26.50 10.60 1.33 38.43
1,601-1,700 28.00 11.20 1.40 40.60
1,701-1,800 29.50 11.80 1.48 42.78
1,801-1,900 31.00 12.40 1.55 44.95
1,901-2,000 32.50 13.00 1.63 47.13
2,001-3,000 38.50 15.40 1.93 55.83
3,001-4,000 44',.50 17.80 2.23 64.53
4,00 i-5,000 50.50 20.20 2.53 73.23
5,001-6,000 56.50 22.60 2.83 81.93
6,001-7,000 62.50 25.00 3.13 90.63
7,001-8,000 68.50 27.40 3.43 99.33
8,001-9,000 74.50 29.80 3.73 108.03
9,001-10,000 80.50 32.20 4.03 116.73
10,001-11,000 86.50 34.60 4.33 125.43
11,001-12,000 92.50 37.00 4.63 134.13
12,001-13,000 98.50 39.40 4.93 142.83
13,001-14,000 104.50 41.80 5.23 151.53
14,001-15,000 110.50 44.20 5.53 160.23
15,001-16,000 116.50 46.60 5.83 168.93
16,001-17,000 122.50 49.00 6.13 177.63
17,001-18,000 128.50 51.40 6.43 18633
18,001-19,000 134.50 53.80 6.73 195.73
19,001-20,000 140.50 56.20 7.03 203.73
20,001-21,000 146.50 58.60 7.33 212.43
21,001-22,000 152.50 61.00 7.63 221.13
7.2,001-23,000 158.50 63.40 7.93 229.83
23,001-24,000 164.50 65.80 8.23 238.53
24,001-25, 100 170.50 68.20 8.53 247,2.3
25,00126,000 175.00 70.00 8.75 253.75
26,00127,000 179.50 71.80 8.98 260.28
27,001-28,000 184.00 73.60 9.20 266.80
28,001-29,000 188.50 75.40 9.43 273.33
29,001-30,000 193.00 77.20 9.65 279.85
30,001-31,000 197.50 79.00 9.88 286.38
31,001-32,000 202.00 80.80 10.10 292.90
32,001-33,000 206.50 8260 10.33 299.43
33,001-34,000 211.00 84.40 10.55 305.95
34,001-35,000 215.50 86.20 10.78 312.48
35,00'1-36,000 220.00 88.00 11.00 319.00
36,001-37,000 224.50 89.90 11.23 325.53
37,001-38,000 229.00 91.60 11.45 332.05
tresupr.doc
i
CITY OF TIGARD BUILDING INSPECTION DIVISIO;. — MST
24-Hour Inspection Line: 639-4175 Business Line: 639-41
!' 1 BUP
Date Requested_ C�"l`4c� 'c�� AM P BLD
Location �, �Z_ ? �__ Suite y MEC
Contact Person ofr F ( — Ph(c-) zC���-�C7c ! PLM
Contractor _ _' - Ph SWR —
L I ' jl 1, iVowner 11%01,/ � ELC
Retaining Wall ELR _
Footing Access:
Foundation FPS _
Fig Frain -
Crawl Drain Inspection : SGN
Notes
Slab —.� '1r SIT
Dost& Beam
—
Exi Sheath/Shear _
Int Sheath/Shear �-
Fi -ming _
(Drywall Railing Lr-O!f __
(Firewall
Fire Sprinkler
�Fire Alarm
Susp'd Ceiling -_ � �L _T —
Roof
Misc: _— -- ----- --- ---
�16 PART FAIL - --- - ---- - -
PrIMBING
Post& Beam -- --�-- -
Under Slab - C� �_10 -f/ — tP _J
lop Out - --
Water Service
Sanitary Sewer - ---- -- --- --- ----_..----
Rain Draii�-
Final -
PASS RT FAIL
Post&Beam ----- — —
Rough In
;as Linn - - -- - — -
fS 'e Dampers
AS PART FAIL
Service
RoughIn -----------______-_----. .�___ — ---- - -----
UG/Slab
I-ow Voltage
Fire Alarm
Final
PASS PART FAILSITE
BackfilllGrading ---- - - - - -- --- --- --i - -
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ =required before next inspection Pay at Lily Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line C ] Please call for einspection RE-_-_-.- — ( ] Unable to inspect no access
ADAApproC
Other
Inspector
Other Date Itor Ext
_ - ----.
Final -
PASS PART FAIL NOT REM E this inspection record from aha job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-hour Inspection Line: 639-4175 Business Line: 639-4171
j BUP
Date Rer < <I�l.,ested. _
AM _PM _ BLD
Location__, _
�;,c �
7 � � � ,. �-• Suite ��C�-) MEC _
Contact Person Ph _ PLM
Contractor_ Ph _ _ SWR
BUILDING Wna6#Owner 1t,J/1_21 k' ceyljlf,. ELC
Retaining Wall ELR
Footing
Foundation ACCESS: / FPS
Ftg Drain if?(({G
Crawl Drain Inspection Notet:: SGN _
Slab _ SIT
Post& Beam _
Ext Sheath/Shear
Int Sheath/Shear
Framing _
Insulation - -
Drywall Nailing - l
Firewall --- -
Fire Sprinkler -
rire '�.^.gym --
Susp'd Ceding
Roof --
Misc: -
Final _
PASS PART FAIL
PLUMBING
Post& Begin ------ --- --._.- ----- - _�.
Under Slab
Top Out
Water Service
Sanitary Sewer - -- -- `^- --
Rain Drains
Final ---- ---------- -- --
PASS PART FAIL
MEi.HANICAL ------------ --- -- —
Post& Beam --- -- --_-- - -
Rough in -- --
Gas Line
Smoke Dampers -
Final -- --- -- -----w - _
PASS PART FAIL. -
ELECTRICAL -- -_- ----------___---- —
S'ZTVI�E-
Rough Ili
UG/Slab
LowVoiiags. --- - -
fire�
mPART FAIL ---.- -_-�_--
WE
Backfill/Grading ---- -- -- - ---- - -
Sanitary Sewer
,Storm Drain [ ]Reinspection fee of$_ _ required before next inspection. Pay at City Nall, 13125 SW Hall Blvd
match Basin
Fire Supply Line I ]Please call for reinspection RE:- - ]Unable to inspect-no access
AD,A
Approach/Sidewalk
Other — Date — �-- InspQGtor ��L-c-��--�� ---Ext -
r incl
PASS PART FAIL 130 NOT REMOVE this inspection record from the job site.
ELECTRICAL -
CITY OF TIGARD RESTRICTED EN RIGY
DEVELOPMENT SERVICES PERMIT ELR2001-00307
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/29/01
SITE ADDRESS: 07319 SW KABLE LN 500 PARCEL: 2S112AC-01500
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING. I-L
BLOCK: LOT: 022 JURISDICTION: TIG
Proiect Description:Add on to CCTV
A.RESIDENTIAL B.COMMERCIAL
AUDIO& STEREO: AUDIO &STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDIAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: CCTV. X
TOTAL#OF_SI'SSTEMS: 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: Phone: 503-469-7244
Reg#: LIC 59944
ELE 26-209CLE
FEES Required Inspections
Type By Date _ Amount Receipt Low Voltage Inspection
PRMT CTR 11/29/01 $7500 2720010000 Elect'I Final
5PCT CTR 11/29/01 $6.00 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
net 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 _ ^���( ,�� /�✓ _ 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. ELFC'N " lk 0 k' DATE:
LICENSE NO:
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
i
11%28;2001 14: 16 FAX 5034697110 ADT SECURITY 1001
Electrical Permit A lication
Date received (' `tr /(' Pennit
--
City of Tigard Irrojecdappl.no.: Expire date: L
Ciryrrf l'iAnrrt Address: 13125 SW Iia11 Blvd,TiBt}�„QRc,q ?.fool bateissued_- _—___— N t, _
Phone: (503) 639-4171 NN��JyY r L Y: f' Receiptno.: —
Pax: (503) 598-1960 CLTY OF 17VARa Case file no.: _ Payment type:
Land use approval: — AUHMIM DIMON
U I &2 fancily dwelling or accessory IN Commercial/industrial U Multi-family U Tenant improvement
U Now construction U Addition/alteration/replacenccnt U Other: U Partial
Job address: 73/ $Op f11d no.: Suite no.: Tax Crap/tax lot account no.:
Lot: Block Subdivision:
Project name: jLi Description and location of work on premises: (;(;Tj/ ;1-9-d"-
Estimated dale of completion/inspection:
LIMAN=Al
Job no: / 3 IZ Feu Max
—n
�—___-- -- ----- Description Business name: 1 Qty. (emit Total
no.hu
''�- I—Sm ri L� Newnhidtntial-altrgleormultl-famllyper
Address: ��—�_._-�
Ci � JV _ __ dwellingmnk imhdesattachedpMe.
City: � Sta(e:Qk ZIP: 0 Servicelncluded.
Pho ���ne &j-*?j00 f ax S0. j*7 E-mail: - 1000 sq.ft.or less — - 4
-Each additional 5(1(1 .ft.�r portion thrrcof
CCU no.: FIC c.bus. lic.no: C.
-i-�-1-- ---- 2 g�wT LE_ Li_mited energy,residential 2
City/mekr ic.no.: _ Linutedenergy,nnn-residential 2
A -A `�2' _, 1 trach manufactured home or modular dwelling
Signo su rv�, ,ectrcia/ d) ---- fate =- - Service and/or feeder 2
—L--- -- -Service
-Installation, — -
Sup.elect.name(print): -__- _11;--e no. alteration or relocation:
200 amps or less 2
Name(print): 201 amps to 400 amps -- 4 2
401 amps to 6W amps 2
I Mailing address: —�---- 1,101 amps to 1000amps T.-_ 2
Y_
t CIT _- `-----�-- State::::- ZIP:—---- Over 1000amps or volts ---- 2
Phone: f'ax: C-trail: Reconnect only I
Owner installation:The inEtallation is l Bing made on property I own Temporary services orfeeders-
which is not intended for stile,lease,rant,or eychange according to Installotion,altet.,tlon,or relocatiow
ORS 447,455,479,670,701. 200 snips or less --- 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps - 2
Bench circuits-nen,alteration,
or exienslon per panel:
Name: A. Fre for branch circuits with purchase of
service or feedef fee,each br-nch circuit 2
City: - - Slate: ZIP: n. Fee for branch circuits without purchase
-- - of service or feeder fee,first branch circuit• _ 2
Phone: Fax: E-mail: Each additional branch circuit: -
Misc.(Service or feeder not Included):
•Service over 225 amps commercial U Health-care facility Each pump or irrigation circle _ _ - - 2
U Service over 320 amps-rating of l dr2 U Hazardous location Each sign or o_ulline lighting _ 2
family dwellings U Building over 10,000 squan feet four or Signal circuit(s)oraIiwited enrrgypancl, x G
U System over 600 volts nou.inal more residential units in nne,tructure alteration,orextension' 2
U Building overduee stonrs U Fenders,411n amps or nage •tkscri tion: .-_-
U Occupant load over 99 petsnns U Manufactured atruc,,w or R'/park Each additional Impectlon over the allowable In any of the above:
U f?gressllighOngplan U Outer. -_ -_--� Perm pecimn ��- _ ���`
Submit_-sets of plane with any of the at*ye. Investigation fee �r
The above are not applicable to temporary conrlruction t ervice. Other -- -----
------ Permit fee.....................$
Not all)udartictiona accept credit cant,please call jurisdiction for more Infomutlon. Notice:'T'his permit application ----
U Visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $
Credo card numb«: _ —_._— �� within 190 days atter it has been State surcharge(11%) ....$
_._.a-.m._e._or cardholder as shown one t'card — explmr accepted as complete, TOTAL. .......................$ _
S
Cardholder al6natute -- Amnum
441)4615(boa CONo
CITY OF TIOARD 24-Hour
'BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
BLIP — --_—
Received Date Requested _6�v —. AM PM _. BUP
Location L—�' `� 1 S�L��`"�-� --Suite S _ MEC
Contact Person "� 1���—�-�-% _ Ph( ) 'i 72 2V PLM
Contractor__ iA `t�L,, , ,r `; ' "� Lit Ph SWR ---- --
BUILDING Tenant/Owner D 71 L — ELC
Footing 01 f_X'; Srrfj Ra.ILIr 1 ELC
Foundation --
Ftg Drain Access: ELR &U/ CC) J6 7
Crawl Drair.
Slab Inspection Notes: SIT
Post& Beam ---------_ __ ._—. -�_--. --__---
Shear Anchors — --- —
Ext Sheath/Shear
Int Sheath/Shear ----
Framing ----- —
Insulation
Drywall Nailing ------- _ 6—� ------------
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling —------
Roof
Other: --�_---_--
Final -----_ -------
PASS_PART FAIL --- u�-- — --___--
PLUMBING_
Post$ Beam ------ - ---- ---
Under SlabRough-In
Water
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
try o[tage —_ -- --- ------ - ---- ----
Fire Alarm
ria" n Reinspection fee of$ .___— _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
S PART FAIL
MTr Please call for reinspection RE: —_. _— Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date__1 Af - L r-; _ Inspector _ ---�'�C - - [ i ce_
Other:
Final _ —_^I DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL.