Permit 4 CITY OF T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
I N
° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00229
T I G A R D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/29/2008
PARCEL: 1 S134AA=01800
SITE ADDRESS: 10110 SW NIMBUS AVE B8 ZONING: I -P
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT: 002 JURISDICTION: TIG
PROJECT: AMERICAN PRINTER SERVICE
Project Description: Installing (1) protective signal 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:
ROBINSON, CONSTANCE A + ADT SECURITY SERVICES, INC
ROBINSON, LYNN + BELL, KAY ET 2815 SW 153RD DR
BY INSIGNIA COMMERCIAL GROUP BEAVERTON, OR 97006
BEAVERTON, OR 97008
Phone: Contact #: PRI 503 469 - 7212
FAX 503- 469 -7114
FEES Reg #: ELE 26- 209CLE
LIC 59944
Description Date Amount SUP LEA389
[ELPRMT] ELR Permit 7/29/2008 $75.00
[TAX] 12% State Surch 7/29/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 or 1.800.332.2344. .
Issued By: / / 1111111 _ Permittee Signature: SC.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 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.
r Jul 29 08 09:27a Stephanie Pate 503-469 p.1
Jul - -
• • ,,,,
- .....'. ...
F,leiStrical Permit Application
- ,
Citt• of Tigahrd
.,. I L312:5 SW Ilan elvd.,"r1, . 4 ...6
: . fignig: 503.434.4 171 • Ft: SO , .1960
503.639.4175
M
‘ A li 'i . 1).,01,,• ,. . 1
. ,,yi,,,T• . • •
..110 ,f1vr
1 We Kcadyby: i l'1/41nai No.
I Other renfiv.
. -- ..-__,
- - - ' r ' 61) Sae now for
Wi lialialliill (Otkinct. viol* Tizad..nr.rov N..) L ..,.. ....... ____.._._ . L., 7:43 tinpislen7ntal inforniarinn
---.-. .... ,-.--.-...,,,........
0 New .1
: .. - .......... - . - _.......,. - ...., - ,..... - 7 ,,. - , - .
TYPV. OF W 0 EANIA. Pl-A7S. RI.V110.11
--" ialgtIc-: ,„.„.._). .
Piaar.a s lum, ; ow apply •.:14•nall ; sws of 1)lons wAc'ois clicdcd WI
COfultruCtion Etc] AtkittiOn/ait s .. ncar
El a:1ml iLiOO 0 other V) 0 SCrviCc Or fender 400 atom. or mom 0 Oa ilfliny. over Illr:c Ntomn.,
1 . wherz 11v availablr fault Comm 0 Marimin and :)03:yarti:i
I
CATEGORY ov coNs-rkucrioN , cact-cd:. MOM anaps al i Kr volt:. or 0 Horning buii4rop.
lv.r., In nro4owl. or excrecin 14 .(X0 0 Commticial a:aicalioral
71 l- anci 2-111Mily thus:Ili:ie. CE2 (7nramerma1finclustrial 0 Aceessury buildiny, °reps 1r,1 J/I miler imminalimn. lwit4•>.
0 M. ulti-larnily 0 Master builds 0 Other: - 13 Fin:pump. 0 Insiallattoro or
Cr Emergency nr.lem larger separately dr^vri) Valr
3()13 SI 1NYORMAT1ON ,tNI) LOCATION
Job site achir.. : 4 - L 4,,,, s
..._ DAdd..„.7.....,„„..7.„., yr
I Ulnit or mom.
LI Six or innn: rcci.riarrOa: URAL OIN upon,. y.
0 Itevicair.mal ,elt;.:Is., parks.
r-
Cily/Stutv:ZiP: 7 c e , I 7.2a 3 D I t,:tititi wolti.s CD Snrprly voir.1;4. (Or Ina,' 1
0 }LmarrinuNincalmm. GOO volt,. runtan.n.
i. SU iLeibldgi■IPL. 110.:w r , PriliCCL 11:1111C:A0 h7,e/c/i ..4. r 0 . __Sorv___icc or terrlor MYCI any, o_r_mors..
r - , SCHEDULE
• Criiiis streoldirections toiob site: ....1 4 0/ c 4,- L. ±..- L ork --- ' " --- ..:LI 1 ,..... - 7 - 1
t " -- ....._
' --- ''''''-^ tiro iftrAidchtini singlc- or Mrati-ramily alwriling
InChigici.otth,:cipArz2AN
, - 1 • ,
1 - ' ..'
I 45. I 5 ' 4
[ Subdivision; Lin no.; . , 1,000 sq. ft. or Ims .
- ----- , • - F l 0 s ti
-i - AA. :sa 50q. N . or portion l i 3.i.40
F .. Tax trupfparcel n4.)... :.-- •-• -1-• '
- - - -
ESCRIPT1()N 01r w0R-K - - j Urnirt cnerrs residrutittn --- - •
, L - 75 00 '
._.l. _
I
-....--..... ----
I i Lirnitcd zah.Tgy, inulti-fitinily i i -_,
' 41e./r)--- /5.00
I i residential_ (2__raliabovc_s_4111 _..., , __,.._ ..... .._, 1,
i ' Servites or Feeders instalkition, artd/ori.c40!....11 ......
1 200 tunin: (Jr so.3t, i ,
..
. .- ---- - 1 --.
0 PROPERTY OlYNER 0 TENANT • - 201 amps Lo 400 amps i 00 li 5 1
- • _f_____
Name:
- 601 limps to I MO arnrys 240.50 I 7
-
Ovcr 1.00D ;Imo in volts 454.65
I ; City!StaitiZIP: I omprorary services or feeders installation, alferolion. alutior
• ... _ relocation
Pluino: ( )
- Ftx: ( ) -
200 amps or les:. t,u.H5 1 . 1
..............- ---- ------- .-..--"......7------------- , 3 _
2
' installation: This installation is being made on property that 1 own which is not al cc ' .1(c° __ '
1
1 intended 1 nr:zile, lease, runt. c)r exchange, according to O 447. 449,.670. inn! 701. 401 amp". to 599 amps 1 1„(1.
1
m
tSrich c3redits - new. aileration. or extensloo. pc2Lat net
L......,......,• _ •• • „ • •• • - ., - -..... • •......,_. Date. .. .. A. BA: fra. hnonth ein:utli with . i
APPI,ICArvr 1 .- ii . (C:CiNTA(.71" PERSON abovc : or fccdcr roc.
2
! ,, Oach
bnnch circuit
pusiriess (mine: 7 I. t,- for branch cimaits 1 _______ 6.55 __I_____I___
- __
i t wirhorie r service o (ceder fee.
I CtIntaeL Milne: /4 -16\\ 2
' . Ilist 'ranch ciratut
_; ,_
Alltin.:t4s.. ' 1 Laeli add') branch circuit 61,5 1 , _.
, , .. - E il.cte 11nt or fectis ro's1 inclottra)
I City/Stole/MP: Each manufactured or mndular I 90.40 1 .
)
- - ..- da/cIlInc, service andlor feckIrr
Mimi:: (02 )1Ie9". /16(5.#r"- I Fax: : 1 ) Kt:connect only 66.N5 )
i 1.1-mailf Pomp or irnranon mot 53 41) I
'I
- 1 - 7, -
1
r. CONTRACTOR Sirn or outline brining , 53.40 1
- ....„ . . .-----.....--....... .
Struat cileint(ti) Or lin d
nme: • tite.- I
! thltiilla!SS a ti)T SECU RITY
I_ cocrry panel, alteration_ or
t
Page ! 75.
C Atitires::: 2815 SW 153" DR c.xteretion. Octcrib■-• 2
•, .. .. .•..... • • ••• • •• . • • ••• • • • • .•- •-•-------------------____ ...... . _______ _ _.......__.....--.... ......... __I__ ... I..
• Citv!!!.ta/.1P;
tel BEAVER TON
i , . , - . • . OR 97006 1 2
- Each additional insirrrion ovcr,:91owable in any of the abnve -
I l'er inspection
' Mem:: (510) 469-7212 I Fax: (503)469-7114 1 ..
ri7vcsrigotion per nutn il br wool 62.5f1 i
! C.C13 Lic.: 599.14 Rlcctrical Lic.; 26209CLE Suprv. Lie.: 1..EA389 • l ' id u'tru'i1 )1 " 1 ". Pc/1'n" I ' 71.75 ..,
El•ECTRICAL PE11MIT FEES
StipliV. FLICC3Cit:tall signvture, require . , t___--- -
Subtotal:
, .„.... . ,, _. __, ,
. i Km remit, of lee): i
. t'rnt mime; KI-N K14.ALIS I Date: 29/0? ! i --
. - ----
i Sfatc surchar ( 1251. of wiinft k): I 9.00
i AuthOrii.et.1 Nie,ntiture.- .,"'
et-e-4.r--• I
___1 TO
T AL P ERM cr . ri:c.: 1
... .....................___.......
34.001
1 1 mi prmnit xppriration expire,. if 3 iirrrnit i. naf IiIrra .Mt.i., 1E31
1 !'rint n:inu:: ' 1)ale:
I _I day% alum It fra.. Nero accepted as romplerc.
' Nunarcr urric:preliOrii Miunctl pvt )Init.
I .ltu.klthe. IN.rreoeola.C.rcneaApp do, or.:Din. .T.Iv -Ill 1*.i 11
axe c
i
CITY OF TIGARD '
BUILDING DIVISION PERMIT #: ELR 2008 002'3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/ �o,/2008
Phone: (503) 639- 4171yl�i
Inspection Requests (24 Hrs.): (503) 639 -4175 F_
INSPECTION WORKSHEET FOR DATE: 9/30/2008 TIME: 7:OOAM PAGE: 23
SITE ADDRESS: CLASS OF WORK:
10110 SW NIMBUS AVE B13
SUBDIVISION: SCROLLS BUSINESS CENTER LOT #: 002 TYPE OF USE:
PROJECT NAME: AMERICAN PRINTER SERVICE
DESCRIPTION: Installing (1) protective signal system.
OWNER: ROBINSON, CONSTANCE A +, PHONE #:
CONTRACTOR: ADT SECURITY SERVICES, INC PHONE #: 503- 469.7212
Inspection Request Scheduled For: Date: 9/30/2008 Pour Time:
Code # Inspection Description Confirm _# Contact # Message
199 Electrical final / 076065-01 \', 603469-7212 N
Corrections /Comments /Instructions:
l
\`
\ ' /
N PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• ° ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: I Date: 1 /713111 " � Phone #: (503) 718- *
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