Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
44 DEVELOPMENT SERVICES PERMIT #: ELR2004 -00228
13125 SW Hall Blvd.. Tigard, OR 97223 (5031 639-4171 DATE ISSUED: 7/26/2004
SITE ADDRESS: 15055 SW SEQUOIA PKWY 100 PARCEL: 2S112DA -00800
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Installation of burglar alarm.
Job # 083 - 18057 -01
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: X 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:
TOTAL # OF SYSTEMS:
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
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 7/26/2004 $75.00 Elect'I Final
[TAX] 8% State Surchar€ 7/26/2004 $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 S� L „ " Permittee Signature (,co .n
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
07/21/2004 16:05 FAX 5034697110 ADT SECURITY [ZOO 1
EteClrical Permit Applica *1, ,S, FOR officE USE ONLY
City
SW Hall Blvd., 011figard Tiga , OR .404_0 Received :- 6 7 0 PerinitNo.: 6 • :28I -� ,i
13125 .., ' t\% j P :1'4 1sa
Phone! 503.639.4171 Pax 503.;IM I, 3. .. 4 "'''' ^ i If( Data/13 . Otha Permit
Inspection Line: 503.639.4175 .,, x (20% , /IN:- '4 I.. DamReady/By: Firm kl See Page 2 for
Wein= www.ci.tigard.orms 0 (- % • --L. - - - NotifiaUMethod:
. • %NI\ Supplemental Informadon
'I , ' , , , , I ..1 -- - . . ■., „ ' , ' ',.■' • ,,. ..,,. ,. • -. : ' , -, .1 . . 6 , ,, ..', , 01 F I , 7 ■Q 1 ',', 7 - .. % -. ;...... ••„.- • , . - ..
' • ' - ' - • ' • " r -,_ , '.■ I I X. ,,ii 1 J• ■.,.' I • ' .1, .1. , :, , ..:9 2.-..zrir-Jr..:- -1 z.L.1[... t.t....1.3,1 ..-- ..: . . • -•
0 New construction 0 Addi .' : eration/replacement Please check all that trppl
D lition Other:
y:
['Service Over 225 amps, comet Oliazardous location
E1 emo EI
,
... Oscrliee over 320 gimps - rating 11Buildng over 10,000 sq - ft.,
I 1 .. . .. ' ,. ,' , , , .. . - _ . ,... . , .. , .
....; , , . , .." .. , , , , on . . . • ,
...m. i , , , ,,1,1 1. ,.O , I 1 I r 4 4
, , , , ,, - , , II , ',.,,, : ., Z2 . I • . . ', ...,.., ,:q - ,' 1; ii' of 1- and 2-fonn1y dwellings 4 or rriore new re.sidential
El I- and 2-family dwelling ■ Commercial/industdel 0 Accessory building 0 System ova 600 volts nominal units in one stmenire
°Building over three stories °Feeders, 400 amps or more
El Multi-family ' 0 Mester btrilder • 0 Other: .
I:Occupant load over 99 persons ipManufactured struettnes or
• - , . - __T __ .: . ._.' tfs-Y 1 .' '.'''''''-''','" ' , :/'''' ', '`' '.• .: 1'2 DE8retieflielling Plea
._ . RV. park
Job n!fl&li[1 I ob site address: . p d ,.. 21 . W ei tto i ex _ i t _. 011calth facility ElOther:
Submit 2 aeto of plans with any of the above.
City/State/MI': &I . i, A . ) 00" I The above &e not applicable to temporary construction sa
I 1 - ' ..; , , . , ,:.;" rT ,: , ..c.::: . 7 . :,--1- f' • Stlite/bldgiftpL no.: p i Project name: 1 i 1 0 --. v # -
Qtr. Fe& Fatid "
Cross street/directions to job site: .
New residential single- or multi-family dwelling unit.
- Includes attached garage.
1,000 sq. ft_ or less _ 14$15 4 ,
Subdivision: Lot no Ba. add 500 sq. ft. or portion 33.40 I
Limited energy, residential _ 75-00 . 2
Tax map/parcel
Limited energy. non-residential 75.00 - 2
-r : I: : ' ` '' fl '''''' ,1( 2 1 ' '.. ''''.- ''' '').?-:.." - ' - 2 -- ',.- ' -- ; ' Each manufactused or modular
d dwelling, eaviec and/or feeder 90.90 2
Services or feeders Installation, alteration, and/or relocation
200 amps or less 80.30 2
..' , ' -, • : . .,. j , ,, , . 11 ,-,..j i -,, „, 1 ,, ,i-..,., , -. ,.1"; . .7 , ,' , 0( . .d., , •:,. . 201 crops to 400 turps 106.85 . 2
-1 -`,' ..' ``._ ' ' ' . - -. ' ._ r.... -, ':. _.. '_ . ' :.7 _. _ .:. , -' -.• , J,`... 401 furips to 600 amps 160.60 . , 2
Name;
601 amps to 1,000 amps 240.60. 2
Address; over 1,000 amps or volts 454.65 2
lily:meet only 66.85 2
City/State/ZIP:
Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( )
200 amps or less 66.85 I 1
Owner installations This installation is being made on property that I own which is not 201 amps to 400 aropa - 100.30
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 1 2 2____
401 amps to 600 amps 133.75
Owner signattme: Date: Branch circuits - new, alteration, or extension, per panel
:'':;,. ;V. ','_ ',-,-.. '1 , '' , ),-, I --I,- 'I,' '• ' , ` : , '1' ', ` - -, , 11 , ',',-,-,, , ,I, ;' , , i .,.... ,'‘, ' ,.:- `'. A. Fee for branch circuits with
- f ' ...... .„ -_ I.'. ' :- ' ) -- . .1,-- '-- --=. -- • .:, ...- ,- .. ,,,
aervic.e or feeder fee, each
6.65 2
Business name: branch cimuit
B. Fee fbr branch circuits
Contact name;
without service or f ee d er f ee.
46.85 2
Acbiress: _ each branch circuit
EactL_add branch circuit - 6.65 2
City/State/ZIP; Miscellaneous (service or feeder not Included)
Phone ( ) Fax: : ) Ihmm or irrigation circle 53.40 , - 2
: ( -
Sign or outline lighting 53.40 2
E-mail: Signal circuit(s) or limited- - •
)1 '.` IlL'i, , '''' ';'' [ ; V -I1 'I , Y '''' ' : ''' . : . ). :4 ' ''. 1 : 11 : :- ;:r . f.e.: .1 ,1' '. 11 . :■' ‘ if; . ... 0 . energy p anel ' alteraticm or
I.
extension. Desenbe: ( Page 2 1S,DD 2
Business name: ADT SECURITY SERVICES, INC.
Address: ; • . T I Ig, , I, •
Each additional inspection over allowable in any of the above
• I a : ! ill; Per inspection 62.50
City/State/DP: (503) 463.7100 trwastigatim par hour (1 a min) .
62.50
Phone: ( ) Fax: ( ) industrial plantper hour 73.75
' 'f"t r '. - t; 7 F.L ' ' ' i r 'l l ". 1 !i', 7 0. 1; :K - U . IITT . 1 7 ■ I I - ' - '1.7 1. : . ' 111 i 11 ; 11
CCB Lic.: 519 (,4 Electrical Lic.: , - ID • ete uprv. Lic.: g. _ . ' Subtotal -75 , ob
Suisrv. Electrician signature, required; - #11 _I M Plan review (25% of permit fee)
State surcharge (8% of Permit fee) G.cc)
Print name: , evi Da 0 / 0 ,
/. ,
TOTAL PERMIT PEE 2 I - 00
Authorized signature:
Thh permit application ovine if a pormlt Is not obtained within 180
days after it has been accepted as complete
Print name Date: 4 Fee methodology set by Tri-County Building industry Service Board
•• Number of inspections per permit allowed.
11 . 111 ruldintramiluVILC•Permiapp.das 12/61 440-4615TOLVO2ICOIVWELB
CITY OF TIGARD 24 -Hour
BUILDING Inspection Ll,;e: (03) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Reque ted / AM PM BUP
Location 1 sv Suite / D6) MEC
Contact Person Ph ( - 2 3 3 - 6 . 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access: i 0
Ftg Drain ELR � ��
Crawl Drain
Slab Inspection Notes:'
Post & Beam &.2C04v -00225
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation 0 146 t Aller
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
Fire Alarm
P A SS PART FAIL fl Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA — Q y
Approach/Sidewalk Dat l Insp ector /k___16,14,446s2,,e_r Est
Other: -
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL