Permit 4 4 ELECTRICAL PERMIT -
CITY TIGARD RESTRICTED ENERGY
1 1A DEVELOPMENT SERVICES PERMIT #: ELR2001 -00130
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 05/04/2001
SITE ADDRESS: 12398 SW SCHOLLS FERRY RD PARCEL: 1S134BC-00800
SUBDIVISION: PP1993 -058 ZONING: C -P
BLOCK: LOT: 002 JURISDICTION: TIG
Project Description: Installation of burglar alarm. Job #083 - 13485 -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:
INSTRUMENTATION: OTHER: BURG.ALARM X
TOTAL # OF SYSTEMS:
Owner: Contractor:
THOMPSON /DAVIDSON LEA SE ADT SECURITY SERVICES, INC
PROPERTY VENTURE, THE 2815 SW 153RD DR
PO BOX 398 BEAVERTON, OR 97006
PORTLAND, OR 97207
Phone: Phone: 503 -469 -7244
Reg #: LIC 59944
ELE 26- 209CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 05/04/2001 $75.00 2720010000 Elect'I Final
5PCT CTR 05/04/2001 $6.00 2720010000
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by jf,, ,4A'Lfi' Permittee Signature A l Lg
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: ,. 'U��i r/� DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
05/04/2001 11:37 FAX 503 469 7110 ADT SECURITY el 001
y ri
Electrical Permit Application
i
� Datereeeived: -� "Al Permit no Loo
- oo/ S,)
X11...'.1 I1 City of Tigard •
Projectlappl. no.: Expire date -
City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.;
Phone: (503) 639 -4171
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: •
TYPE OF PEItMI I
0 1 & 2 family dwelling or accessory 1111 <crnmertaial /industrial 0 Multi- family 0 Tenant improvement
0 New construction 0 Addition/alteration/replacement 0 Other. • •0 Partial
JOB SITE INFORFIATION
lob address: • /2,3f ,t.) SciAolit axtf/ R _ Bldg. no.: Suite no.: Tax map /tax lot/account no.:
—
Lot: I Block: Subdivision: 1
Project name: ' 'Description and location of work on remise ran Tin
Estimated date of completions •
�
CONTRACTOR APPLICATION FEE SCHEDULE •
Job no: 093 Fee At
Business name: S x
Security sclvit.cS Description Qty- (ea.) Total no. rasp
Ad dress: 2815 S.W. 153 llr. New �dential- single ormniti- famfyper
awellnrgmdt. rneludon attached wage.
City: Beaverton, O 'Rat 70Oglp: Serrliaeindudad:
Phoneike .. J2 f LI I Fax 1/44 //O I E-niall: 1000 sq• It or less 4
CCB no.: O,yy I Elec. bus. lie. no: ,71 (t
Each additional 500 sq. fl or portion thereof
Limited energy, residential 2
Ci / fietro lie. no.: ` Limited energy, non - residential 2
rJ 7`/ 70 Each manufactured home or modular dwelling
Si . ; lure of supervising electrician (r , uired) ' ate Setvicc and/or feeder 2
print): a ( � ( Li 00 Services of feeders — instsllallott,
Sup. elect. name (
- A -I - - alteration otrelocation:
PROPER' Y MI NER 200 amps or less 2
Name (print): ep f apl -mu 6, erg 201 amps to 400 amps 2
C,U 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: 57i - Son -1582.1 Fax: - I E - mail. Reconneetoniy 1
Owner installation: The installation is being made on property I own Temporally services or feeders ...
t
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orteloeatiop
ORS 447, 455, 479. 670, 701. 200 amps or leas 2
201 amps to 400 amps 2
Owner's signature: _ Dane: 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: 1 Zip H. Fee for branch circuits without purchase
Phone: Fax: �� of service or feeder fee, that branch circuit: 2
- Each oddidonnl branch circuit
PLAN REVIEW (Please check all that appl)) Misc. (Service or feeder not included):
O Service over 225 amps - commercial Q Health -care fvciliity Each pump or irrigation circle - 2
Cl Service over 320 amps -rating of 161:2 O Hazardous location Each signor outline lighting 2
. family dwellings 0 Building over 10,000 square feet four or Signal eitwit(s) or a limited energy panel, Ti
C) System ovcr600 volts nominal more residential units in one structure alteration, or extension* I • 2
Cl Banding over three stories O Feeders, 400 amps or more 'Dosetipdon:
O Occupant load over 99 persons O Manufactured structures or 1W park
Each additional utapeetlon over the alloeablo in any of the obor
0 E lmssfightingplan O Other: Per inspection I I I I
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all Jwlsdhaloas accept coast cards, please can jurisdiction for more informatics. Notice: This permit application Permit fee $ r � s
0 Visa 0 MasterCard expires if a permit -is not obtained Plan review (at _ 46) $
remit oad nut= / / within 180 days after k has been State surcharge (8%) •••• $
ma accepted as complete. TOTAL $
Name of cstdhotder as thown on credit card
$
Cardholder signature Amo ®t
440-0615 (GNOICOtro
CITY OF TIGARD BUILDING INSPECTION DIVISION
%24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
Date Requested / — 1 0 AM PM BLD
Location / 0.3 g Suite a MEC
Contact Person / 1 Ph ?(� 9 7�?' ELM
Contractor Ph SWR
BUILDING ler Owner �� ELC
Retaining Wall ELR gs06 / 00/30
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes:
L_ G T I / SGN
Slab V SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm (.10/:A71€
Susp'd Ceiling /0411
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
Fi
PAS PART FAIL
S
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. 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 l /0 Inspector Gft-b Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.