Permit ELECTRICAL PERMIT -
P^ CITY OF T
RESTRICTED ENERGY
oo A' DEVELOPMENT SERVICES PERMIT #: ELR2004 -00268
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/24/2004
SITE ADDRESS: 16640 SW 72ND AVE B -10 PARCEL: 2S113AD -01900
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L
BLOCK: LOT: 009 JURISDICTION: TIG
Proiect Description: Limited energy for fire alarm system.
Job # 7240126580.
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: X OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
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 LEA
LIC 150191
ELE 26- 207CLE APP. SAYS CI
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 8/24/2004 $75.00 Elect! Final
[TAX] 8% State Surchari 8/24/2004 $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 T , Jz Permittee Signatures c=
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 -20 -2004 13: 12 HONEYWELL 503 968 3398 P. 02/02
Y 4 • lectrical Permit A I I,I '� .
qty of Tigard C �� t1/'� 4.0L., Permit l a:e�4 4 66 6
13125 SW Hall Blvd., Tigard, OR 99223 AUG Plan Revt
Phone: 503.639.4171 Fax: 503.598.1960 2 L 004 2 '' • Date�By: Ot P�'t
Inspection Line: 503.639.4175 CirY `, L Date ReadyBy: M : 53 See Page 2 for
Internet: www.ei•tigard.or.us BOB T AG Supplemental Information
.,, ., .. , ...a• :..,, • r._F• � l j;w. :;. P1. r r . _ nflC l�1 . *ry :
t pp U U A RD q No • ethod: . oplement,
-a.�. .1. �zJ:., ..N : � . ; !d �1 : � :' :,- � ° .� . . , .P I. ..lu�• - : : -', .;I. .r. : ; v�: : `�• ` . ' P L91 ? 1' : . ,
❑ New construction Er/Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other: • ❑Service over 225 amps, comm'l Hazardous location
�� �'�' ,x{ , , , „ i CI Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
"' "! f d = ; ^ 4 '' - .0!!!, ;, , of 1- and 2-family dwellings
4 or more new residential
err_.. l�r�:• �: ��ze: �?, �.: � ,
�` s' 4• ���- ''•` :..?k : ....- �i`L. ::.4 °'S � Y Ss
❑ I - and 2- family dwelling Q Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
1:1 Multi - family ❑Master builder ❑ Other
['Building over three stories ❑Feeders, 400 amps or more
_ ' _ ❑occupant load over 99 persons ❑Manufactured structures or
. " • '%: i ,r� y t! • 1 t Pr •` .'"n..:'. . - M . - ..< U r 1 u 't :i1 A[' 1 j 1- '& I , ❑ Egress /itg Ian RV park
•. • ....' P .,. bitci'. : ,e:.i o 1 = ' r :.'tI � F11 iwJ•. . Ise.1, : ... .-._' ni,:l -•. J� 8 P
Job no.1i US :I Job site address: ' ti(/' 6 13 fMUe ❑Health -care facility ❑Ocher:
�,
I 1 Submit 2 sets of plans with any of the above.
City /State/ZIP: 1�',nC1 oR 912:v ' The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: I Project name: \j-exts 1 vitf bishei &is s s mow= ' ''' r d ti` ` ` ""t x y . • ..
Description Qtr. ste 1 Toml
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. f1. or less ' 145.15 ' 4
Subdivision: Lot no.: Ea. add 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax ma I areal no.:
p p Limited energy, non - residential 75.00 2
i,y..+ y47��: w,�- 34::: :' :.. . ,v 1 .` , � tr �, .e ; :Z• L '' . *
;, ,. r• s : �,`1: Y , r? ..1 : gy�p � i --,:*--,---.i',44,66' c manu factured or modular
,: ,l;iiiTi �i �,. . :'+�: :i :r�!'^ :: a %r - -. r :F . � . .,� a a • . =',I� Q� �.�:: � � _ o,:< 3n: !si'a., , : - Ba h
Sery
I a 1 � 1 A I dwelling, service and/or feeder 90.90 _ 2
�1 th hDrY1 �S oil e jiGl �LIS 5ervicca or feeders Installation, alteration, And/or relocation
200 amps or less 80.30 2
"P4. -. :.... .. gyp:• r :,.I,k • f: itl .i4 !, C r ' • ;.,c ,; :'• . .> 201 amps to 400 strips .. 106.85 2
.. ^:::o y 4 . ' � '4'r `;a i :'.i r :V• .' ' �iLt, �!!ti10.! :•. :• ::.,. "'. i ' < : ::`:., :r :iT+ ':•:1: : 401 amps l0 600 amps 160.60 2
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
Phone: ( ) Fax: ( ) relocation -
200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 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 to 600 amps - 133.75 _ 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
{�t +� ,, }g4� '•4,' ";•r'. ,, ' }l ?r,,; a i " "` �„ @ r `r
l „! ? A. Fee for branch tircuiu with
arfK' << ?M:.x :. .. +:. g!: ?-f = �., 8!�= - 2 , 0 :� . . Fee
ice or feeder fax, each
6.65 2
Business name: bnmch circuit - ,
13. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
each branch circuit
Address: - .
Each add'1 branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder net included)
Pump or irrigation circle _ 53.40 2
Phone: ( ) i Fax: = ( ) Sign or outline lighting 53.40 2 •
E - mail: ' Signal circuit(s) or limited -
: �� . :•'1' ;• 3 !!•^: (4; c+;" _.. •FF fir ••, •.;` ..> �a'rc: a•.rs. - l 'll . :4'M .' '+. energy panel, alteration, or • ' "` � � �� extension. Describe: 1 Page 2 ... 2
Business name: .
Address: 1 541 5 s r i 6 uup Pim 4 * 1D D Each additional inspection over allowable in any of the above
Per inspection 62.50 '
City/State/ZIP: Po rl QW) , DR. 6 112:1)4 Investigation per hour (r br ruin) 62.50 -
/,� tog- QQ 2 }� /� p � Industrial per hour
73.75
Phone: ( ) m loo 53 V V I Pax: ( ) 61 (P D - 6-3 I g In rial i
y ::.. • .. dust plant
-- 1?'R.1g3
v L.
CCB Lic.: 6 D 1 I Electrical Lic.: jd G , Suprv. Lic.: t I.fi LA _, ,,.. : Subtotal 1S' ':
_ r•
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: 81'~' Horeiletotc Date: 1 1 o'-F State surcharge (B% of permit fee) f0
TOTAL. PERMIT FEE $ I
Authorized signature: �; . / True permit application expires if a permit 4 not obtained within tan
days liter It tree been accepted as complete
Print name: $ri'p/UQ, Date: Qj I 1 1 04 • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections =permit allowed
TOTAL P.02
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP - 14
Received > Date Requested J C1 • AM PM BUP
Location r �( Ye) � � �� 1�1� �l�t Suite MEC
Contact Person j V Ph ( ) 9 3 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner Vay.u.:4 ELC
Footing
ELC
Foundation Access: C` 7
Ftg Drain ELR ` � 1 .� - 0 6 2-G
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Sr Anchors
Ext Ar�
Ext Sheath/Shear
Int Sheath/Shear .�
Framing
Insulation
Drywall Nailing Fire wall Pk51 er r A Fire Sprinkler
Fire Alarm (�
Susp'd Ceiling
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
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
411111,> Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
(/ v
Approach/Sidewalk
Other: Date r 7 Inspector ( ''L Ext
l
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL