Permit 1 c.• ELECTRICAL PERMIT -
r CITY OF TI GARD RESTRICTED ENERGY
_r i ��� DEVELOPMENT SERVICES PERMIT #: ELR2003 -00114
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/15/03
SITE ADDRESS: 11875 SW PACIFIC HWY PARCEL: 1S135DD -00900
SUBDIVISION: HOFFARBER TRACTS NO.2 ZONING: C -G
BLOCK: LOT: 021 JURISDICTION: TIG
Proiect Description: Alarm system pre -wire and trim out.
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:
INSTRUMENTATION: OTHER: BURG.ALARM X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
LEFEVER, GEORGE & TAMMY SIGNATURE SECURITY INC
11875 SW PACIFIC HWY 14901 NE 32ND.CIR.
TIGARD, OR 97223 VANCOUVER, WA 97682
Phone: Phone: 888 - 668 - 1010
Reg #: LIC 138693
ELE 37- 865CLE
SUP 2668RET
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 4/15/03 $75.00 Elect'I Final
[TAX] 8% State Tax 4/15/03 $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 throuc
Issued by 4 ,6,�,?„ 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
04/15/2003 08:41 FAX 5035981960 CITY OF TIGARD al002
Electrical Permit Application F OR OFFICE I :SE ONLY
Receives p r) Electrical /�
��, • DatdBy 7 / �3 1 Permit No.: t I /t�Oo3 – OW/ '/ Approval
City 0� . Date/B g Sign No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503 -639 -4171 Fax: 503-598-1960 , Post-Review land Use
Data/By: Case No.:
Internet: www.ci.tigard.or.us l ,� 1 ! Contact Juris.: ® See Pa 2 for
24 -hour Inspection Request: 503- 639 -4175 °— Name/Method: Supplemental Information.
. ,.... ...,...,... I.:.' :'°: ,`•; ::i. • 40$1)0_ • ...•• :,•'.iigil; i ;: i ;.:: : " .
•3 .:.:•; ' ' .� � t 2fl::�t.gg i'F�r>•r�.�}I t �.'4,:: � <, � ;!$
El N ew construction ❑ Demolition CI Service over 225 amps- ' ❑ Health-care facility
Addition alteratio lacement Other:
commercial ❑ Hazardous location
El / 4 ❑ Service over 320 amps - rating of ❑ Building over 10,000 square feet,
::'•.;;;;;.::;;.; :::•••••:::: ;.:,:. .:.:.: ;; Vii .. R ljO1NS•�f»'� +ltZe1t1' ;:' . ,:; 1 ;:,,. i t° . . i`. 1 1 8t 2 family dwellings four or more residential units in
❑ 1 & 2- Family dwelling 144 CommerciaVIndustfial 0 System over 600 volts nominal one structure
n ❑ Building over three stories 0 Feeders, 400 amps or more
1:1 ACCesso Accessory Building Multi-Family ❑ Occupant load over 99 persons 0 Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan 0 Other:
Fl
.:,, . ''..3130812E2. �• ; :��,:; 1 • � : Submit sets of plans with any of the above.
,. _ . a d i Q1'i :'8A(���+ f� :'r; • ;.: ble construction service.
The above are not applicable to tem racy conatru
Job site address: i 1 75 s w �l° // L . th"Y ::, :•,:: , • A ;:'
Suite #: I Bldg. / #: Number of inspections per permit allowed
Project Name: NVTK -R it) R ''h o r it/6---, Description _ . - QtY R« (ca) Total j
Cross street/Directions to job site:
New resldentia6singearmaltidaara per
dwelling snit. includes attached garage_
Service Included:
1000 sq. tt or less 145.15 4
Each additional 500 so. ft. or portion thereof 33.40 I
Subdivision: I Lot #: Limited energy, residential _ 75.00 2
Limited energy, non residential 75.00 2
Tax map/parcel #: Each manufactured home or modular dwelling
P 6 ; . ::DESCl 0l4:0P WORK , :1•: :1; •51 ' ,I:: `• :•.:..• service and:or feeder 90.90 2
:',.••••:••
p � Se rvices orfeeders - I
ALARM $ y ST EM ?Is - W I fr g TR-I M DST alteration or relocation:
200-amps or less 80.30 2
201 amps to 400 amps 106.85 2
401 amens to 600 amps , - -- , 160.60 2
a : I .i ' ` I ` Over 1000 F°55 lts 240.60 • 2
:�' q„' :: t:�i all' 'i '.';:•i! `1:i ,,i :l i; r v
Ov amps o 454.65 2
Name: Recormect only 66.85 2
Address: Temporary services or feeders - installation,
alteration, or relocation:
City /State/Zip: . 200 amps or less 66.85 1
Phone:
201 amps to 400 amps 100.30 2
� ;:C ax: 133.75 2
; ;CAPPI;d'c` iNT• l:! .: i :1 °':' . . , I. CTIPER O i:. i..:. i :i :i 4 01 to 600 a mps Branch circuits - new, alteration, or
Name: extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 6.65 2
City /State/Zip: B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 46.85 , 2
Phone: I Fax: Each additional branch circuit 6.65 2
E-mail: Misc.(servicc or feeder not included):
i , . •r ;,, i i , ,': r Fach pump or irrigation cycle 53.40 2
: i ` : ; :. ; ,..., �,.. ::. li.� r.1 =ii i r�1;1::i : �.0 4�`I Q . !;':;,: _ Each sign or outline lighting • 53.40 2
Job No: Signal circuits) or a limited energy panel, .2,<•
Business Name: 5 /6�NRE 5Eevri Ty Descr ioon extension Page z 7 2
Address: /51901 NE � Ci .
+ : y�V�� W� g 8� Q 2 Each additional inspection over the allowable in any of the above:
i. /StSte /Zl p d gAIeo U Per inspection per hour (min. 1 hour) 62.50
^ Phone: 360 750 —4o0o0 Fax: j1 - /SS 7 investigation fee:
• '
Ott er•
'v CCB Lic. #: t i 3/613 Lic. #.1_37— Sf (, S L E P ... �. ... �.. -.
0 Supervising electrician .
" � o
trician i 0 - t Subtotal S 7,,
signature req e{ Plan Review (25 %0 of Permit Fee) ' $
Print Name: I mE ?JS L c. #: Z bcfr faCT State Surcharge (8% of Permit Fcc) $ /i - a e
TOTAL PERMIT FEE $ R / • 0 C-
AuthoriZed — Notice: This permit application expires if a permit is not obtained within
Signature: Date: 180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board -
(Please print name)
CITY OF 24 -Hour
BUILDING - Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/BUP
Received Date Re ested .5-1/ AM PM BUP
Location b ? s Suite MEC
Contact Person - C- • Ph ( ) 36 o - 7Sa -looeo PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner r i aA.•1 - ELC
Footing
ELC
Foundation
g Access:
Ft ELR 3 - a 0// 4/
Drain
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 a / -
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
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk D a Inspector Ext
Other:
Final DO NOT REMOVE this inspection record fr the Jo te.
PASS PART FAIL