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Permit CITY OF T I G A R D ELECTRICAL PERMIT PERMIT #: ELC2000 -00370 DEVELOPMENT SERVICES DATE ISSUED: 07/03/2000 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S113AB -00800 SITE ADDRESS: 16135 SW 74TH AVE SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P BLOCK: LOT : JURISDICTION: TIG Proiect Description: (1) signal circuit RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL: 1 MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: DUNCAN, JOHN A AND ADT SECURITY SERVICES, INC JANICE LEE 2815 SW 153RD DR 7060 SW PALMER WAY BEAVERTON, OR 97006 BEAVERTON, OR 97007 Phone: Phone: 503469 -7100 Reg #: LIC 0059944 ELE 26209CLE FEES Required Inspections Type By Date Amount Receipt Elect'I Final PRMT DST 07/03/200C $60.00 0003433 5PCT DST 07/03/200C $4.80 0003433 Total $64.80 RIGIN, 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. PERMITTEE'S SIGNATURE ISSUED BY: 6, 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: CaII 639 -4175 by 7:OOpm for an inspection the next business day 503 598 1960 e, 03/17/00 FRi 12:15 FAX 503 598 1960 CITY OF TIGARD 41003 CITY OE TIGARD 13 SW HALL BLVD. Electrical Permit Application Plan Check# RECEIVED Rec'd By TIGARD OR 97223 Date Recd & - Zq -CP 0 Phone (503) 639 -4171, x304 JUN 2 9 2900 Date to P.E. inspection (503) 639 -4175 Date to DST Print of Type N � I Permit # Do10 - ,.O _ p Fax (503) 598 - 1960 Incomplete or illegible will hi reWa peed ll" • r Called PIZ 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed Name (or name of business) C, Service included: Items Cost Sum 4 - Address 141.1 36 ''I r^ 4a. Residential - per unit City /State /Zip ( v/' , , C� Cl -I-2;24 Z-� t ' 1000 sq. ft. or less $ 117.75 4 `� �"T Each additional 500 sq. ft. or Commercial El Residential El thereof $ 26.75 1 Limited Energy $ 60.00 Each Manufd Horne or Modular 2a. Contractor installation only: - -- Dwelling or Feeder $ 72.75 2 (Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders information for COT data base). Installation, alteration, or relocation Electrical Contractor ADT Security Services, Inc. 200ampsorless $ 6425 Address 2815 SW 153rd Dr . 201 amps to 400 am s 2 P $ 85.50 2 City RaavPrYprl State �R Zip 97006 401 amps to 600 amps $ 128.50 2 Phone NO. (5 . - 601 amps to 1000 amps $ 192.50 2 ��� Over 1000 amps or volts $ 363.75 - 2 Job N0. _ Reconnect only Elec. Cont. Lice. No. 76_209c,T,E Exp.Date 10/2000 $ 53.50 • 2 OR State CCB Reg. No. 59 944 Ex Date Installation, Temporary Services or Feeders p• 5 � 7 /01 Installation, alteration, or relocation CQT Business Tax or Metro No. Exp.Date 200 amps or less $ 53.50 2 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n 11 �1 4 , 401 amps to 600 amps $ 100.00 2 Over 600 amps to 1000 volts, License No. ` i2745-._ C" Exp.Date see "b" above. Phone No. 4d. Branch Circuits New, alteration or extension per panel 2b. For owner installations: a) The fee for branch circuits �(-- with purchase of service or feeder fee. ne �i 1. , s "'ifiiittt��lCttfame a v A i Wak.\ -r '• i Each branch circuit $ 5.35 2 Address / b) The fee for branch circuits City State Zip without purchase of service Phone No. or feeder fee. --= c�>L� -�L� X 7 i First branch circuit $ 37.50 Each additional branch circuit $ 5.35 The installation is being made on property I own which is not intended for sale, lease or rent. 4e. v c e ous . (Sery ice feeder not inGuded) Each pump orfee or irrigation circle • $ 42.75 Owner's Signature Each sign or outline lighting $ 42.75 Signal circuit(s) or a limited energy 3. Plan Review section (if required):* panel, alteration or extension 1 $ 60.00 $ 60.00 Minor Labels (10) • $ 100.00 I I Please check appropriate riate item and enter fee in section 5B. 4f. Each additional inspection over • , 4 or more residential units in one structure the allowable in any of the above Service and feeder 225 amps or more Per inspection $ 50.00 1' ' ' • - System over 600 volts nominal Per hour $ 50.00 In Plant • $ 59.00 Classified area or structure containing special occupancy as described in N.E.C. Chapter 5 5. Fees: Sa. 8% S Enter total Surcharge above fees $ 4_ R n * Submit 2 sets of plans with application where any of the above apply. Surcharge (.08 above total fees) i • Not required for temporary construction services. $ Subtotal $ NOTICE 6b. Enter 25% of fine 5a for Plan Review if required (Sec. 3) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ $64.80 ' iS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ $64,..80 is \dsts\forms \e Iectric. doc CITY OF TIGARD BUILDING INSPECTION DIVISION ° 24-1-lour Inspection Line: 639 -4175 Business Line: 639 -4171 MST / / BUP Date Requested q[ 26 l AM PM BLD Location /6'l3S Set) - 741'4 Suite MEC Contact Person G Ph 6 1 - e - 8gfs8 PLM Contractor Par— Ph SWR BUILDING e Tenant/Owner r �1117 —rve S70 Retaining Wall ELR Footing Access: Foundation 1 FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Fire wall Fire Sprinkler - Fire Alarm Susp'd Ceiling 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 P PART IL • ELECTRICAL Rough In UG /Slab `r Low Voltage a ° Fire Alarm Final 5C PASS P 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk /� Other Date 0 Inspector / Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.