Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
Ail DEVELOPMENT SERVICES PERMIT #: ELR2004 -00247
Aj
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/2/2004
SITE ADDRESS: 10763 SW GREENBURG RD 110 PARCEL: 1S135BC -00201
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: Installation of security system.
Job # 3151 -190.
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:
BUSINESS PROPERTY DEVELOPMENT SONITROL (AKA SOUND SECURITY)
22020 - 17TH AVE SE SUITE 200 8220 N. INTERSTATE AVE.
BOTHELL, WA 98021 PORTLAND, OR 97217
Phone: 425- 483 -3442 Phone: 503- 223 -5822
Reg #: LIC 53535
ELE 26- 370CLE
SUP 1812LEA
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 8/2/2004 $75.00 Elect'I Final
[TAX] 8% State Surchart 8/2/2004 $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 Permittee Signature
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
J►. t s. n C }_ xF l
Elec Permit Application i Receive FUR OFFICE�;USE`'ONLY ,
,-.
//. Electrical s �y0 / 0+�a
RECEIVED Date/By 2 DY Permit No. � (�/ 7 lJ
Planning Approval Sign
C ity of 'Tigard Date/By: Permit No.:
13125 SW Hall Blvd. AUG U 2 20 Plan Review Other
Date/By: Permit No.:
Tigard, Oregon 97223 Post
Phone: 503- 639 -4171 CITY . � . l di, j ( Post Re La No
Internet: www.ci.tigas�� ING DIVISION ,.i.]I�.,td!' e
; J ., Contact Case Laasend : Us ®See'Page2for
24 -hour Inspection Request: 503- 639 -4175 ''' Name/Method: "f \(f Supplemental Information.
ea °ch that a" `1
R - REVIEW: :1 PP ji . x. .- ; :: -:
• ..,.. �:_, -. • -`:�� . ;TYPE > :O ....,.
ns ,o ❑ D ❑ P Service over 225 amps- ❑ Health -care facility
El construction commercial ❑ Hazardous location
❑ Addition/alteration/replacement ❑ Other: ❑ Service over 320 amps - rating of ❑ Building over 10,000 square feet,
,:,se . .' :i ;.: ; ;: �� - , I & 2 family dwellings four or more residential units in
� s : < ; �:,,,��;;�:., �CA'TEGQRI';QFw; ��` ::�'� >M ;:
r ❑ System over 600 volts nominal one structure
[11 1 & 2- Family dwelling `,/ Commercial/Industrial Building over three stories ❑ Feeders, 400 amps or more
❑ Accessory Building ❑ Multi- Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
�� V 4 N Submit — sets of plans with any of the above.
>;a e: % „.;; ! » 3 =.NJOB SITE= :INFOR11It1TION aud=l O.GATIOI�' The above are not applicable.to temporary construction service.
Sob site address: 1011 la3 ce) 50 C-11--ZPYl but Ct■ a..... �... �:... ...... _._ a,.tv .:4-EEv: >,SCHED. ....:..._> ->wi.:,', :'.,,..:..
Suite #: Bldg. /Apt. #: Number of inspections per permit allowed
�� Description Qty ' Fee (ea.) Total .
Project Name: U New residential- single or multi - family per y
Cross street/Directions to job site: dwelling unit. Includes attached garage.
Service included:
1000 sq. ft. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 1
Limited energy, residential 75.00 2
Subdivision: Lot #. Limited energy, non residential 75.00 2
Tax map /p / arcel #: � a Each manufactured home or modular dwelling
service and/or feeder 90.90 2
- ;: ,•x,_; .e
,;� . :
� ,�DESCRIPTION'OF WORK` - - -' ', -<�: - =
- :':% =_ -'= ”' Services or feeders - installation,
'..p t -- k .. r .X .1� l l ! 1 1 ('' R �-�.. ; alteration or relocation:
�L�C l , } x �Y3 200 amps or less 80.30 2
is �� 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
s ".' 601 arcs to 1000 amps 240.60 2
:;(wPROPERTY'OWNER . .'` ;1 ❑ ENANT':.
?T -- ;= 'r' ?r tw' :" Over 1000 amps or volts 454.65 2
Name: 3 YES X) y ' QIJti� \ 1 ; Reconnect only 66.85 2
Address: 'D-a.4_. '__C•_, — \ ` L. SOU Temporary services or feeders - installation,
� � ' 1 200 alteration, less relocation: 66.85 1
City /State /Zip: `�GZ Y..M I 20o amps or less
�j 201 amps to 400 amps 100.30 2
Phone: a5 -� 5' U�� 401 to 600 amps 133.75 2
?:? FM .AP.PLLCANV" ; `.;.:: :' '". "; .: ° E1:. CONTACT. PERSON: "cJ< .`.; :' Branch circuits - new, alteration, or
Name: extension per panel:
A. Fee for branch circuits with purchase of 6.65 2
Address: service or feeder fee, each branch circuit
City /State /Zip: B. Fee for branch circuits without purchase of 2
service or feeder fee, first branch circuit 46.85
Phone:
Fax: Each additional branch circuit 6.65 2
Misc.(Service or feeder not included): 2
E-mail: - -., Each pump or irrigation circle 53.40
tt: , ,�r - ; .:• 7) _ '�N,TRACTO$;::. .. ...... '" : r�",.. 53.40 2
� �� � ,, •, CO - :::;.� ��•�•" =�= x Each sign or outline lighting
Job No: + j \ 5 `, - 1 \ O Signal circuit(s) or a limited energy panel, r./ C W 2
• a lteration, or extension 1- Page 2
Business Name: A t o . ,_ , � - A Description:
Address: a .v� K e, O. j `t 1 Cu _ -
Each additional inspection over the allowable in any of the above:
City /State /Zip: p i� �� (IK\ d , 0� ���' , Per inspection per hour (min. 1 hour) 62.50
Phone: DD-3- 5 is a_ 2 Fax: 9 r -- - - 1 1 1 3 Investigation fee:
CCB Lic. #: 53535 Other.
Lic. #: aLp- 3 � - _ ,K, : s 1 gliZ
=a ,: :; ' .. ;EI'ectncal #PetniF.ee - ....
Supervising electricia Subtotal $ 11 i i 00
signature required: e4-42e"Lle P lan Review (25% of Permit Fee) $
Print Name :'��. c � " C Lic. #: � > L _ State Surcharge (8% of Permit Fee) $
etUv
TOTAL PERMIT FEE $ ( 2 ( c b
Authorized Notice: This permit application expires if a permit is not obtained within
Date: 180 days after it has been accepted as complete.
Signature: *Fee methodology set by Tri -County Building Industry Service Board.
(Please print name) n
i :\Dsts\Permit Forms \E1cPermitApp.doc 01/03 {a�J
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY: •
Fee for all systems $75.00
Check Type of Work Involved:
n Audio and Stereo Systems • .
n Burglar Alarm
n Garage Door Opener - --
El Heating, Ventilation and Air Conditioning System •
n Vacuum Systems* •
•
0 Other
COMMERCIAL WORK ONLY:
Fee for each system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
,) J
n Audio and Stereo Systems
n Boiler Controls
n Clock Systems
n Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control
n Medical
n Nurse Calls
Outdoor Landscape Lighting
24. • Protective Signaling
•
n Other - - — -- - - - — - -
Number of Systems
• * No licenses are required. Licenses are required for all
other installations •
i:\Dsts\Permit Forms \E1cPermitAppPg2.doc 0 1/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection We: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date " 9 60 AM PM BUP
Location b e3 SA) Z' Suite // o MEC
Contact Person - Ph ( ) PLM
�S—
Contractor Ph ( 703 SWR `��
BUILDING Tenant/Owner %�
Footing
Foundation Access: ELC 7
Ftg Drain t spa
Crawl Drain
Slab Inspection Notes: e/. SIT
Post & Beam
Ext Shear Sheath/Shear Anchors MG= Ext eah /h
Int Sheath/Shear
Framing
Insulation .
-
Drywall Nailing � ` L•ri11 >rl► %I l
Firewall
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
_Volta. a
larm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
A S S PART FAIL
SI Ei Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line � j teot-zyu-
ADA -44 /4 Approach/Sidewalk Date _ D Inspector J � "' / /� Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL