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Permit
n CITY O F ® I D ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00119 TIG 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/19/2008 PARCEL: 25101 DB - 00101 SITE ADDRESS: 07420 SW HUNZIKER RD F ZONING: C -P SUBDIVISION: HUNZIKER PROFESSIONAL CENTER LOT: JURISDICTION: TIG PROJECT: BALANCE TOUR WORLD Project Description: Installing (1) low voltage alarm 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: X INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: RAY HALLBERG BRINKS HOME SECURITY c/o HALLBERG, RAY C TRUST 8080 SW CIRRUS DR 3270 LAKEVIEW BLVD BEAVERTON, OR 97008 LAKE OSWEGO, OR 97035 Phone: Contact #: PRI 503 -641 -0287 FAX 503 -641 -0960 FEES Reg #: ELE 34- 166CLE LIC 44421 Description Date Amount SUP 3213LEA [ELPRMT] ELR Permit 5/19/2008 $75.00 [TAX] 12% State Surch 5/19/2008 $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. Issued By: t. ___ . , - 0 ;:; ) Permittee Signature: / r - N 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: gzae,jU - 0)(1f REQUIRED ON GREEN INSPECTION CARD. ✓ Code I Inspection Description 1 PASS Date I By 1 Code 1 Inspection Description I PASS Date By 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 X 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 9] 5 Fire alarm rough -in 305 Plumbing underslab 920 Suppression trip test 310 Crawl drain 995 Misc. inspection: 315 Post /beam plumbing 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: \ Buil ding \Forms \InspCard- AOP- Blank.doc 02/02/07 05/18/2008 19:41 5036410960 � i BRINKS HOME SECURITY PAGE 02/04 Electrical Permit Application 1 FOR OFI ICE 1 (1NI -/ • City of Tigard , !� +�' ,, � '� ., i (r2r •crrnitNo.: � UQ 4*"- /1 13125 SW Hall Blvd„ Tigard. OR 97223 watiill , t T, O ther Permit: u Phone: 503.639.4171 Fax: 503.598.1960 VI �1 s v� I t : A R D Internet: Inspection n Line. 503.639.417 S $ G D� Notified/Method: + ' cndy /fly; A�Oy�,r El See Page 2 for v ,L 1 r ` Sttppternrntnllnfnrmntton uwwtrgard or.go '' tYPt t 'WORK _ Please check all that e tftl below): ,iPtiaN tVi tyv 0 New construction ® Addition /alteration /replacement imply (submit 3 sets of plus w /items checked ❑ Service or ibcdcr 400 amp!, or more ❑ Building over three stories. 0 Demolition ❑ Other: where the available Pzult current ❑ Marinas and boatyards. ': ;oF :Coi�'STRZTCrIoN • exceeds 10.000 snips nl 150 volts or Floating buildmgs, , , lees In ground. or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ❑ Commercial/industrial 0 Accessory building amps for all other installations, buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. 0 Installation of 75 KVA nr ` ` 1': o J019; !Sl1'E'. i 1141` R]M!YATION :AND l:LOCATION mo r load of , .. 1 -- . system. , O Emergency system larger separately derived stem ©Addition of m Q •'A" "r" "1,2" ,• '1" 100HP or more. occupancy. Job no.: 80538213 Job site address: 7420 SW Hunziker SY Q Recreational vehicle arks. ❑ Six or more residential units. P ❑ Hcalth.care (Witten. ❑ Supply voltage far more than CitylState /ZIP: Tigard, OR 97223 - 0 Hazardous loontinns. 600 volts nominal. Suite/bldg. /apt. no.: F Project name: ❑ Service or feeder 600 amps or more. I >.,,, r ,`FEE SCHEDULE • ; Cross street /directions to job site: 7r Ave Description i Qtr. r ' Fees r T "ml 1 New residential single- or multi - family dwelling unit, Includes numbed garage. Subdivision: Lot no.: 1,000 sq. ft. or lest: 1 145.15 4 Ea. add'I 500 sq. R. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION "OF :WORK (witfi above sq. IL) Limited energy, multi- Pamily 75.00 2 Low Voltage Alarm installation residential (with above .sq. ft.) Services or feeders installation, alteration, and /or relocation 200 amps or less 1 80.30 2 , i; ®''pROpEir,'Lh iCJVI'■' ,®:,TENA'N7 201 amps to 400 amps 106.85 2 Name: Balance Tour World Bookkeeping 401 amps to 600 amps 16().60 2 601 amps to 1.000 amps 1 I 240.60 2 Address: Over 1,000 amps or volts I 454.65 I 2 Temporary services or feeders installation, niterntinn, and /or City / State/ZIP: _ relocation , Phone: ( ) Fax: ( ) _ 200 amps or less 66.85 1 Owner installation: This installation is being made on property that 1 own which is not 201 ampit to 400 amps 100.30 2 intended for sale. lease, rent, or exchange, according to ORS 447. 449, 670, and 701. 401 amps to 599 amps 133.75 _ , 2 Branch circuits – new, alteration. or extension, per panel ranch circuits with a , APPLT above service or foetal• fcc. f Owner signature. Date: - - A. Fee for b C ❑ , 'CONTACT 1. KL'T; 'PERSON. _ 6.65 2 each branch circ uit _ Business name: B. Fee for brunch circuits without service or feeder fcc, 46.85 2 Contact name: first branch circuit Each add'1 brunch circuit 6.65 2 Address: - Miscellaneous (service or feeder not included) . 1 City /State/ZIP; Each manufactured or modular j 90.90 2 dwelling, service and/or feeder l Phone: ( ) Fax: : ( ) Reconnect only 66.85 1 2 E -mail: Pump or irrigation circle r 53.40 2 ' ' - CONTRACTOR' Sign or outline lighting 53.40 2 Signal circuit(s) or limited - Business name: Brinks Home Security energy panel, alteration. or extension. D escribe, 1 Page 2 75 2 Address: 8080 SW Cirrus Driver City / State/ZIP: Beaverton, OR 97008 Each additional inspection over allowable in any of the above — Per inspection 62.50 Phone; (503) 611 -0287 Fax: (503) 641 -0960 _ investigation per hour (1 iir min) , CCB Tie_: 044421 Elc..uic.1 Li .: 34166CLE Irv. Lie.: 3213LEA Industrial plant per hour _ 73.75 1 � .. ' ELECTR1CAL. PERMIT i•FEES Suprv. Electrician signature. req 4. •,f` � Subtotal: 75 DO / Date: 05/16/08 Plan review (25% of permit. fcc)- State surcharge (12% of permit fee): f/O Authorized signature: apgr ` / ,,j/ TOTAL PERMIT FEE: / G implication This permit expires If n permit is not ado ned within 180 Print name: Jackie Me 41e Date: 05 /1 6 /08 days alter it has been accepted as complete. Number o inspections allowed per permit 1;\ Duldine \r'cmmits\EI.C.OcrmitApn.aoc o5r2Pa6 44O-4615 /OS/COM/WEB