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Permit CITY TI GARO ELECTRICAL PERMIT - # I DEVELOPMENT SERVICES PERMIT #: ELR2001 -00110 aealv `..� RESTRICTED ENERGY 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 04/13/2001 SITE ADDRESS: 07319 SW KABLE LN 500 PARCEL: 2S112AC-01500 SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -L BLOCK: LOT: 022 JURISDICTION: TIG Project Description: Installation of protective signaling, CCTV and Card Access. Job #083 - 13353 - 01102103. 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: : X TOTAL # OF SYSTEMS: 3 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 Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 04/13/2001 $225.00 2720010000 Elect'l Final 5PCT CTR 04/13/2001 $18.00 2720010000 Total $243.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. Issued by ; �! / , d/. Permittee Signature /J/ • u / / I OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale. lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N DATE: LICENSE NO: Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day Electrical Permit Application v 'E Datereceiveda, it q Pe rmit no. � / . pQf/ ._ > i( ,� ACi Ciry� of Tigard Project/appl. no' f Expire date: it f�Tig A ddress: 13125 SW Hall Blvd, Ti:. d OR 97223 Date issued: By: Receipt no.: V " Ph90..$ x(503) 639 -4171 p - ax: (503) 598 -1960 / , ff Case file no.: Payment type: �� 0 Land use approval: V' l v \ . '''' --- TYPE 'OF PERMIT ❑ 1 & 2 family dwelling or accessory 41•6mmercial/industrial d ❑ Multi- family ❑ Tenant improvement ❑ New construction / ❑ Addition/alteration /replacement ❑ Other: Cl Partial • / S S JOB SITE INFORMATION Job address: ' 73 jc 5VV g.aby i„A,J1 R. dt Bldg. no.: Suite no.: 1 / fax map /tax lot/account no.: Lot: Block: Subdivision: Project name: e- 4d e.t.th'pt -- • I Description and location of work on premises: , IO )l`oJ-v r,c1 Q ' Estimated date of completion/inspectionf CONTRACTOR APPLICATION FEE SCHEDULE Job no: Q�� Fee Max Job nes 3 : ) "" O �1 V 1t:Ch - Description Qty. (ea.) Total no insp Address: 2 815 S.W. b 3 Dr. New residential - single or multi- family per �yt� dwelling unit Includes attached garage. City: Be verton, (Rat / Ol.(g•IP: Service included: Phone:[,/ j jQ- 7Di i. I Fax: go-7110 I E -mail: 1000 sq. ft. or less 4 q 41y pip _ Each additional 500 sq. ft. or portion thereof CCB no.: i Elec bus. lic. no: ,,_....,/r_ (�(�' Limited energy, residential 2 Ci / etro lic. n•.' Limited energy, non- residential 2 ✓ - A t 04 01 Each manufactured home or modular dwelling 11: -. re r p-rvisin: electrtci. ' (required) Date Service and/or feeder 2 Services or feeders — installation, Sup. elect. name (print):. —& k (tU License no 1 Al alteration or relocation: PROPERTY OWNER 200 amps or less v 2 Name (print): • 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: - 601 amps to 1000 amps 2 City: I State: I ZIP: Over 1000 amps or volts 2 Phone: I Fax: I E -mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - - which is not intended for sale, lease, rent, or exchange according to installation ,alteration,orrelocation: 200 amps or less 2 20 ORS 447, 455, 479, 670, 701. 201 1 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 -- ENGINEER - - -_ - Branch circuits - new, alteration, _ = or extension per panel: • Name: A Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: I State: I ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit: 2 Phone: Fax: E-mail: Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): • ❑ Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle 2 O Service over 320 amps- rating of 1 &2 ❑ Hazardous location Each sign or outline lighting 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, O. System over 600 volts nominal more residential units in one structure alteration, or extension* 0 o�oj 2 CI Building over three stories ❑ Feeders, 400 amps or more *Description: , O Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lightingplan - ❑ Other: Per inspection Submit sets of plans with any of the above. . Investigation fee The above are not applicable to temporary construction service. Other • N� Permit fee $ — Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application O Visa ❑ MasterCard expires if a permit is not obtained Plan review (at — %) $ p Credit card number: / I within 180 days after it has been State surcharge (8 %) .... $ �j 4 1�1 Expires accepted as complete. TOTAL $ _ 2 Name of cardholder as shown on credit card $ , • Cardholder signature Amount 440 -4615 (6/00 /COM) • 1 t • • Electrical Permit Fees: Limited Energy Fees: Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) • Service included: Items Cost Total ' Check Type of Work Involved: Residential ; per unit 1000 sq. ft. or less $145.15 4 n Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 ❑ Burglar Alarm . Limited Energy $75.00 • Each Manufd Home or Modular Garage Door Opener Dwelling Service or Feeder $90.90 2 Services or Feeders n Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less " $80.30 2 , 201 amps to 400 amps $106:85 2 Vacuum Systems* • 401 amps to 600 amps $160.60 2 s • 601 amps to 1000 amps $240.60 2 Other Over 1000 amps or volts $454.65 2 • Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORKdNVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation 200 amps or less $66.85 2 Fee for each system : - :. _ $75.00 201 amps to 400 amps • $100.30 2 (SEE OAR 918 -260 -260) 401 amps to 600 amps $133.75 2 Over 600 amps to 1000 volts, Check Type of Work Involved: see "b" above. Branch Circuits n Audio and Stereo Systems New, alteration or extension per panel a) The fee for branch circuits Boiler Controls with purchase of service or feeder fee. ' n .' Clock Systems • Each branch circuit $6.65 2 b) The fee for branch circuits pi Data Telecommunication Installation without purchase of service or feeder fee. n Fire Alarm Installation First branch circuit $46.85 Each additional branch circuit $6.65 • ri HVAC Miscellaneous (Service or feeder not included) 0 Instrumentation Each pump or irrigation circle $53.40 Each sign or outline lighting $53.40 ri Intercom and Paging Systems Signal circuit(s) or a limited energy . panel, alteration or extension $75.00 Minor Labels (10) $125.00 n Landscape Irrigation Control Each additional inspection over I Medical • the allowable in any of the above Per inspection $62.50 ❑ Per hour $62.50 Nurse Calls • • In Plant $73.75 Outdoor Landscape Lighting Fees: �---�/ ,tom Protective Signaling Enter total of above fees $ .lJ 1j at ,r( Other ' 8% State Surcharge $ 25% Plan Review. Fee ' Number of Systems See "Plan Review" section on $ front of application. * No licenses are required. Licenses are required for all other installations Total Balance Due $ Fees: 00 Enter total of above fees .. ❑ Trust Account # ,u 60 • • 8% State Surcharge $ re?' Total Balance Due ia' is \dsts \forms \elc- fees.doc 10/09/00 OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Busfl ess Line: 639 -4171 BUP Date Requested q - ( AM PM BLD Location 7 3 / Suite 5 0 MEC Contact Person Ph 4 `, • _ T PLM Contractor 1- DT Ph SWR BUILDING : Tenant/Owner PQ c.. /°I CC, I ELC Retaining Wall ELR ��� , 7 d //b Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation 1 / % � Drywall Nailing Cc f V C 1 � QC �— - 19 2 Firewall Fire Sprinkler Fire Alarm Susp'd•Ceiling Roof Misc: Final PASS PART FAIL PLUMBING "° '° Post & Beam Under Slab F./ q 1 y /� Top Out �� Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL (11.11111:1F MECHANICAL „':.• W:y'' <' Post & Beam Rough In Gas Line Smoke Dampers Final A T FAIL ELECTRICA.` Rough In UG /Slab Low Voltage . Fire Alarm •. 2116: RT FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspectio Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date - 2 l 'o Inspect /L__ Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.. .