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Permit • q CITY F TI D ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00301 d a'j DATE ISSUED: 10/23/2008 TIGARDI 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 112D D -00500 SITE ADDRESS: 15860 SW UPPER BOONES FERRY RD B15 ZONING: I -L SUBDIVISION: OREGON BUSINESS PARK I LOT: JURISDICTION: TIG PROJECT: ENVIRONMENTAL CONTROLS Project Description: Burglar alarm. 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: BURG ALARM X TOTAL # OF SYSTEMS: 1 Owner: Contractor: SUBOTNICK, RUTH + PROTECTION ONE ALARM MONITORIN SIEGEL, LOTTIE 15500 SW 72ND AVE BY PACIFIC REALTY ASSOC STE. 100 PORTLAND, OR 97224 PORTLAND, OR 97224 Phone: Contact #: PRI 503- 624 -0244 FAX 1- 866 - 223 -9925 FEES Reg #: ELE 34- 428CLE LIC 116325 Description Date Amount [ELPRMT] ELR Permit 10/23/200E $75.00 [TAX] 12% State Surch 10/23/200E $9.00 REQUIRED ITEMS AND REPORTS Total $84.00 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 or 1.800.332.2344. ns / Issued By: 4 / Permittee Signature: O �i°f U e'�.o �/ 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. INSPECTOR'S SIGNATURES ARE NOT Inspections Required for: Z ,2ppf- y2'J,/ . REQUIRED ON GREEN INSPECTION CARD. l e Code I Inspection Description PASS Date I B Code 1 Inspection Description I PASS Date B BUP - Building Permit ELC - Electrical Permit 405 Excavation 105 Underground /slab cover 410 Fill 110 Temporary electrical service 415 Grading 115 Electrical service 205 Footing 120 Electrical rough -in 805 MFG - Structure grading /footing 125 Wall cover 210 Foundation walls 130 Ceiling cover 215 Footing drain 135 Low voltage 220 Slab 140 Sign installation 310 Crawl drain 145 A/C or heating unit circuit 225 Post /beam structural 150 Hot tub /spa /pool 230 Underfloor insulation 195 Misc. inspection: . 235 Shear walls /anchors 199 Electrical final 240 Exterior sheathing 245 Firewall 250 Roof nailing ELR - Restricted Energy Permit 255 Wtr proofing basement walls Ci 135 Low voltage . 260 Tilt -up panel / 195 Misc. inspection: 265 Masonry 199 Electrical final 270 Reinforcing steel (rebar) 275 Framing 810 MFG - Structure set -up MEC - Mechanical Permit 280 Insulation 605 Post /beam mechanical 285 Drywall nailing 610 Gas line 287 Suspended ceiling 615 Mechanical rough -in 295 Misc. inspection: 620 Hydronic piping 899 MFG - Structure final 625 Duct work 498 Grading final 630 Fire damper 299 Final inspection 635 Smoke detector shutdown 640 Exhaust hood 695 Misc. inspection: 699 Mechanical final BUP - Fire Protection System Permit 905 Sprinkler underfloor /slab PLM - Plumbing Permit 910 Sprinkler rough -in 915 Fire alarm rough -in 305 Plumbing underslab 310 Crawl drain 920 Suppression trip test 315 Post /beam plumbing 995 Misc. inspection: 998 Alarm final 320 Plumbing rough -in . _ 999 Sprinkler final 322 Shower pan 330 Water service 335 Rain drain • 340 Storm drain SIT - Site Work Permit 505 Sanitary sewer , 405 Excavation 345 Culvert /catch basin 410 Fill 350 Septic tank • 415 Grading 395 Misc. inspection: 205 Footing 399 Plumbing final 210 Foundation walls • 215 Footing drain 420 Sprinkler supply lines SWR - Sewer Permit 495 Misc. inspection: 505 Sanitary sewer 498 Grading final 595 Misc. inspection: 499 Final inspection _ 599 Final inspection I: \Building \Forms \InspCard- AOP- Blank.doc 02/02/07 EOCT. 23. 2008_1 8: 53AMppiication : tk . - < "�- y of Tigard ! .- . --- ` .,� ' s � f• 1 IV - 'of' -', �,r } } ` t9 e. :,, i. City and Received :' S'° w i ° 13125 SW Hall Blvd., Tigard, OR 97223 Date /B : /0 a3 p. A. hermit N°1"-- o, ' •y Plan Review �00� QO 30 -� 0 P hone: 503.639.4171 Pax; 503,598.1960 T ,�`,K Inspection lane; 503.639.4175 Aa y' Other Pormir Date Itc nd /B� — kw: Internet www.tigard or.gov RECEIVED y Y furls: ® See Pago zz Ivor Notified/Method: t ,:, 't� FI ,,, j{ 0. 776- Supplemental Inforrnatlon € ' 1 r � t i a 111 ' i (1 n:zat, 1.@ ', , t ,%� t ,i 0 7�1 ' i! I; ' ` � � ��ti118� it 1 , { �;� tff�v�� 4;r.,+,j��19 t.i s �, ,1 , ❑New COnstl'llCtion — � � , � �� "� #' • � �. �l� l } � : E �!: • [r Addition/alter: e. acement Please chock all that apply (submit1 sets of plans w /items checked below): 0 Demolition Q ❑ Service or feeder 400 amps or more i Other MI► a Gru"' p 0 Building over three stories. !t• In €I kt I €sl. id „tliFi] ul$4 , t I pn i a 7 '1 ° 1, where the available fault current ❑ Marinas and boatyards, !,i nt a °° sE,t+ , t i :a ' tF�tisfr,s t , r; gi :la 8n 1 �4 , t tl �1,tu' } t, ; exceeds 10,000 amps at 150 volts or ❑ Floating buildings. El 1- and 2- family dwelling ( "Comincrci industrial D Accessory building eltStt less to ground, or exceeds 14,000 ❑ Commercial-use agricultural 1:1 Multi - family El Master builder amps for all Other installations. In sngs ta ❑ Other: ❑ Fire pump tin , " , e asn It � , , Installation of 75 KVA or 0 } 9,. , aana,atn`l'rom t it ` ' E. �,i i t , , 1 � ' rgeno a stem t C �� ; i � U ,, , ' � ❑ Y argersepat' atcly der ived system tt d, a at• ., ci 6 , ski •, s ,,, ilk ^t 1 ❑Addition of new motor load of l Job 110.::6 ,0 i Job site address: /5 �, , f" e. 100IiP or morn occupancy, c�tN „ a • r }. 0 Si Or moro residential unfit . ,y � — s ❑ Recreational vehicle parks. City/State/ZIP: . 1, t? •' p] Ole i r.. 01calth -care facilities, Q Supply voltage for more than ❑Hazardous locations, 600 volts nominal. Suite/bldg. /apt, no...4/API Project 1 ❑Service or feeder 600 mi.?, mare. �_ [!� It ! Il[!, iJ1 11� Cross street/directions to job site: - Min' q'. s IP , dN �>4t, or .�{1 wed.. on «. Temt MN New residential single- or multi - family dwelling unit. Includes attached ' arage, Subdivision; 1,000 s.. Lot no.: or less 500 145,15 �� Tax map /parcel no.. Ea. addl 500 s : ft. or portion MI 33:40 Ell I d `� ! 1 1` 1 137 "� n', elil o , , ' Limited energy, residential � v salt: „' ' with above s . ft. 7$.00 Limited energy, multi- family III SIP i - r 111! - , j1 Imo.:• Itt. L residential with shoves . ft, 75.00 © Services or fenders Installation alteration and/or relocation lit i,li'.:,er Et d , : tlo i'a ) ilk} ;}� 200 amps or less NM 80.30 � ii, al: t t V na a 11 NE .'I . -1 , t s Il 111 ]ill 201 amps to 400 amps al 106.85 13 401 amps to 600 am•s ME 160,60 1131 Address: 601 am.s to 1,000 am.s 1.11 240.60 Ell Over 1,000 amps or volts - 454:65 e City /State/ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) Fax ( ) 200 amps or less 1.1 66.85 El Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps MI 100.30 U intended for sale, Iease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps ME 133,75 Engsnall Q liar Owner signature: yy �{ f #t j ilig p �t { Date: �; i { {`� above service '�- ' !mi,.i... F?I'?'t!11 1 " — N� i ,�fi�4ll .inl ,'i�tll i P l ' .i' r' 4ftarta,, ;�t9; a E A ce or circuits feede fee, Business name: each branch circuit 6.05 III E. Fee for branch circuits Contact name without service or feeder fee, 46.85 II first branch circuit Address: Each add'' branch circuit 1.111 6.65 n City/State/ZIP: Miscellaneous service or feeder not included Each manufactured or modular Phone: ( ) dwellin', service and/or fader 90.90 � Fax: ; ( ) Reconnect only 1111 66.85 � tI E-mail: Nul�ll f lilt ttt t ��;� 1ptgt�■�tt��iI tt�RilI;;!! 1' U� Pump or Irri_ation circle 53.40 uk111111Hililitll1 it it tN ' ..� dionv lql rout .,11 1littlttflgll E : i{ !l�• . 1 uiial;ta� :1i. 1 ,ll lft91 Si or outline li NE 53.40 r © Business name: j �a. I, 1 i Signal circuit(s) or limited. Address: c^' �' energy panel, alteration, or R c" 7 1 _MO fr eJ l. W. extension. Describe: Page 2 City /State/ZIP: ` fQir `t Ili* ' E , ; t , t . , : Hq j•U .I J'I - t.1 kat.11ai-,JJ• .f the above Phone: ( a ) 44 '5, '9,,4:k Fax: ( 6 ) . tee Perin 0250 �� 02 Invest'_atition on . er hour (1 hr min) 62. 1. CCB Lac.; 1 i , • Electrical Lic.: �J �'°3 -',. / . , 5 � � , y �7Lic.; .�� (�� Industrial 111111 '73.75 Suprv. Electrician �� , i.; r , t ;! 11,; f , i . , >a' 1' lent per hour ' i�Fi' ,, I �,, d 1 signature required: ��i s' 11a :r 'lilt I1 '` � - ' Subtotal: - �� Print name: X. N S•. L•be�ND ' Date: (0 23 w J Plan review (25% of permit fee): � r . a State surcharge (12% of permit fco): , .0% Authorized signature: /∎ / / r . •—+� TOTAL PERMIT FEE; Print name: r` This permit s p p '"" Date: ��t P pplication es ires it a ermitis not obtained Within 180 l �%!!lIR.•� days after a bas been accepted as complete, t.ta ldluporinitt∎ELC'•pcnaMpp.Jac (15/23/06 440.4615T(1 I /05/COM/WEB " Ivltmbcr of ■rlgpeetions allowed per permit.