Permit TIGARD ELECTRICAL PERMIT -
CITY O F RESTRICTED ENERGY
DEVELOPMENT H PMENT Tigard. (503) 639 -4171 DATE PERMIT
8/12/2004 00254
SITE ADDRESS: 07440 SW HUNZIKER RD A PARCEL: 2S101 DB 00101
SUBDIVISION: HUNZIKER PROF. CENTER ZONING: C -P
BLOCK: LOT: JURISDICTION: TIG
Proiect Description: Installation of burglar alarm system.
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:
HALLBERG, RAY C ADT SECURITY SERVICES, INC
do HALLBERG, RAY C TRUST 2815 SW 153RD DR
3270 LAKEVIEW BLVD BEAVERTON, OR 97006
LAKE OSWEGO, OR 97035
Phone: Phone: 503 469 - 7244
Reg #: LIC 59944
ELE 26- 209CLE
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 8/12/2004 $75.00 Elect Final
[TAX] 8% State Surchart 8/12/2004 $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 % r J� S��ii Permittee Signature xi,e,
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
08/]•'/2004 09:09 FAX 5034697110 ADT SECURITY Ij001 /003
::etrical Permit A 11 1 ilea * e 1
1 � S 1 FOIL OFFICE USE ONLY
x ity of Tigard _
e erY e
13125 SW Hall Blvd., Tigard, 0 <<);rr G l Q DaW : , _ Q y PermirNo.:6- / V--‘4_25-- f
Phone: 303.639.4171 Fax: 503.'::,1960 1 ' .� ,: ^►' Plan w
Internet: www Ci tlO 53.6391417 5 �t � � � 1 lrf � i Notified/Method: ate yBr Other Nett:
Pa ge
SupD men Informatio
ee fvr •
i.. .. ..... . .. .: n„ - : .. . . . "'I " 'J1 ,n , rJ; 1. .:.i :J,y�:: ; ; ':, ir, �,.
,
r,: °,ii , : A !'� .t. , t 5 . . , ,17 lF =; R4'.'
0
New c -a _�, � ai�'•��,�, # " - �_� t,,;,��.�,�'•' i � , rl �;....
�'`-� construction , ❑ ra ollg - o Y teraiion/ apply: i.i �tl�ic�;" C - ..
I,,,,t Demolition I eP ens
- d O ement F]azardoua location
Other: C]Serv1
check all that aply:
Ce over 225 amps. camm'! ❑
r Inc
'.,• ...' ,,' ✓' ...,: �, . . .Ii;, 7 1 'i'e.rr ?iiS`Ja,.il'S�i.'iT ?• �: .l COYeI. 320 6 ^Itit7
,1 x,1'1 �. s( �f
,r,...;�!i' ° ii: 0� 1,:,:.. 1 • � I� ,,.. ° arnp n guildng over 10000 a
•.. •u: . 'kjL' if. d,j1 ,A��aJ��ii�ili�1;F1n-y� Of 1- and 2- i q. � ,
. :.•..I: .... _s::__: ',.',_'- f6nlily dwellings 4 or more new residential
l- and 2-family dwelling 01 Colmnereial/induSlrial ❑ Accessory building ❑System over 600 volts nominal emits is one structure
El Multi- fattilly � ❑ Master bilk QBnildin
der 0 other: g over three stories I ❑Recders, 400 arms or more
park
❑
I ?t t { 11. ,! ';'-':';'-'[-'1"'-'i''':' :1 i :' � ant load oVer 99
:.. p On3 ['Manufactured structures Or
7 � ... . s .. ... a ring
❑ SIT$s/ltgh p RV.
Job no.: Di . J�, 9ite address: h 1 : j]Health -Fare fhc,li []Other
City /State/ZIP: �' — S ubm it 2 seta of plans • w any of the above_
Project name: 4 :: JI 1 10t applies Sty construction service.
11lr� 3 The 1_..13
q 2,? ' above arc applicable to temporary
Suite/bldg./apt. no 4 -- ••.__� _
w .,
Cross street/directions to job site; b Fn. Total ••
Nov residential single- or multl- family dwelling unit
Includes attached garage.
1,000 sq. ft. or less 145 :15 4
Subdivision:
I Lot no ; Ea. add? 500 sq. ft or portion 33.40 1
Tax p /parcel no.: Limited en
erBY, resid
! :._> ; :::•;::::,.. .:: r:.u;Tui . ■;;1,; • scyi;;I,:: . . : crgy, aoa sidential 75 00 2
Limited m LA- gig
Elii ;°' ' . ..._ ._....... E.achmanufhcwred arma
M t .- t ! , dwelling, service and/orfeedtsr 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
............... li . h '}" :°'i "1 201 amp
Name:
_ ... ..... • .;a , :,....: ''': • '� ��� ....._ ...... ....... ; -.. � :;�:;:� aol � 106.85
:': �: .,, :. . s to 400 amps
s to 600 snips L 60.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454-65
2
City/State/ZIP: Reconnect only 66.85 2
Temporary services or feeders inatallatloa, alteration, and/or
Phone: ( ) Fax: ( ) relocation
Owner Installation: This installation is being made on 200 amps or leas 66.85 1
intended for sole, lease, rent, or exchange, according to ORS 447 449, 670, and which 01 � ot 201 am to 400 arr� 100.35 2
Owner sr
401 u a m p3 to 600 amps 13 7 2
e I
::,'•:,�,;;•:: ; •, . �,:, , . _ circuits -new, alteration, or extension,
. ' ...,. ,i,. ;' :ip''r.i:,r,; :;'' n, per panel
"I
......_. .:: ..._.:::n.., .: e,.•:: �: ., :•!i', :; � }��
: ::..:. r'•'.:. `: ; ", .. . i "rY, ;n ;.: :; A. Fee forbr circuits ,... ..:..:::.... :: �;' � I: . ,..:�• nits with
Business name: ecrvicts or feeds fee, each 6,65
I'^ LEN
branch circuit 2
Contact horns: I ►
D. Fee for branch circuits
wilhout service or feeder fee,
46,85 2
Address:
each branch circuit
G�ty /StetP/ZIP: ��� bath add'1 branch circuit _ 6.65 2
Miscellaneous (service or feeder not included)
Phone: (5f)5) 5 J' ity01 Fax:: ( ) Pump or irrigation circle 53.40 2
$ tnatl: Sign or outline lighting 53 -40 2
E-mail:
; + ■ • , c,•,0- :. ;, i . t, ,;.: nj.• �� i�� '0-i, :I. � ^._ ;m rr" - - - circuit(s) S or limited-
L, .._. _a „ :.. a d '., l i ar.6: : ,., '., ; 01 rid .r' ,.. i�:' •,, r : ;: ,, t; 2.' -
,
........... '. t a, l •..�l,.,.al �i :
L
..... .....:.......... , '., I -... - -Id�'��r� ,Id�P�!r! I'0-_,': �!�'� -
: .. ..... .:.. : ,._.., : ,,;1; : < °ir:;,'rv;' ii;a: energy panel, alteration, or
5 Business name: ADT SECURITY SERVICES, INC. extension Describe: i Page 2 f 10 2
Address:
Each additional inspection over allowable in any of the above
City /State /ZIP: (30J) 469.7100 Per inspection 62,50
' Investigation per hour (1 ht min) 62,50
II
Phone: ( ) Fax: ( ) Industrial plant per hour _ 73 -75
CCB tic.: l;A1�IYI. €it2 �;d.l ri ll it t ? " ;? ";I Il ° il: JI. ,! iiiMitS
51 ( Electrical Lic.: /. a ct.e uprv. Lic.: � . �._r,:._ u . al
Su Electrician si ��
Subtotal d
1� gnature jrequired: i !/ Plan review (25% of permit fee)
`
State surcharge (8% of permit fee)
Print name: /
Date:
WM
Authorized signature: • TOTAL PERMIT FEF e
Tbta permit oppltcatlon expires If a permit is nor obtained within 150
Print name: days after it hos boon accepted as comple to
-Jots: ° Fee methodology set by Tri- County Building Industry Scrvlce Board
: V .doe 12/92 N Number of inspections per permit allowed,
440-46 t s7(I0/01 /COMfWEB
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business - Line: (503) 639 -4171 MST
• BUP
Received Date Requested - 7 AM PM BUP
Location 6 �...� /� L. Suite MEC
Contact Person _/ D Ph ( ) � '1 7 ° 5 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC f�
Access:
Ftg Drain ELR ad 7 o
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
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
Low Voltage
F - larm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
44, PART FAIL
SI ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ply cf
Approach /Sidewalk Date 7 Inspector ✓ 4 , » — e ' . '
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL