Permit (2) • CITY O TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
�L.�I�n DEVELOPMENT H BMENq Tigard, 1639 -4171 DATE PERMIT #: ISSUED: 6/23 2004
SITE ADDRESS: 09730 SW TIGARD ST PARCEL: 2S102BA -00600
SUBDIVISION: NO.TIGARDVILLE ADDITION AMEND. ZONING: I -P
BLOCK: LOT: 059 • JURISDICTION: TIG
Project Description: Low voltage: CCTV system.
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: CCTV X
TOTAL # OF SYSTEMS:
Owner: Contractor:
MULL, GREGORY S AND PROTEC INC
MULL, GEORGE E 720 NE FLANDERS
19350 SW POMONA DR PORTLAND, OR 97232
BEAVERTON, OR 97007
Phone: 503- 620 -3424 Phone: 235 -4000
Reg #: LIC 55414
ELE 34 -215C
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 6/23/2004 $75.00 Elect'I Final
[TAX] 8% State Surchari 6/23/2004 $6.00
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 are set forth in OAR 952 -001 -0010
through OAR 952 -101 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699.
Issued by „ �� A. % Permittee Signature d7
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
.11371-21 —2E104 14 19 PROTEC 5032350363 P.02iO4
•
•
•
;tectrica! P r it A lication Ai E')
city o Tigard iitilt OI - vici:1.1NrO \1x
13125 SW Hall Blvd. 23 j Received
Phone: 503.639.4171 Tigard. A 97223 ` ;n ot, DatdB : / / :� Fenait No .
Phone: 5 .63 503.639.4175 3598.1960 9 _ D eu Re _ %/r �/
Ili, Dr<tdB ;
t ti www.ci s ' ��� a �! .. - D ether Permit rr N ot[ ,
r �
Y:
1
:�YU �
ed/M see pa
shod- ezr
1 0
niter lotorm tl
_ . _. . � • . i' s'rJ ��� f ,,..:,,. J SuRfrle r a on
New co Q . .. _ . _,. .... • , • _ : ; ,,«,.;,�„.
❑ construction ^. ' i ' ... ... :. } { ;r.;._.; . ` r , �. , gq y c
P'+ AddiNO alterati l :-I'-1 h c a that '�"'!
❑ Demolition ❑ Other: P etttent Please check an the . .
,� ";c „ - _ � � . ' '` ❑Service over 225 eamm
-, ,••,;;.,... ❑ ervice ,i ❑Ha r 10,
13 1,. and 2 -family ' .. .. ..... .'
.. . . . : .'' + . il . , : . . •t S over 320 a
Y dwelling ►: Commercial/industrial .. � ..: ,:;',, : ,' ; :;`, . �: i;;..; � .' �'` �„ r ; ' .; t�' , M �. �! i ;,��� '.� `�% oft- and2 - fa amps ❑Buildngoverl0,000
2-family dwellings 4 or more new residentia
❑ Multi -farm! ❑ Accessory building ❑System over 600 volts
' Multi-family
i' M bu ilder ❑ Other: ❑ Bin g over three stories al o
Y ter 'n units in one structure
.,... • ,. ,. '.� •'''
`.', +;;': : I >i;. : t'.... L ..• .., , ,�
['Occupant Feeders, 400 amps or rlu •
Job r :'..:” :. ':�,:_ ` _,.''' i:f, .:41):,;:l...'1,, ' 1 , i ..: , , 1 ,. � y - �,.., upantloado • jr' :T�;• t;. Ian Parsons ❑RV park
structures
no.i,� 4, by 1 Job site address: r� 7 ❑Egess/ligh(ing P RV park
9 .7 b $ W Ti , • • s—: ❑Health -care facility ❑Other:
Cit /State/ZIP: Submit z sets of plans with any of the above.
*A. The above are not applicably to temporary counction service.
Suite/bldg./apt. /apt no,: Fro _ licabl
Project came:
`` ` :
�lt _� :n' :6. '• �
'�I :II :I .1 Ij .I: }' ��.-' '� I:
Cross street/directions to job site: c..
New residential single. or multi family dwelling unit.
Includes attache garage.
Subdivision: 1,000 sq. R. or less INS 145.15 illin
Tax map/parcel Lot no.: Ea addkl sq. portion 33.40 MIN
nia l no,: 500 R. or po
�,,; Limited energy, _
.*
�a 75.00
:cl 1 ' ; _ � - i :. _ _ ., . ..
�: :',9' ; . i � r i � L I; . r�,.:.:7i ; i` °, _ . , r llnh ed T1Dn- • � �gY, r esidrndal 7
:' ...It:
.lf", ,,•: Each manufactured or modular ~ 5,00
u . _ dwellin_, service and/or feeder r 90.90
.. 1 installation, alteration, and/or relocation
.
Services w
orf
feeders enI
I
i 1' i' rr ` ` � :' ^':1; =.r ii t,!, , 200 amps or less 80.
: i,1, B t �,� r. "i ryiq,:; ,ti 4 ,. ' t a v,;:: ,,, 201 s to 4 35
' .. amp amps
�(� 106.85 -
At
` _ • 401 amps to 600 amps EN 160.60
]
Address: I S w , 601 amps to 1,000 amps 240,60
; Over 1,000: .. a or volts r
4 56.5
Reconnect only
66.85
Phone: a Temporary aeivleea or feeders installation, alteration, and/or
• relocation
Owner Installation: This installation is being made on property that I own which is not 200 amps or less
intended for sale, lease, rem, or exchan according 201 n 66.85
ge, accordin to ORS 447, 449, 670, and 701. amps m 6 00 amps 100.30
Owner signature:
Date:
Branchcircul 401 amps to 600 amps
s1 ; 133.75
i t i'
,: i' ; ':6 .. , 1 r; i 1 , t . ' : .a , . :; 1 � i new, alteration, or extension, per panel
Business Hattie: a � ` 1 "` .'t ; +v:.i(;; A Pee for branch circuits with
Br i t feeder fee, each
•
Contact name: branch circuit 6.65
B. Fee for branch circuits
Address: without service or feeder fee, Ill each branch circuit 46 85
City/State/ZIP:
6.65 -
Phone :( )
Miscellaneous (service or feeder not Included)
E-mail.
Pump or irrigation circle 53.40
Si
or Sign outline
. , lighting
•' • • 53,40
r04' r ; i l,' ,":: e n a P al red-
.... ..§-'-''''''.:'"-:'-',I..-1_1,-:%.
r:�' , • q a .r ; t; .:,�: ; •. x .: .. ", ., fan 5 or
L �, � �'. • �.1_, -� . '�1: "'��� ,ty. ..,:: , CTI q'gYP� alteration. i•:. ,u,. fk 61.7 'wL'° f)!; r r �l
Business name: �:5:' :,, s;u6G,','; Panel a on, or
� s
�� li ` Z; extension. Describe: Page 2
kddress: 1
►. 4 2:7— Each additional inspection over allowable in any of the abov
:ity /state/ZIP. 'c) �� . 9..3 Per inspection 62.50
'hone: �3) f Investigation per hour (t M mini r 62.50
:CB Li c COO Fax: 5) 3,5'_ 8363 Industrial plant per hour ow 73.75
Lie.. V yl Electrical Lic.;3 �+ S uprv. Lic,: `1',- " : : ; :.: , : ,;.. ...:h,; ,.,,, 5
VG '�o�iaLtz14
'ir i . (.,,. �: .. ; '�i:f; i' i }1;r;; 4u,�a,• r °: ,...rs
uprv. Electrician signature, requir L Subtotal ‘ 5: ea.
rint name: ,. , 1 . , j
Date: tv �I Q - State surcharge (8%e of permit fee) • oa
uthoriud signature: f D TOTAL PERMIT F E 91 .'
This permit application °spires It • permit Is not obtained within II
itr[ natnC: days after-It hu hoes accepted as compteic
Date: • Fee methodolegy set by Tri Count Building I nd
ddieaPam;n191.0 - P�,l doe 12/03
•• Number of inspections per permit allowed.
�Y Service Board
440.461 sT(10/02/cDM,wa9
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
Received Date Requested 3 I AM o — — PM BUP
Location 7 6 L i% /1r2 Suite MEC
Contact Person Ph ( ) 02 O -' a PLM
Contractor Ph ( ) { °� -' SWR
BUILDING Ten t/Owner 6TEsiDE } ELC
Footing f4 I CX 2-0 3'( - --ELC
Foundation Access:
Ftg Drain ELR '7G'6 Do 7 7
Crawl Drain .(
Slab Inspection Notes: 1 0 y� - SIT
Post & Beam � / .�[t)
Shear Anchors C
Ext Sheath/Shear - l ' ) A A - - d - . 44 A 111 / /
Int Sheath/Shear J
Framing
Insulation
Drywall Nailing
Firewall P12 r� / D �� Fi A(//1211—/ Fire Sprinkler � � C '� V �.IJ
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL - -
PLUMBING •
Post & Beam •
Under Slab
Rough -In
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
Low Voltage
Fi e Alarm
a __FM!. El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
illarD PART FAIL
El Please call for reinspection RE: D Unable to inspect - no access
Fire Supply Line
ADA d O AVIZIE
Date 1
Approach/Sidewalk Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL