12600 SW 72ND AVENUE-3 i
Sf]taInN aN't.! Ms 009ZT
1 ELECTRICAL ENERGY-
CITY OF
TIGARD ENE
\ RESTRICTED F(GY
{ DEVELOPMENT SERVICES PERMIT#: E..LR2000-00124
13125 SW Hall Blvd., Tiqard, OR 97223 (5031639-4171 DATE ISSUED: 05/30/2000
SITE ADDRESS: 12600 SW 72ND AVE
PARCEL: 2S 101 AC-00600
SUBDIVISION: BEVELAND NO. 2 ZONING: MUE
BLOCK: LOT: 012 JURISDICTION: TIG
Proiect Description: Install burglar alarm system in existing comme.cial building.
A. RESIDENTIAL _ B.CO_MM_ERCIAL
AUDIO & STEREO: _ AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/1"ELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: BURGLAR AL Y,
TOTAL#OF SYSTEMS: I
Owner: Contractor:
ROTH, JACOB T JR + THERESA A PROFESSIONAL SECURITY
12600 SW 72ND AVE PO BOX 848
TIGARD, OR 97223 LEBANON, OR 97355
Phony:: Phone: 503-451-1330 ORIGINAL
'leg #:
FEES Required Inspections
Type By nate _ Amount Receipt _ Elect'I Service
PRMT KJP 05130/200C $60.00 F!ANDRCPT Elect'I Final
5PCT KJP 05/30/200( $4.80 HANDRCPT
Total $64.80 —
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicanle 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 roles adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952-001-0010 thugfi-PAR 952-001-0080 You may obtain copies of tf��se ,ules or d,rect questions to OUNC at (503)
246-1987 n
Issued by � � r L0,—_) _ 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
LICENSE NO:
Call 639-4175 by 7:00 P.M.fo•an inspection needed the next business day
U5. 1'/ 00 9111) Ub:51 FAX 503 538 1961; CITIi OF 'I'IGARII �OU2
CITY OF TIGARD RESTRIC TED ENERGY ELECTRICAL L"M Recd by
13125 SW HALL BLVD Date Rec.'d.
TIGARD OR 97223 PRINT OR TYPE
V -503-639-4171 X304 MAY I nP,n Pet-nit t_�_�-h��"_mac' c>r-t Lel
F -503-598-1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS CUS1 Call-d
WILL NOT BE ACC Y U[VELQpM1Nj
Name of Development Project TYPE OF WORK INVOLVED- RESIDENTIAL ONLY
O r J Reetrlcted Energy Foo................................. $60.00
G T (FUR ALL SYSTEMS)
,JOB Street Add,ess � Ste ar
ADDRESS , • )U(L U 5)w 1dn Chock Type of Work Involved
City/S_tateI Zlp�. Prone A ❑ Audio ano Stereo Systems
1 7J3`� tc3- - )q7-
Name
7 Nannie C/349 Hurgly Alarm
�' M ❑ Garage Door Opener'
OWNER MaUMpAtdr3ss
ttyyStale Zip Phone A ❑ Heatlng, ventilation and AI•Conditioning System'
❑ Vacuum Systems'
�YU�C"�St
or("I SeLL�x, �� C] Other _�---------
CONTRACTOR MelbAddress ��` r
1.-0 }� TYPE OF WORK INVOLVED-C;OMMERCI�Nt�
(Prior to issuance o ily`/'stale I Poona A Fee for each system................................ 580.0
copy of ell I:ersoe �T?10tk nth �J� �• 4�I 1,3�o ISLE OAR 918-260.260)
are rogt iced If Oregon onir. Did Lie.A Ex Date
expired In C.O T, j to I �}-1 y 0`� Check Type cf Work Involved:
dala oase) Electrical Contr L4.4 Ex ale
a')- t ) 1 L 1 D p U ALdlo aid Stereo 3lstems
C.O.T.or Metro L.1c fT--� Exp.Date _
t3oNer Gontinis
Owner's Name (
OWNER- rMalling Address
APPLIUANT ❑ Data Ielecommumcalon installa:wn
CityJSlale lip Phone a r re Alarm Instaliatwn
This pepermit is ssued under OAF 913-320-370.Thta epplirant agrees tc
make oniv restricted oreigy installations l iCo volt amps cr less)under this ❑ HVAC
pe•md end to do th+foi•owing
instrumentation
1 Only use electrical liceasad parsons to d.)installations where required.
Ce•taln residentle)and other transactions are exempt from licans'ng. Intercom and Paging Systema
These have asterisks('). All*then need Ilcenatng;
C]
2 CAII for inspections when InataUstlon under this permit aro ready'or Lerdscops Irrigation Control'
insooct on at 603.639.4176; Medical
3. Purchase separate permits for all Installations that are not reedy for an Nurse Colts
Inepectior when the inspeoto 6 out to Inspect under this perml;
4. Ass ime responsibility for av►u-ing that all corrections reduired by the ❑ Outdoor landscape Lighting' '
Insoecttx are done,and,
❑ Protective Signaling
5 Assume fesponslbiuty for calling for a final Irspectlen when all of titsy
FY7 C r1
corrections are completed. I t 1 ,Permits re non•Iransferable and non-refundable uric expire if work Is W
started within 180 days of Issuance or 1f work is suspended for 1 BU days Number of Systems
The person signing for this pormit must be the app;cant or a parser No Ileansa/are required Licenses art required ru al other Installssons
au riled to hind the applicant
= ), n-
8-1.
)
Signature FNTFR FEES
e•.SURCH .JE(.08X TOTAL ABOVE) 6 _U)_
Authority if other then Applicant — - TOTAL IIyt _
r UstiVermstresele doc]IDs
/ _ ELF=CTRICAL PERMIT
CITYOF TIGAR�1 � F < fir. PERIvui M ELC2000-00190
DEVELOPMENT SERVICES - - - DATE ISSUED: 4/19/00
17.,7 gffALtM 13125 SW Hall Blvd., Ticiard. OR 97223 (503) 639-4171 PARCEL: 2S101AC-00600
SITE ADDRESS: 12600 -.W 72ND AVE
SUBDIVISION: BEVELAND NO. 2 ZONING: MUE
BLOCK- LOT : 012 JURISDICTION: TIG
Proiect Description: Installation of one 200 amp temporwy service for construction trailer for ODOT jobsite.
RESIDENTIAL UNIT TEMP SRVC/FEEDERS _ _MISCELLANEOUS
1000 SF OR LESS: `^ 0 200 amp: 1 PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR 1-ABEL (10):
—__
SERVICE/FEEDER BPANCH CIRCUITS__ ADD'L_INSPECTIONS__
0 200 amp: W/SERVICE OR F=EEDER: a PER INSPECTION
201 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1600 amp: _ _ PLAN REVIEW SECTION
10004 amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
— Reconnect only: SVC/FDR >- 225 AMPS: �. CLASS AREA/SPEC OCC:___
Owner: Contractor:
ROTH, JACOB T JR + THERESA A ELECTRICAL CONSTRUCTION CO
12600 SW 72ND AVE 'O BOX 10286
TIGARD, OR 97223 PUH I LAND, OR 97296
Phone: Phone: 224-3511
Reg #: LIC 049737 O� ,
SUP 2986S
ELE 2.6-45C
- FEES _ _ Required Inspections
Type By -�` Date Amount Receipt Elect'I Service
PRMT DEB 4/19/00 $5350 1564 Elect'I Final
5PCT DEB 4/19/00 $428 1564
Total ` $57.78
This Permit is issued subject to the regulations contained in the Tigard Municpal Code,State of OR Specialty C(des a id 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 d work is
suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Uti'.ty Notification Center Those
ru!es 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 �-
�/ r
PERMITTEE'S SIGNATUREISL=UED�BY:
fc
.iL ---r--r
UWNER INSTALLATION ONLY
The installation is being made on property I own which is riot ii tended for sale, lease, or rent
OWNER'S SIGNATURE: --_ _—. DATE:
_ CONTRACTOR INSTALLATION_ONLY
SIGNAT URE OF SUPR. ELEC'N: �c Nµ� `c``„ - ----- -- ---- DATE:---.____
LICENSE NO: &aq�
Call 639-475 by 7:00pm for an Inspection the next business day
AFR-19-00 4c, ' 47 AM EC CO, BLU 2 FAX NO, 503 248 6353 P, 2
CITY OF TIGARD RECFlVEfilctrical Permit Application Plan C�
13125 SIN HALL BLVD. Recd
TIGARD OR 97223 AF�(i i ?(�� t3ate Rse'd
Data to P.E.
Phone(503)632 Ai 171,x30 Date to DST
Inspection 503 839J175
t011111001 It' ,` '11 VELUrall
p ( 1 Print of Type 0
Fax(503)598-1960 Incomplete or Illegible will not bs accepte ' Called
Irl Job Address: _-- 4.F Completo Fee Schedule Below:
�; Nurrlber of Inspections r rmli aRnwed
m
Nae of Deve opment_�C-�)T Slcr t f C.
Name(or name of business) v Service Included'. Items Cost Sum
Add'ess I211orX). 4a. Residential•per unit
el rstatefzip ' r 1000 sq,IL ca less s 117,75 4
h dCi i�- ---- - Earr,adevional Soo an n.or ---- -
portion lhereul s te.7% 1
Comrnerdal 10 Residential I t rrulod Energy 4 N oo
Each Manurd Hams or Modular
2a. Contractor Installatlon only: Dueling Servioe or Fader _ a 72.76 2
(pe,to permit Issuance,applicar is must provide ccaiwctar license 4b.bervims or Feeders
Info tr.r.lon for COT data bass). Ir»IaUtion.alteration,or felocal0.1
Eledrieal Gonaaetor E C COMPANY 200 amps or lens 1 64.26 _ 7
Address PD Box — -- 2m amps to u:0 sT1pl 3 85.60 2
101 amps to t5ti0 amps i 128,50 2
Cit/ PaRTI-A Lir) State QR ZiP ���_�. I KI amps to 1C01smps i tB'1.60 2
Prune No. n'j_22 4_.z S 1 1 _. I Over 1000 amps or vols, s 36375 �_--- a
Job Na t _ T _ _ Reconnect only _ i 63.60 2
Elec,Cont.Lice. No._2 F_e! ycl _UP Date l 0"�_D_ 4e.temporary Services or Feeders
CR State CC8 Rev.No.A-9-L11.___.Exo Date 1 _15-D Insre4efion,alleratlon,or relocat on
COT Business Tax or ) €Xp.D dL=1 L__0 200 amps or less _ I 5 53 50 53• 2
201 amps to 4C0 amps f so 26 Ida
401 mps to 600 asps 4 tc0.0n 1
Signature of Supt.Flrtc1 i' c h
(her 600 Amps to 1000 volts,
�' -S - - age"b^above.
License No Exp.Dale 1 0�(1 1 _n td.Branch Cln:ults
rhorle No _ 501-224-3511. . - Now,alterallon or orionalon por panel
a)T?w-log fnr branch drmulls
2b. For owner installallons: wNh purchase of servfev or
feeder fee
Print Ownel's Narric, Each toiwch a,Cult
------- t)Trio fee Iw branch rjrrults
Address ------ -- __. _ -- -- wrrheuf p,aohsae of seMrre
CIN State _Zp —_. --- -- or w'!dar too.
Phone_Nof itst branei circuli 31.50
_ - -- -- --
------- - F_ach addita�al branch dreu't 5 35 __
The installation is being made On property I own%&"Ch is nn1 N W-rollaneoua
intended for m!p,lease or rent. (Serica or feeder motIrv-wdsd)
Each pump er lnigalion circle - 12 76
Each elfin nr outline lighting 3 41.75
Owner's Signature
-- ------- --- ` -'—'—' 8 anal Nrralit(e)or a limited enemy
panat.elloralinn nr setensuxl 3 so cc
3. Plan Relilew sectle!n(if required):' Mcur tabek(10) _ s 1100.00
Please check appropriate item and enter fee in section 50. W.Cach eddIllonel!rlepecdon over
4 or more rseidential units n nne structurs the allowable In any of the above
Per inspir dion 4 6000
SaMos,and feeder 226 amps or mat Per hour 4 80.00 _^
System over 800 volts naniral In Nanl ^ f 61100
_ Class,rred area er 6f;LrM.1r7 contalning apecAl o=porr_y W
deserlheA in N E.C.ChsFter 5 5, Fees:
5a,pnlar tc,tal of ab6-3.
.ove roes >< J3. ,
Submit 2 atta of plarss with apoleallon/suers any of the sbow spr+'y 0'A SwchArlo(Oi1 X IM 11 fort) f
Not required fro temporary rorals trucGon services. Subtofaf
6b.Form 2514 of the 6a by
NpTICB Plan no A"itm0red(Ser, a) i
PERfNrm IsFCOMC VOID IF ViOR11 OR CON;TRUCTILIN AUTHORIZED Subtnfar 3��
13 NQ1 CO'VINIENNCED WI T HIN 180 DAYS,OR IF CONSTRUCTION OR /1 Q'�t
WORK IS SUSPENDF-D OR A?IANCCNED FOR A PERIOD OF 160 DAYS � Tr,isr Arnounl R `'t `
AT ANY TIME AFTER WORK 13 COMMENCED Total balance Outl �
r
(tdets`.rErmtlele.uta doe
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
?:-Dour Inspection Line: 639-4175 Business Line: 639-4171 --
Si1P
Datu Requested Z " AM_ PM BL.D
Location 14-�OC7o -7_ Suite
— MEC
Contact Person Ph Z 6_�3S yQ _ PLM _-
Contractor � Ph _2 3 0 5�� SWR
BUILDING Tenant/Owner ELC
Retaining Wall -- ELR _
Footing Accesa:
Foundation FPS
Ftg Drain ---"-"--"'
Crawl Drain Inspection Notes: ���� ---.----
Slab
Post&Beam SIT
Ext Sheath/Shear
Int Sheath/Shear - --- —
Framing
Insulation - —— --
Drywall Neiling
Firewall
Fire Sprinkler ----_ �� -- - —C'2^x/�L�► /` �/✓�'3�J
Fire Alarm —
Susp'd Ceiling _—
Roof
Final
PASS PART FAIL ---- _—
PLUMBING
Post 8 Beam -- — -- - - -
Under Slab
Top Out -- - ----_ _-- ------ -
Water Service
Sanitary Sewer --
Rain Drains
Final ---------- --- - ------ - --.—
PASS PART FAIL
MECHANICAL `-
host 8 Beam — _ - — --- — -
Rough In
Gas Line
Smoke Dampers ------------------- -- -�—
Final - ---- --- - - ---- _ -----
PASS PART FAI..
LECTRI(:A — -------- -- ----- ------..
Service
Rough In _._V - �- ------ ----- --- ---
UG/Slab
Low Voltage _—_.-- --- -- --- - --------
Fire Alarm
ASS ART FAIL
Backfill/Grading -------- -- ---- ------ — ---
Sanitary Sewer
Storm Drain I J Reinspection feo of$_ _—_—required before next inspection r1ay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fere Supply Line [ ]Please call for re.nspection RE: _ - _ _—_ I ]Unable to inspect-no access
ADA
Approach/Sidewalk Date
Other _ Inspector_ �c c Ext _
Final —� —
PASS PART FAIL. 0
NOT REMOVE this Inspection record from the job site.