Permit ' RESTRICTEDE
CITY OF TIGARD ERG
RESTRICTED ENERGY
�µ � DEVELOPMENT SERVICES PERMIT #: ELR2002 -00128
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 DATE ISSUED: 7/19/02
SITE ADDRESS: 15862 SW 72ND AVE 150 PARCEL: 2S112DD -00200
SUBDIVISION: OREGON BUSINESS PARK III ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Low voltage for 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:
INSTRUMENTATION: OTHER: ALARM: X
TOTAL # OF SYSTEMS:
Owner: Contractor:
PACIFIC REALTY ASSOCIATES HONEYWELL INC
15350 SW SEQUOIA PKWY #300 -WMI 15495 SW SEQUOIA
PORTLAND, OR 97224 STE 100
PORTLAND, OR 97224
Phone: Phone: 968 -3300
Reg #: SUP 941 -JLE
LIC 57824
ELE 26- 207CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 7/19/02 $75.00 2720020000 Elect'I Final
5PCT CTR 7/19/02 $6.00 2720020000
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 thr gh OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
Issued by 87. Ce - $2
Issued w �,��� Permittee Signature �'1-
OWNER INSTALLATION ONLY
The installation is being made on property 1 own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: 0 ! 0-14119 _ DATE:
LICENSE NO: cie/f 177 /"
CaII 639 -4175 by 7:00 P.M. for an inspection needed the next business day
JUL -16 - 2002 10 00 HONEYWELL 503 968 3398 P . 02/03
Electrical Permit APphication
' Date received: 7 ( - Permit noL/� j) -
F {per Ci of Ti gard ��16 i Pr cct/a l.ntt.:
Ak !1 i� o.11 h J pP Expirc LrJ /1
C.'i y of Jq c4rd
Address: 13125 SW Hall Blvd, ' tg a r i l; OR 9 ® •
Phone: (503) 639 -4171 bate issued By: f3.45 ReCetpl no.:
Fax: (503) 598 -1960 JUL 1 6 2002 Cage file no.: Payment type;
Land use approval: i.. a 6 '‘).r' 1 LI 4 fix ).. r 1)
Bin i.n. k, � 'a i• , . , 44)2 0 a- -i0/9 2.-`7.--`pt
TU•PE OF PERMIT
0 1 & 2 family dwelling or accessory ,® Commetcial/industrial 0 Multi - family ❑ Tenant improvement
0 New construction U Addition /alteration/replacement 0 Other: 0 Partial
JOR SITE INI
lob address: / 5 9 6 D. 51-0 7 a'L.2_. 4v.� . Bldg. no.: Suite. no.: Tax map/tax lot/amount no.:
Lot: _Block: Subdivision:
Project name: �/E,e I FO N/ e.. FY AI Description and location of work on premises: � 4- g- f n y S Teil!n -
Estimated date of completion/inspection: - a,4, -p a-
CONTRACTOR APPLICATION FEE SCHEDULE
Sob too: 'j Q t�„ _b7 c,, 6,p- J Fee Mu
Business name: HONEYWELL Dmeription Oh. (ea) Total , no. [nap
Address: 1 5 _ 4 95 SW Se a uola Pkwy, #100 N e w "'x'
or m°to ra°°°y per
dwelling unit. Includes attached garage.
City: Portl Stater ZIP: 97 22 . 4 ' Service ha
Phone 503= 968 = 3304 'Fax: 968 - 33981 E -mail: 1000 sq. ft. or le:.c. 4
CCB no,:
Each a d dit ional 500 ft. or ntnn thereof
26- 207CL �' p0
5782A Elec bus lit no: Limited energy, residential 2
City /metro lie. no.: 4619 Limited energy, non- residential 2
1— 12 - Each manufactured ]tome or modular dwelling -
Rig re of supervising electrician (required) Date Service and/or feeder 2
Sup. elect. name (print): S teve Morehouse License no: 94 1JLE Senk or 'mien - instattation,
aheration or relocation:
PROI'LR1I' OWNER 200 amps or less 2
Name (print): 201 amps to 400 amps 2
Mailing address: - 401 amps to 600 amp 2
601 amps to 1000 amps 2
City: State: ZIP: Over 1000 amps or volts 2
Phone: Fax: E -mail: _ Reconnect only - t
Owner installation: The installation is being made on propcny 1 own Temporary service. or feedea -
which is not intended for sale, lease, rent, or exchange according to Ilatioa, alteration, orretonnoae
ORS 447, 455, 479, 670, 701. 200 amps oe Less 2
201 amps to 400 amps 2
Owners signature: Date: - 401 to 600 amps 2
nr _ ENGINEER Brooch circortis - new,alteration,
err errenaion per panel:
• Name; • A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: 1 State: J ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit 2
Phone: Fax: E
Each additions/ branch circuit:
PLAN RI YIL11'(Please check all that apply) Misc. (Service or feeder nal Included):
O Service over 225 amps-commercial 0 Health -care facility Each pump or impation circle 2
O Service over 320 amps - raring of 1 &2 0 Hazardous location Each sign or outline IightinI 2
family dwellings 0 Building over 10,000 square feet four or Signal circnit(s) or a limited energy panel. 1 J ! - 75
❑ System Over 600 volts nominal more residential unit_, in nue strutter alteration, o, exteux ion' 2 _
0 Building over three stories 0 Feeders. 400 amps or more
o Occupant load over 99 person: 0 Manufactured suucnrrex or RV Lkh additional n
P 1 t� Each add "etional insprrtitan over the allowable in any of the above:
❑ F.(•trss/lightingplan ❑ Other: •
Perinapcetion 1 1 1 )
Submit sets of pleas with any oI the above. investigation fee
The store are not applicable to temporary sonar uctiun service. Other ..
`Na alt jurisdictions weep nndi, duds, please call jurisdiction tea mine info,matiaa Notice: This permit application Permit fee 2 5_,.. )
O Visa S MasterCard expires if a permit is not obtained Plan review (at _ 9b) $
Credit card number: 5 5 96 OD o017' Off/ /oq within IRO days after it has been State surcharge (8%) .... $ (p • 00
P+16e:O C ## t -7 er,' Expire: accepted as complete. TOTAL $ • 00
N or c eta a% y oa rte •t card
1
Cir bignalrcr Am0am1 / 440.4613 (M)
CITY OF TIGi ,3D 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested 7 <2 '7 AM PM BUP
Location .__J 37 ( ,5 w 7 Z 14t' 4' Suite MEC
Contact Person PrN Ph ( ) 793 Z Y � f PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
g Access:
Ft Drain ELR 2r Z -GO) / a
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fir: S • rinkler
Susp • eiling
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
ECTRICAL
Sery
Rough -In
UG/Slab
Low Vo - • e
1 PART FAIL 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA _ �
Approach/Sidewalk Date ` � Inspector �.cA-4. 7d't «� Ext
Other:
Final DO NOT REMOVE this inspection record from th job site.
PASS PART FAIL