Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00127
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/27/2008
PARCEL: 2S 113AB -00101
SITE ADDRESS: 16101 SW 72ND AVE BLDG A -200 ZONING: IP
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG
PROJECT: QUALCOM
Project Description: Installing (1) low voltage access control 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: : X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES ADT SECURITY SERVICES, INC
15350 SW SEQUOIA PKWY #300 -WMI 2815 SW 153RD DR
PORTLAND, OR 97224 BEAVERTON, OR 97006
Phone: Contact #: PRI 503- 469 -7212
FAX 503- 469 -7114
Reg #: ELE 26- 209CLE
FEES LIC 59944
Description Date Amount SUP 389LEA
[ELPRMT] ELR Permit 5/27/2008 $75.00
[TAX] 12% State Surch 5/27/2008 $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: j Permittee Signature: /�,ov
Ii
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:
Cali 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.
May 27 03 12:53p Stephanie Pate 503.469 p.1
Electrical Permit Applicati ' FOR OFFICE ( O■1.1' ` ;,
City of Tigard DIED % '�� /I - No.:2 , - ' I 7
r -∎ 11125 SW Hall 81vd ., Ti ?...1 • ..I •
/�
Mau: 503.639.4171 Fax 11 .77:. der Paretic
Y i C; .t i s l) Inspection Lint: 503.639.4175 Q Date Reidyfe ': awe B !fee Pace 2 far
lnbatieat: wtvW.tiBnrd.orgov l h 2, 7 200b Nor;aavi idbod Sappkmemtal Information
TYPE OF WO GARD PLAN REVIEW
WI -
El New construction El AdditiO61/k Please sheet all met apply (enbait a aers of plane sWitems checked below):
Q Demolition ❑ Q
0 service or feeder 400 amps or more 0 DetWiwg over three Modes.
$UILD wham e the available fault cones ❑Merlon and beaten/dn.
CATEGORY OP COrt&IRUC 1014 mxema ia000.n't5 I" volts C r 0 PloatingNaldimn.
1- and 2- family dwelling ®Cotnnlerei Commercial/industrial ❑ Ac building tan m g and, or ROW 0 Commercial - use apic ai
ry asps for an 011+7 iestattatima. hwldiops.
❑ Multi-family 0 114agtr r builder ❑ Other: O Fire pump. D lrmtalmtion of 75 XYA of
1O$ SITE INFORMATION AND LOCATION 0 Y system Iona swans* derived system.
O Addition ofa.w,ienor lord of p A °,"E", "t- x",•4.1 ",
Job no.: 83-070097- 6 Job site address,: /6 /Dl ..$60 '1' �r stootem43;10, p sixm mote seentia► emits El Recreational vehicle parks.
City/State/ZIP: TIGARD OR 9 7a j , 7 D Iloalth-canm facilities ❑ Study wimps for more than
OIiatardoos locations. 600 wla nominal.
dg./apt. no.: - 9 � I P to j ctx name: r URL CO/27 7, / NG 0 Service or tbeder 600 amps at men
Cross street/dimclioas to job site: 1 SCHEDULE
n. nTipla, 1 ell•• 1 vk• L 'r t_� i
New residential Magic- or mute.faunily dwelling emit.
Includes attached garage.
Subdivision: r no.: 1000 sq_ Q or less 145.15 1 4
t E& edd'1500 sq. ft or portico 33.40 1
Tim map /parcel no.: Limited energy, residential
DESCRIPTION OP WORK (wild "hew sq. It 75.00 2
Limited allergy, multi-family
„_ ./ srsidentilal (with above sq. ft.) 75.1]0 2
Services or feeders installation. alteration, and/or reloeatdon
0 PROPERTY Y OWNKR 200 amen eo 1400 80.30
❑ T gTtTAM' 201 mope W 2
400 amps 106.1U
NSOW I 401 mops to 600 amps 160.60 2
- - 601 imps to 1.000 amps 240.60 2
Address: Over 1.000 mops or volts 454.65 2
-
City/StatrliJP: Temporary services or feeders installationn, alteration, and/or
- relocation _
PhortC_ ( ) I Fax: ( ) 200 amps or leas 66.85 l
Owner isstallatiea: This installation is being made On property that 1 own whirls is not 201 temps to 400 amens 100.30 2
intoudai for sale, Tease, rent, or cadre, according to ORS 447, 449, 670, and 701. 401 tins to 599 amps 133.75 2
Brooch circuits, -- new, alteration. or rzteanioa. !panel
Owner fie A Fcc for branch circuits with
U APPLICANT .1 DCONrACT Feast:* above service or fescue fee, 6.63 2
each branteh circuit
Breeiness fie .B. Fee for broach circuits
• Contact ntmae: Q , ,. . without sexvia offender kr, 46:85 2
first branch circuit
Addre. Each add9 branch circuit I 6.65 2
Maacellaacous jxrvice or feeder or included)
City /Statc/Z1P: Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone:: COS) sys - D,r'3 1 Fax:: ( ) Reconnect only _ 66.85 2
E -mail: Pump or irrigation circle 5140 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: ADT SECURITY
Signal circvit(s) or limited -
Addresi: 2815 SW 153 ' DR. extension. Pat alteration. or 1 Page 2 75.00 2
City/Stat 2li: BEAVERTON OR 97006 F,ad* additional inspection over allowable in anyof the above
Phone: (30.1)469 -7212 , Fax: (503)469-7114 Pa inspection 62.50 Investigation per hour (1 brain) 62.50
CCR Lie.: 59944 j Electrical Lie.: 26209CLE J Suprv. lac.: LEA389 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician sig0adtero. A.. Ie.0 a" Subto al: ' 75.00
Print name: KEN KRAUS 2 7 O f/ Plan review (25% of permit fee): -
Or State surcharge (12% of permit fee): 9.00
Authotizcd si� Gt u0J
TOTAL PERMIT FEE: 84.00
Print name: KEN KRAUS ' se
Dam: This pettish' application pew is oa obtained within ISO
} �+ - accepted as comtde
t9eeaaatv�narLGhea,4 / � GC � ts7(►'�oS/COaVWr]1 � Number of inspections I
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2008 -00127
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/27/2001
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/11/2008 TIME: 7:O0AM PAGE: 34
SITE ADDRESS: 16101 SW 72ND AVE BLDG A CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: MALCOM
DESCRIPTION: Installing (1) low voltage access control system.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: ADT SECURITY SERVICES, INC PHONE #: 503 - 469-7212
Inspection Request Scheduled For: Date: 7/11/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 072481 -01 503 - 469-7212 N
Corrections /Comments /Instructions:
\ •
\ v
4 \ \
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • 'V Date: 1 t 61) Phone #: (503) 718- 2-ifittY