Permit CITY T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2005 -00092
DATE ISSUED: 4/18/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 113AC -00103
SITE ADDRESS: 07216 SW DURHAM RD P100 ZONING: I -P
SUBDIVISION: PACTRUST LOT: JURISDICTION: TIG
Project Description: 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: X
INSTRUMENTATION: OTHER:
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: Phone: 503- 469 -7244
Reg #: LIC 59944
ELE 26- 209CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 4/18/2005 $75.00
[TAX] 8% State Surcha 4/18/2005 $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: ,./) 76 TL� Permittee Signature: 3.e, p5 \t
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 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.
•
04/18/2005 11:26 FAX 5034697110 ADT SECURITY f;3J.001/003
- -- Electrical Permit ADDlicaiion.,. -. .. roR 01410E USE ONLY
' Cf of Ti an
g pii, � Dates : d — P t �2 a - 0 , 0 , 2 13I25 SW Hall Blvd , Tigard, OR 9722 4 plan Review
Phone: 503.639.4171 Fax: 503.598,19 A p, 1' ir.' I C D • Other Permit
Inspection Line: 503.639.4175 F1[" a l `' l ' l ( J Date Ready/BY• See Page 2 for
Intranet: www_ci- tigard,orlus ; Notified/Method: Supplemental Information
r I i . . y -, , n i LIP' ! I pia r¢ I 7yyr 7, -r ltiv h
I r i , c i , , I 'Atli �J ,t 4 rf k � s. , g F J " ' i.. ; ?t „,,,.„,pi
W t.. . o- t ' , 1 � hti 9 1 t .�. ��I tL +'I, � e � •l�t,ir `' • New construction 0 Addition/alt -': pr IT .. �t't t- , I 1 w' Please check all that apply:
Demolition
1:1 Q OtheC: Hazard us location
Serv over 225 amps, eormn'1 0 -
, : ;y , ❑Service over 320 amps retire ❑Bulldn over 10,000 sq. R.,
..: ; :: ' .:.. r:' , i' . ; -�` ii -,I1� o i- and 2-family dwellings 4 or more new residential
.... ,:.... ......:.::.:: � .,;. r;: , _..:.;_.:,,.:' ; '!.,. !.,n1,"'y_ i: Y P3 side
p 1- and 2- family dwelling A CommerCia industaial ❑ Accessory building QSystem over 600 volts nominal units in one structure
❑ Multi - family CI Master builder CI Other:
:;..,.., . :....: .:.:........ red strut
.. • ,. , : „ „. persons resar
;1 • ; •.‘.: 1 : : :.
Building over a atones eta, amps or more
• . ,
['Occupant load over 99 ems Manufactu tli
•i III 1f1 t II 111 JII 1 t + J I :f. 7,' 1•1''ii -, , 1
_ ['Egress/lighting Ply park
ring R
V
J o b no.: p$3 - gco site address: — IUD (I, �1 ; }i /? I ) , 1 ❑Health -care facility ❑Other.
I. ib ` Dr �Q.00.4) The above are no
n�tM t �u ► t [ SSubmit/. sets o t applicable with any of the above.
City/State/ZIP: f t a livable to temporary conauuction service_
Pm CCt II8IIlt3 `� � j , • 2,11..e. i ' ygE,Zrd.^�' < f.CI A' +t. ' i 1 t�:� _ „
Snite/bldgiapt, no.: � I, _ __ j N ei W 0 1C .�� ._ a t.: 1 i, ' ..,, . - ' ” 'eta ... y : ' . :
bF +6N�u' Drtrlptlon Ow. Fee Tetpl
Cross street/directions to job site: • New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 59. R or less I 145:15 F
Subdivision_ • Lot no.: Es. add9 500 sq. ft. or portion 33.40 1
Tax neap /parcel no.: mud energy, residential 75.00 2
Limited energy, non-residential 75.00 2
is
•11 '
...: ' ,...,: . ...:
:. ........ '.:�;, ''• ; : ' '''k. '.:.:,., • + { %iii , •i . ,..7;1' Each msrttifacktt or modular
dwelling, service and/or feeder 90.90 , 2
M� kl • / 3 ' Services or feeders installation, alteration, and/or relocation
200 amps or leas , 80.30 J 2
j - 1 I J ! I 1 a i+;-„1,,i " ._...�.. .. . !� �•. Il L ,�—„ i? ,r`r� 201 �a to 400 8rf1p3 106.85 . li ,,C.7:;-: i r
°' I - 401 lrmpa to 600 srctpa 160.60 2
Name:
601 ampI to 1,000 amps 240.60. 2
Address: Over 1,000 amps or volts 454.65 2
City /StStn/LIP: ��� only 66.85 2
Temporary services or feeders installation, alteration, and/or
Phone ( ) I Fax relocation
200 amps or less 66.85 1
Owner installation: This' installation is being made on property that I own which is not 201 amps to 400 a m p s 100 - 30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701 • _
401 amps to 600 amps 1 33.75 2 T
Owner signature: _ Date: Branch circuits - new, alteration, or extension, per panel
u G'r i k.v :.
1: . ....:�::.:: J:,)r'1' it st;I � . . ;'I`.; ,: ; � : A. Fee for branch circuits with
, .. _.., ....., .....:: - :.. ;::: ,.,..:.,..:.;_.::...:..._..,.:. , :- :.,..... :. _ '. service or feeder fee, each
Business name:
branch circuit 6.65 2
Contact name: , t r-1-.
B. Fee for brunch circuits
without service or feeder fee, 46.85 2
Address:
each branch circuit
- - Each add'l branch circuit 6.65 V 2
City /State/Z1P: Miscellaneous (service or feeder not Included)
►�c r r 12 0'% 1 / p� 3 ) 3 /_� n q Pump or irrigation circle 53.40 2
Phone: 'y `t� J i f b `� Fes; W "/a 1 -7
mail:
Sign or outline lighting 53 -40 2
Signal circuit(s) or limited
r i : I'1:: f ",, 'C�
u.,':�1 ^;,'. „ ::t c ': +.. :.fir 'i7 .I:':�'Ilr vrl'. 1. ener Palle', alters
�. r;:' ;dl 1 . .'L.. .,.i''. I:, 'i il::n d, _�d wl 'Ir:': :r.,;, t. L,,I•. sF ; ?. ` BY non. or
'`.-'-�: �, ,...rul_�_.: _.: +_•:.ii : .'i:_ias,:.•. 1__.:.' r 1-' r.!: � r ��'.,. I,_, ��...._. d:: i; 1�J::' d: �_. �.. ,��,�Ad::A`Zlf F
extension, Describe: Page 2 2
Business name: ADT SECURITY SERVICES, INC.
Address:
217'5 S.W. 153 DR. Each additional inspection over allowable in any of the above
IFRT(lN R_
()__S17Af15 Per inspection 62.50
City /State/ZTP: (503) 469-7100 Investigation per hour (1 hr nun) 62,50
Phone: ( ) Fax: 0 `"1 I r,q — 1 I'D Industrial plant per hour 73.75
u' ''r : k'J ifricitfg til 1.170,:d. e, ttr` Iii fil� 1 S a R F'r , ' 71.g, ` - $
CCB Lic.: 7I el Litt l Electrical Lic.: uprv. Lic.: ..t , , Li._at,l4lst r : , llr,,Ls,:__�rr,1,,., �:a b omll . _
`7 CLfr P ;q - Subtowl
Suprv. Electrician signature, required: - — Plan review (25% of permit fee)
• /4. A t ... .. '
Print name: vein r.waA Date: r'"1 i g Do State surcharge (8% of permit fee) 10 .
• TOTAL PERMIT FEE 3 ,
Authorized signature: v
I Thls permit application expires If a permit is not obtained within I$0
Print name: day, after It has bean accepted as complete
Date; * Fee methodology set by Tri -County Building Industry Service Board
—" " Number of inspections per permit allowed,
i} nuitding■PmnluxELC- Pmnritppp.4se 112/ CO 440,4615f(10A4/COJ1•Uw5B
CITY OF TIGARD • . ,
BUILDING DIVISION PERMIT #: ELR2005 -00092
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4/1812005
Phone: (503) 639 -4171 :
Inspection Requests (24 Hrs.): (503) 639 -4175 :��..111
INSPECTION WORKSHEET FOR DATE: 4/28/2005 TIME: 7:42AM PAGE: 89
SITE ADDRESS: 07216 SW DURHAM RD P100 CLASS OF WORK:
SUBDIVISION: PACTRUST LOT #: TYPE OF USE:
PROJECT NAME: NEWKIRK
DESCRIPTION: Burglar alarm.
OWNER: PACIFIC REALTY ASSOCIATES, CI PHONE #: •
CONTRACTOR: ADT SECURITY SERVICES, INC PHONE #: *03- 469 -7244
Inspection Request Scheduled For: Date: 4/28/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltagoV: 005510 -01 503.469 -72:4 N
Corrections /Comments /Instructions:
C (--;
Ii>117 •
p
y
,[PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
// _.�
Inspector: / / /.., , Date: "2 Phone #: (503) 718-