Permit (46) CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
l � DEVELOPMENT SERVICES PERMIT #: ELR2005 - 00066
R �I 417.1 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/23/2005
PARCEL: 2S115BA -02500
SITE ADDRESS: 16200 SW PACIFIC HWY W. ZONING: C -G
SUBDIVISION: TIGARD TOWNE SQUARE LOT: 001 JURISDICTION: TIG
Project Description: Extend data, phone, music & security.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 3
Owner: Contractor:
F + S SECURITY ELECTRONICS INC
708 20TH ST SE
SALEM, OR 97301
Phone: Phone: 503- 371 -3984
Reg #: LIC 00034054
ELE 24 -199CL
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 3/23/2005 $225.00
[TAX] 8% State Surcha 3/23/2005 $18.00
Total $243.00
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 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: Permittee Signature: c ,,n„ 1/41 ,
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.
03/23/2005 11:19 503- 585 -5392 FS ELECTRONICS INC PAGE 01
03/23/2008 08:88 FAX 6033081980 2.4 ITY OF TIGARD 11002
E1 ctrical Permit , ' f, . , ; „, 4 1i 1 +, , 1 , , . , .,
City of Tigard R00ej` 70 I, – 1� c., L- "O
W �
639.4171 T Fa t 03995.1960 MAR 2 3 200 .�. ' . .
now 2 Odor Porde
tnrpeatIon Lino: 503.639.4175 .. 1 1 i p re ■ Oa Pao 211
» vrww.el. ip rd.er.us . TY OE T 1v A a NalRed&Mothod: _ T l \ f Supplanted Isfonsatkan
1:1 Now ceneaueeim+ , _l. !4 .1 Ba li ..,.. „... Plesw ahacken th tepP
p Demolition • Hiller. • 0 • . C Melvin oval= sate, cumin p 1•isordoun location
(]setvtee over 320 amps – asliae ❑>3tdldog -ft”
' . CiTEOOI%Y- OR : .' : , . • ' • of i- and bhmrly dwellings 4 or mom now r id.ntial
"CI 1- and 2 -thmily dwellin Communist/industrial t industrial ❑ Accessory building ❑ �e e'er 60o vows nomt<ul rmlu in one m.mnue
Ogtar. OBundhR over t roesoden ❑F.e s.400aatpauaea
❑Muni- f1rttll Aiasterbull
Q, ❑Oceupme load over 99 paw i
persons ❑ daati amnia stratum turn cr
JOB KIN INPOi TION 'AND IiOCartor - . Ciewnialiakins Obu RV park
lob nos yob the adah>:ad� %�� l �1 b c, �j w 1 � D rhene e na6y � –
• r� `( submit 1 sets of pima with any of the above.
Cip4smt alP Alan! , OR a The above sae not applicable m usrpafnq contbuedo■ telvica
------ . • �- "stns .. .
suite/Suite/bids/apt. nor: Prvjaoc+s.me �.,� • «; • �
w ueee J 49 1 rel. 1 Two 1
Cross street« to job sit& ( ( Now sins mdat -madly dwelling mil.
1,000 sq. d, or km 14115 4
Subdivision : I LOr iron: Es. EMI EMI 500 sq. ft. or portion 33.40 1
- -- Limited eeat8)r, tetddend.l 75.00 2
Tax imp/pares' no.: Limited rangy, eorrrsddendsl - 7100 2
DESIM PTION OF WORK . , Ezell aaauBe■ red or modular ' •
r1/4.16/einci . t (� dwel6ee. service andAOr tl �4g
S 90.90. 2
•
t ' ``C / v 115 f C PLr A/�� Swims or eta! Waeuaitan�ak■radorb ■ad/ar rdodtle■
P 200 amps or leas • 80.30 2
Q YROPER'PY R A �TENAIYi 201 amps to 400 amps 106.83 .. 2
001 amps to 600 amps 160.60 2
Nance: a l 601 amps to 1.000 mains 240.60 2
Addy Over 1,000 amps of volts 454.65
Rsco*u etoely 6615 3
City/Stale/ZEN '- 41/
Temporary services ar Imam ba.q»a.l•■. ■leaeattoa, and/or – mintedsa
Pboar (�7 7 9 -. J Fax ( ) 200 or Ina 66.85 1
Owear This inar.lmtion in being made On property that I own which is not 20l .sops to 000 alms I Op30 2
6,teeded for sale, lease, n or atdisa$4 according to ORS 447, 449, 670. end 701. . 401 anrpe to 600 snaps 133 -7s 2
Own- sib: Date _8inaara eiraoib - new. ettorudon, or e=esaalon. pp .
0 .pp=,m • I.. Cl CONTACT PERSON • A. Fee ax brash aiawits with
marries or order Am each 6.65 2
Business MUM botch abcuit - —.4
B. Fee fie tooth nnvila
Contact fern: without 1onion or fonder fse. 46.85 2
rash branch Necult
Each add, bomb choait 6,65 , 2
Chy/SmtnILLC: M - oc-°I i ' (service or 19.69+ as lielu6ea) 53A0 2
• Plwns ( ) p r's ' s� orautl glu 53.40 2
E-mn l; _ _ Signal ) or deiced.
• C Oa. el, de
pans oton. or -3c �
41 �ap
Buddies Hann+:: 73 S S t = I , '� exudon. bmr�ibe: Page 2 � 2
gads addIdoad inspection ever atb.reble In ■ et de above
Address: —701; Pow a 6250 �T
Cat�d56auRIP: 5 tee R - 1 ? 7 / _ lovaetigation perbour(1 Mink) 6150
N Phan" 0 - ../4, '- - ! Pax. ( # , �i 53 / 2 . bad 79.75
ELECTRICAL rimer IFEES• '
CCB Lim � �I .1.. ic.:/ /; . c
Suprv. Eloetrieien Arum requited: Pten review (v5t6 of permit flee)
Print Harr �!A/ r. 5 l Danz; 3 W — m, MitiMId (896 of Tomtit tie)_ j _2
A1dhOriend algnature 1111° � %/ This poring mmeeptto mows ma wait at m tw:■a amain inis tee
ems altar it bas b mo aoapo nl as wan.wre
Print name Dam: • Fig,nut0Mobgy to WTI—Cam Building Midway Sarriue email
_. ° Numhe of Insmedero pmForn t aliened
I.umosmuwoomos.c.rmedb,en.aa 144f 447-61r•1IW+GOMnvn:3 0 0
FROM 5035981960 TO 03/23/2005 9:01 AM Page 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR200500066
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/23/2005
Phone: (503) 639 -4171 m rdypll °1 � ' i�
Inspection Requests (24 Hrs.): (503) 639 -4175 �- `'I
INSPECTION WORKSHEET FOR DATE: 4/13/2005 TIME: 7:10AM PAGE: 80
SITE ADDRESS: 16200 SW PACIFIC HWY W CLASS OF WORK:
SUBDIVISION: TIGARD TOWNE SQUARE LOT #: 001 TYPE OF USE:
PROJECT NAME: PARTY MART
DESCRIPTION: Extend data, phone, music & security.
OWNER: SN INVESTMENT PROPERTIES, PHONE #:
CONTRACTOR: F + S SECURITY ELECTRONICS INC PHONE #: 503.371 -3984
Inspection Request Scheduled For: Date: 4/13/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 004358 -01 503 -371 -3984 Y
Corrections /Comments/ Instructions:
Ho p•`s ice, b ( r,sL,E) ,-,- --
'S')
S ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED .
Inspector: Date: / ^ Or Phone #: (503) 718-