Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
A DEVELOPMENT SERVICES PERMIT #: ELR2004 -00264
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/18/2004
SITE ADDRESS: 13221 SW 68TH PKWY 460 PARCEL: 2S101 DA -00102
SUBDIVISION: TRIANGLE CORPORATE PARK ZONING: MUE
BLOCK: LOT: 002 JURISDICTION: TIG
Proiect Description: Access control - 7 door 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:
ROBINSON, ROY HONEYWELL INC
2655 SEELY AVE. 15495 SW SEQUOIA
SAN JOSE, CA 95134 STE 100
PORTLAND, OR 97224
Phone: 408 - 943 -1234 Phone: 408 - 943 -1234
Reg #: SEJB68 -3598 LEA
L968- 330050191
ELE 26- 207CLE APP. SAYS C1
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 8/18/2004 $75.00 Elect'l Final
[TAX] 8% State Surchar€ 8/18/2004 $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 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699.
Issued by /UD■ Permittee Signature sl
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
AUG -18 -2004 12 23 HONEYWELL 503 968 3398 P.01/02
•
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard RECEIVE ' D , / lip U �� � ' PermitNo.:( L did , 6
13115 SW Hall Blvd -, Tigard, OR 97223 Plan Review
Phone: 503.639,4171 Fax: 503.598.1960 !%.1 , f' Date/Br Other Fermin
Inspection Line: 503.639.4175 r > -'1 1 Da Rrad H Sec Page t for ■
AUG 18 21 ° Notified/Method: • 1i �f S upplemental Information
Internet: t www.ci.tigardor.us
a- ::,: ,.: ! r ;
•v:. ,.w:. - sJY�� •' ' : d i ^+:1 . . , � r`.!'' d' ". i'Infa' � ".Viii '' :'. �? �I� p L, : Fl:i�;�C�`.!'' !� :. i
•� ; " • "a+ - ° - 5'� :.�� ' � . ..
d:•', ' .C• ;
. ;
•r'�; .1 1 , =' ;..... . ? , •,a. ° - , ,
� ::._ : .: r , .. .,. - ...• ..
µ New construction ❑ Atlettliglinientlgitelitent Please check all that apply:
❑ Demolition (] Other ❑Service over 225 amps, comm'i ❑Hazardous location
:.�; ❑Sctvice over 320 amps – rating ❑ Buildng overt 0,000 sy. ft., + " . r �J � i � r � .�' °�� ze' '' ° � � � � ;!: ..: : ., :; � • ' vt' ig;� of l -and 2 dwellings a or more new residential
�•.I fr'i.V.e , r'_ , .. :S �., �• � .�.. nt 'J.. - .. ._. .: avr. ,lw_�.��.._:.
❑ 1 - and 2 - family dwelling IJ✓ Colrmlercia1/industrial ❑ Accessory building ['System over 600 volts nominal emits in one structure
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other: ❑Manufactured structures or
Y ❑Occupant l oad over 99 peranns
r: � - - r . crr RV ark
s :� d �; :a, r , . ` t!'' p.. F ' a o{� ' s `Q: . f�; }? ti° .'- E s/lightingplan P
Job n0.171401 21 Iii Job site address: 13221 SIN 1peuTI4v ii4(00 0Healih -care facility ❑Other: '
. Submit 1 sets of plans with any of the above.
City/State/ZIP: Ti la ral , b R '1122 The above are not applicable to temporary construction service. -
� �
Suitc/bldgJapt no.:"l�o Project name: �
1 `d`'""� 1 ' ..
�0►V� Description I Qry, 1 Fan 1 1 ' NMI l
Cross street/directions to job bite: r New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. R. or less 145.15 4
_
Subdivision: 1 Lot no.: Fa. add 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 - 2
Tax map/parcel no.. Limited energy, non - residential 75.00 2
� };`� F >::9.w.:. .1° ,c , ,••=r0 `' s'`�� -' or modular -
` �% �:: t! �,: �; •m,!:,!�1�>.:. <.� r .��- �' .,...�. :,,: 5. ,��citrt•1.,. ^. -•.,t Each manufactured
r dwellin:, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation _
200 amps or less 80.30 2
• •L« '. - 5 , . - 201 amps to 400 amps 106.85 2
�� w ��1l_y�y._ry,{� � :
� • y�Il {'y, • 5...�.i.!• : ' .���, l� i � � l:
! • fit.,. 1:00, _"`- -4' "" .c +i '. r,•. D,!.' -r•,. ' ''''''1'.3"i'''-''''''' • , ' - . - ,:'< 401 amps to600amps 160.60
Name: _ 601 amps to 1,000 amps 240.60 2
Address. Over 1.000 amps or volts 454.65 2
- — Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) Fax: L. ) 200 arms or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps 1a 600 amps _ 133.75 . 2
Owner signature: _Date: Branch clrcnits– new, alteradon, or extension, per panel
1 �•re - ��., �� �. e if=s• yo- �';a r����::.r�}',(:?� u; r""""""' s„:`. A. Fee for branch circuits with ;r , ; : - . • r , . a�.. d. ;i 'r • t. -• servi or feeder fee, each
Business name: y branch circuit 6.65 — 2
B. Pee for branch circuits
. Contact name: without service or feeder fee, 46,85 2
each branch circuit
Address: Each add'I branch circuit 6.65 2
City /State/ZIP: . Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) 1 Fax: : ( ) Sign or outline lighting 53.40 2
E Signal circuit(s) or limited
_, - , -: r:ru 1, - .. ,.. ,,� r .. . .,,. . ti • :+ 5, 7�4;T.:::u��; .,:7,i'i : a,.�»,..- :.. •'r energy panel, alteration, or
•... - x' _ �.;`�i 4 1• GfLI� .�.:.e , �... • ��hir.n'.��:: - .:= C.'r� .' ?a fiJ7 Y :� :,a,�,
•;y` ^ y. : "' °''" ' K extension. Describe: 1 Page 2 7 2
Business name: . o{/t . —
Address: 1641S S 6eiet in i I iv D Each additional inspection over allowable ID any of the above
�/ Per inspection 62,50
City/State/ZIP: r1-101,y0 DR ( / ' Investigation per hour (I hr min) 62.50
Phone: ( �?j) q ' teS 23 D O Fax_ ( ) q 6 p 2 V 2 1 _ ;s, 'Industrial plant per hour 73.75
Y iJ v D - J I ; • ?.. .: wa
CCB Lic.: 150 I�l I Electrical Lic.: 2(p- 74164,Suprv. Lic.: 6141 1 - Subtotal 'T j
Suprv. Electrician signature, required: r, Plan review (25% of permit fee)
Print name: "1 (��/�!1 U
State surcharge (8% of permit fce) L
-, l Dale: g I� (Dt f TOTAL PERMIT FEE ,�/ l
Authorized signature: ,l(� A/
7X - 1
This permit application expires If a permit Is not obtained within 180
� , I f b • Fee Print name! g� -�(Q, Date: � methodology ,et by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
-- . • . . .- • . - -- .. . --., eAf msivir/JYJ/rrimrwra
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line:-.(503)639-4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 1/ — e 7 AM PM BUP
Location /3 3 D` 1 (p R Suite 94 d MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) 7q - 4 7_3 SWR
BUILDING Tenant/Owner - (.c�i ELC
Footing
ELC
Foundation Access:
Ftg Drain ELR 04b % / _
Crawl Drain
Slab Inspection Notes: h 0 0 5 s G � * SIT
Post & Beam 1 J
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING (2, E
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
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line J�
ADA
Approach/Sidewalk Date d Inspector Ext
Other:
Final DO NOT REMOVE this Inspection recor from t : Job site.
PASS PART FAIL