Permit ELECTRICAL PERMIT -
C I TY OF T I G A R D RESTRICTED ENERGY
'i Il DEVELOPMENT SERVICES PERMIT #: ELR2004 -00290
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/13/2004
SITE ADDRESS: 07340 SW HUNZIKER RD 200 PARCEL: 2S101 DB -00100
SUBDIVISION: ZONING: C -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Low voltage - security alarm.
Job # 083 - 18217 -01.
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:
ROBINSON DEVELOPMENT ADT SECURITY SERVICES, INC
PO BOX 91305 2815 SW 153RD DR
PORTLAND, OR 97291 BEAVERTON, OR 97006
Phone: Phone: 503 469 - 7244
Reg #: LIC 59944
ELE 26- 209CLE
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 9/13/2004 $75.00 Elect'I Final
[TAX] 8% State Surchari 9/13/2004 $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 - .u__ Permittee Signature n p
OWNER INSTALLATION ONLY V 1
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
09/ J4 12:42 FAX 5034697110 ADT SECURITY a 001
Eft' ;rical Fi , n� A pp Ic
� , 1 { : �® FOR OFFICE USE ONLY
City of Tigard Seceived _ _ /, D4t.sy: % ",3 e ' Permit No: - .,/ , r� 13125 SW hall Blvd., Tigard, OR 9 t‘ev
23 ' ( I` ,!� ®7� �(,I
Phone: 503-639.4171 Fax: 503.598.196@�CQ 1 - , -, r. >,,,: ij D atrJBy e/By OWa_Pamit
ew
J1Spection Line: 503.6394173 JJ1G. _ ; ' r•� J
Internet: www.oi_tigard -or,'us G ps - - -14 oa6 altriecBho�d: P ei i in%
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New � ,...._......r, .. ._. i a._ i:.1.�d1��!., ka! l7 - ' ; � 1 i_ d! lii� r. � i�. 1 r., �lr6: v .,..:, ?i; • - ,.
❑
construction ❑ A + ; on/alteration/replacement Please check all that apply:
❑service over 225 amps, comm'1 ❑hazardous location
❑ Demolition ❑ Other;
r r r ❑Service over 320 a -satin
.. ,•, . : , +�:' ,, : ,ri: ;• - �p 8 ❑Builds over :0
,J � �.,. ; i ii `; •.iii: %; l i: ' ` i�; '• i`•.; ; ; i ` " I. :f:•. -�: " . ' lid : ' � �
... . -J 1 ;..; . .... . o - an 2 dwellings 4 or more new residential ❑ 1 - and 2 - family dwelling /_ Co n cia1/industrial 0 Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi- fhmilY ❑ Haslet builder ❑ Other; ❑Building over three stn see ❑Reeders, 400 amps or marz
:'•,: I
upam load over 99 persons ❑Manufactured structures or
':ffir '.,:11!..I , II :r 1 IfO:; CC
i`I l Jcs! Il
r.. � -. .. . -.... �' •
. - ..... B 'ght¢1g Plan RV.par
Job no.'►� %,r�� I j: . site address. 'O 1 W J L''' ' C7 ]tb�ar>r facility In Other:
Submit 2 sets of plans with any of the above.
City/StateZIP' ( Z 'f 1 Z The above are not applicable to temporary construction service_
S1uto/bld J t no.. r , c :. :,i,_; ; a; , '�l;i1!'i :j, ii ift : 7 2.: :,_- r
Sa p I Project name: f i 7f I t rri one . _, .. • 1.' r�,, :,:; ,,I . I —
( �1 ! 11 �67 (CrI�A:�. : � ;i '' .; ' : . °; °L; ' a ��li u'_ �- _....,: ;.i :c:,a c �,.,..,!._:� ��- E +' ..
nasGipsioa Qb- FM Tout
Cross street/directions to job site: • New residential single- or multi - family dwelling u
Includes attached garage.
1,000 sq. ft. or less 145:15 - 4
Subdivision: • Lot no.: Ea. addl 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: l Limited energy, residential 75.00 2
Limited energy. non-residential 75.00 ' 2
'` j�h':: �: it c,: .r . �,'.,,.. ,
13raC11 In:Q1ui�C
Chtd
I dwelling, service an d/Or feed feeder 90.90 -- • 2
Services or feeders installation, alteration, and/or relocation
. .. .. 20 saps or less
80.30 2
• ;:,., , :��•. - ..: :. 201 augrs to 400 amps 106.85 2 I.
Name :...__..:___....... _. _ . : ..: I 401 cps m 600 arrrps 160.60 2
_601 amps to 1,000 amps 240.60 L 2
Address: I Over 1,000 amps or volts 454.65 _ 2
City/Stare/ZIP: _.: - Reconnect only 66.85 2
Temporary services or feeders installation, alteration, and/or I
Phnne: 9O( I Fax: ( ) - relocation _
200 amps or leas 66 -85 1
Owner installation: This installation is being made on property that I own which is not 20I 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
. ,, - new, alteration, or extension, per panel
; •;!I;;, . is :,:
r:
r.
r..
r.
._ , ... , ..;, :: i : i:;'::� :' A Fee for branch circuits ►vltJt
service or feeder fee, each
Business name: • branch circuit 6.65 2
Contact name: — E. Fee for branch circuits
without service or feeder fee, 46.85 2
Address: each branch circuit —
Each adds branch circuit 6.65 2
City/State/Z]!1?: Miscellaneous (service or feeder not included)
Phone: ( ) F : ( ) Pump or irrigation circle 53x40 2
_ - - Sign or outline lighting 53.40 2
E-mail
Signal circuit(s) or limited- .
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:r.__,._,_...r_........ sin . Dcs ibe:
Business name: ADT SECURITY SERVICES, INC. t Page 2 5 2
Address: 21115 5.W.15drd 17R. y Each additional Inspection over allowable in any of the Above
—
REAVI:RTCIN, OR 117QnF Per inspection 62.50
City /State/ZIP: (503) 469 -7100 Investigation per hour (1 hr min) 62.50
Phone: ( ) Pax: ( - Industrial plant per hour 73.75
j`s ?• I � 1•y. ';'II ? 1:`S °i' , 7":% 4I I IFIII :I, �l :i `l 'J I;Ik �i:I ice°
cc >3zr.ie- 1 ,....: ,- , ., ,... . <�� aI 1, , , ,, �L, ,, .�1 ��.
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r,��i. } 1� Electrical Lie.: �� uprv. Lic.: g L
Subtotal �6� Cl')
Suprv. Electrician signature, required: Plan review (25% of permit fee)
1/A_i I .14 4
Print name: V � Date: OIA I (1 State surcharge (8% of permit fee) ,. DD I� J_5L
TOTAL PERMIT FEE s� 00
Authorized signature: Id
This permit application expires If a permit to not obtained within 150
Print name: ”' days after it has been accepted as complete
Date: • Foe medtodology set by Tri -County Building Industry Service Board
" Number of inspections per permit allowed.
LAtluilding■PernduaiLC •PerinlcApp,dac 17103 . 440•4615T(10/02/COM/Wpa
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line; (503) 639 -4175
MST
INSPECTION DIVIS[OiI Business Line: (503) 639 -4171
BUP
Received Date Requested // el' AM 3.6 PM BUP
Location 3 q v.L! 4 Suite 69° MEC
Contact Person IYA p Ph ( ) ( ) a D PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner W.206 T (L -- 0c ) c - ? D
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain '-
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof l
Other:
Final C
PASS PART FAIL
PLUMBING
Post & Beam 17
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 Vol -.e U:f
Fire 1M
Fi El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date �� /o,
Inspect ∎.! ∎. « Ext
Other:
Final DO NOT REMOVE this Inspection record rom the ob site.
PASS PART FAIL