Permit 1
C 1 OF TIGAR® RESTRICTED ENERGY
4" ,I�� ®EV W H B IViENa r SERVICES ) 639 -4171 DATE ISSUED: E 820001 -00284
13125 SITE ADDRESS: 15865 SW 74TH AVE 110 PARCEL:. 2S112DC -01400
SUBDIVISION: CREEKVIEW INDUSTRIAL PARK ZONING: I -P
BLOCK: LOT: 004 JURISDICTION: TIG
Project Description: Installation of burglar alarm.
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: BURG. ALAR X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC AMERICAN PROPERTY EXCH FIRST RESPONSE SYSTEMS GROUP
PACIFIC SANTA FE CORP 4647 SW HUBER ST
17700 SW UPPER BOONES FERRY RD PORTLAND, OR 97219
PORTLAND, OR 97224
Phone: Phone: 244 -5996
Reg #: LIC 00111713
ELE 26 -956CL
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 11/8/01 $75.00 2720010000 Elect'I Final
5PCT CTR 11/8/01 $6.00 2720010000
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987. '
Issued by , Permittee Signature (Y)'j ---
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: ,'7 ��� ` l'�i�� DATE:
LICENSE NO: 7 --Ei
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
11/06;01 TUE 1 7 7 43 FAX 503 244 9076 FIRST REPONSE PDX RI 002
ii... ua; zu�us it). 4� Ali a uaaatslunu uAAX err A,41 sclJ tjuuL
V
E1ec1rm4'd1 Permit AppliC
Datereceived: t1 i D Pt rt»it no.:§1.4 ✓i J •/off S
S - of and RFC�NE® Projcedappl.na.: parcdate;
City of Tigard Address' 131.25 SW Hall Blvd, Tigard, OR 972 Date issued: 13y ,All Receipt no.:
Phone_ (503) 639 -4171 70c; i
Fax: (503) 598 -1960 , ,?'; 1 ,j C; ^ C ase tile no.: Payment type:
Land use approval: .—, n[licl notES4
' TVPF Of PERMIT .
�Commercial/indusQial ❑ Mulri- family p Tenant CI 1 & 2 family dwelling or accessory cant im)Zroverrlell[
El New construction trAdditioatalterationireplacernent ❑ Other _ J Parch]
0l3 SITE INrQ It1YIN1 ION
Job address! 15 86,5 ..5 (.4.1-- 7 N 0 5v'r7-- //O >3idg. no.: Suite no_: Tax map/txx lot/account no.:
Lot: BIock: Subdivision:
Project 'name:}jI Nj 4 4 -&TnR Description and location of work on premises: 0v-Eazq Li i St l t .
Estimated date of cotnpledion/inspection: {, — O
CONTRACTOR O APP11C'ATION •-- -' ILL S('11E-=DI.1.1•_ .
Job no; R— 0&g'
Business manic: 1 (s !es Poi4, 5 t? , Description 111.111 Total no_ Ins
SGV � � r? 5 T New residential- single0 m :hi- famil per
Address: 1.-16,4 7 dio llingunit Tncluod®onieebedg;rgge.
igsr y LP kJ D _ S tate:0e Z : 7 2_1 Se virzindudod:
Phone: bo3--a_ 4 r/ -579 _ Fax: zL/ 41 - , • ' 1000 sq. ft or less 4 ,
Each e. amoral son sit ft. or portion tharvpf ���—
CC13 ao.: 1 I Z l 07' Elec. bus_ He. no: : _C� 1_ m lif nit ed energy, residential 1111111=1 _ 2
City /metro lie. no.: 6p/ • Limited energy, non- residential INN_ _IKON
U ) 1 � Each manufactured home or modular dwelling ■111
Signature of supervisin 4, .s r. • 4 Scrvicc and /or feed 2
Sup, elect, namo (print)_ i,icantta no: Services or feeders—Installation,
alteration or relocation:
PROPERTY OWNER . wo w„ps oriels IIII 2
Name (print): 201 amps to 400 amps __
moiling adliless: 401 am _�
amps to 600 amps — 2
601 amps to lono amps 111•Mill _ 2
City: State: ZTP: Over 1000 amps orvens . ■_ 2
Phone: Fax: E -mail: - Reconnect only _IIIIII� 1
Owner installation: The installation is being made on property I own [moDrnrynorrices or feedere-
which is not intended for sale, lease, rent, or exchange according tD [ nstallntlon ,altery[iost,orrelocation:
III
OILS, 4 455. 479. 670, 701. 200 amps or less 2
201 amps to 40' amps __
Owner's sit+ attire: Date: ____ 1 to 600 am • s �_�
ENGINEER Branch circuits- new, alteration,
_ . 1 or eater:elan Dar panel:
Name: A. Fee for brunch circuits with purchase of
Address: acrvieo or feeder fee, each branch circuit 2
City: State: 2TP: S_ Fer for branehciecoiIS withoutpurchaac
• of service or feeler fee, first branch eircultf w 2
Phone. . ax. small: Each additional branch circuit_ _OM
. ° se= P1,.SINl. c check all -that apply) Ir1lsa . (Service or feeder not indnded):
D, Soviet over 225 uznps- commemiai D Hcalth.wrcfacility - E ach pampa Irrigation circle ■� � 2
i] Service over '_%2.0 amps - rating of lfi2 O Hazudcusiocution Each sign or outline lighting _MII - 2
&roily dwellings t] Building over 10,000 square feet four or Signal clrcu t(s) or a limited energy panel,
Q System ovcr600 volts nominal more residential %mita in ono ntzueture dteration, or extension* � - 2
❑ Building over three pones 0 Feeders, 400 urnps o r mere .mod Lon: -
0 occupant load over 99 pctsons ❑ Mac ybacturcd atruearres or RV park 7 41- c addit1ennl inspection o+'ar the allowafjle in ally ofthe glmre •
❑ Egre srlighting plan 0 Other • Per 1 nq. oCdon
Submit setaoClast midi of heab ove. �_`
P y Investigation
The above are not applicable to temporary construction service- Other
Nor all judtdictloae sraapt era 11t cards, pIcase call juriseattloa foe more Information_ Notice: This permit application Permit fee `/ �
a visa u MasterCard expires if a permit is not obtained. Plan review (at _ %) $
Credit card number: l / within I80 days after it has been State sUlMbarge (8 %) .,,. $ 1 '
tip " accepted as complete. TOTAL $ g-f • ��
Nm e
ae -of .ntholder as shown on credit card .
Cardholder signature Amnnr
640.41615 (6/DO/COM)
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
Date Requested /1) �'' AM PM BLD
Location /- g& 7 ! " P-tom- Suite / /0 MEC
Contact Person D , � Ph `f "S Z qc, PLM
Contractor D% Ph SWR
BUILDING Tenant /Owner�� 1 --��
Retaining Wall ELR O / co
Footing Access:
Foundation L y; , �� � z � FPS
Ftg Drain �P SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling "`r a
Roof
Misc:
Final
PASS PART FAIL
•
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
•
Rain Drains
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
Fl
411-` PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date 11
!j'' -- 17/ InspectorLoy�,/ �l Ext
Final (�
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.