Permit CITY OF T I G A R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
_ DEVELOPMENT SERVICES PERMIT #: ELR2004 -00227
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/26/2004
SITE ADDRESS: 15055 SW SEQUOIA PKWY 120 PARCEL: 2S112DA -00800
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Installation of Burglar Alarm.
Job # 083 - 18059 -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 Surcharl 7/26/2004 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699.
Issued by Permittee Signature �tre, p \`v
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
07/21/2^f" 16:04 FAX 5034697110 ADT SECURITY e001
I 'log
El Permit Avi)licatiraE,CEIV, D I OIt OFFICE USE O \L1'
City of Tigard —�V �, PenmtN&- c (- DDV OO 7'
13126 SW Hall Blvd. :1161rd, OR 97223 JUL ', _ -- - Phone: 503.639.4171 Fax: 503.598.1960 Q P • me w Other Permit:
Inspeotlon Lane: 503.639.4175 4.•„•,-,11,11'r n Dt t►
Internet: www.oitigard.or,us CITY OF fi rs>r D N ee ee d d ®eeeo
� ( T � Sl� xror
,
'r " ..n' I '. ,' I J } 9. 16 H1 '' ' .l ilt !I Y , 'Tit rL '' 0 IL , ,I 11 „541 j'r J1 41 , ,, .;„j J F` i ,$y
.:� .,, ., I z +i' ..... � . - ; d ?. {:II_,�,..�. , :-.„1 1 .. , .: ,, :.. , - -. . ,- .. ,,,, i I F.i .; u. ` III .. � t , ^ , .
❑ New construction • tion ❑ Addititm/alteiition/replacement Please
check all that apply:
0 Demolition ❑ Other ❑Service over 225 IMPS, mm:1'I ❑Hazardous location
, p �l r l; ❑Service ova 320 amps - rating ❑Htdidng over 10,000 sq. ft.,
I . 1 I 1 L l `(l 1 Y y` ( :p I , Il y 7 U I .I
4 ' U1> I r r I 1 F ! j F I1 ri
. r , �• I I of 1 - and 2-iluIDly dwellings 4 Or more new recldenpal
0 i- and 2-family dwelling ;:, Commercial dustrial 0 Accessory building _ ❑stem over 600 volts nominal units in one structure
❑ Multi-family ❑Bvitdmg ova three stories ,
❑ Master b tSlder ❑Other ❑Feeders or morn
¢ ❑ upant load over 99 persons [IManuiha d structures or
'' -, 1 '' ''"'el -, I 1 ..d'� II `F 1'I 1' I i IE II. ,. .. '' : E wa.L
i 1 , - .. 1 4
i 1 .) ? 4 �. d { II ? V 5 I ❑>lgreas/lighting plan RV p xk
Job n - i !ie ' M k ob site address: `4 SW • I Llo iek_ I ❑fie facility ❑ Other.
Submit 2 sets of plans with any of t9te above.
Cir/ /StateJZIP: P I . j` A_ ') / 1 • J The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: 2.4D Projt t name: I ' ", .. ' `'111 1 ri .',' i u, i i ; ° , • -.‘,.:(7-,......-
T ./k . l [!, / ► I Inetertgoll Qty. Pee. 1 relit ' »
Cross street/di'rections to job site: - New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. R. or less 14515 4 •
Subdivision: Lot no.: Ha. add'l 500 sq. ft. or portion 33.40 1 -
Limited energy, residential 75.00 2
Limited energy, act- residential 75.00 • 2
'i'i 3,I; 3 , ,:.:111', - 1:i( : ,!,;(0)0.:, :' .v :i . Kr ■ Bach manttfacnred or modtllnr
dwelling, service and/or feeder 90.90 , 2
1` ' / L0.. ( J "u Servi or feeders Installation, alteration, and/or relocation
200 arms or lose 80.30 2
I I I , . l j - 1. . ., .. , ■ �' 3 ' ` I . - ' _ � . I `' Ih� .'.�' " ` ' . i ' 4I' , J3 r ' i ;. 201 amps to 400 amps 106.85 2 • • ' 401 amps to 600 an pa 160.60 2
Name: 601 amps to 1,000 amps 7.4060 z
Address: Over 1,000 amps or volts 454..6 2
City/StataJ�: Reowmoot only 66,85 2
Temporary services or feeders insteliadon, alteration, and/or
Phone: ( ) p ax: ( ) relocation
Owner installation: This installation is be made on 20 amps to or Ices 400 66.85 1
� PropertY that I own which is not 201 amps to 400 amps 100.30 1 2
intended for sale, lease, runt, or exchange, according to ORS 447, 449, 670, and 701.
signature: 401 stops to 600 amps 133.75 2
Date: Branch circuits — new, alteration, or extension, per panel
-, L ,. - I . I } 1 1 1 1 , '
I' ' I I 11 ; :1 < <' I, i�) A. Fee for broach circuit' ad*
� .. .:'.'... � I e r.�� ti 'a Ii
ecrviee or fader fee, each
Business txalne: branch circuit 6.65 2
•
Contact name: B. Fee for branch circuits
•
without service or feeder fcc, 46.85 2
Address each branch circuit Each adds branch circuit 6.65 2
City/State/21F: ' Mlseel aneoUS (service or feeder not included)
Phone: ( ) Fax : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting _ 53.40 2
E-mail; i } U i t 1' I f l t Signal circuit(e) or limited- .
r. .:.r I ti r v. '� ., : .- I , : U ) I •1., I Ilr i pl + i. I1�,,Ir!',,, i I I ! energy Panel, alteration, or
=. a . r _ i . , i .. I . me: extension. Describe: 1 Page 2 iS 2
Business na ADT SECURITY SERVICE$, INC. 1
Address; • l• a Each additional Inspection over allowable In any or the above
s • , • ; 1 , ; Per inspection 62.50
City/State/ZIP: (503) 489-7100
investigation per hour (t hr rain) 62.50
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
1
■ 1C.: al Lic.: / I' `. ii•t1i I x,1 '. , i 1 II'),hall I]II„II J l P 7 ; ,L1': 1•
Electri .- Ctz uprv. Lic.: ,
.,� Subtotal r 15 • 00
Suprv. Electrician signature, required; - ,� - `; - Plan review (25% of permit fee)
Print name: C . , �, Date: �� ,. 1 , State surcharge (8% of permit fee) G l�
TOTAL PYr'11miT 1 E b I - der
Authorized signature; Tble exalt application P PP expires if a permit It not obtained within 180
days altar It has been accepted as ceerplete
Print name: Date: • Fee metltedobgysetby7ti-Caunty Building Industry Service award
•• Number of Impectinne per permit onlowed,
BRultdirlalt !a 12/03 er0- 4515rhn17/1"VI WRk
CITY OF TIGARD 24 -Hour
BUILDING Inspection Une: x(503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested Fl - AM PM BUP
Location / 57)5-6' Suite /`;'d c, MEC
Contact Person •GI.P� Ph ( ) 33 6 / /1 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beams 4
Shear Anchors
Ext Sheath/Shear Int Sheath/Shear
(1(D
Framing
Insulation C / ( CI /V�
Drywall Nailing C � I r
Firewall
Fire Sprinkler
f
Fire Alarm
lJ
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
)1 PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Please call for reinspection RE: D Unable to inspect — no access
Fire Supply Line
ADA — 5 —0 16init L Approach /Sidewalk Date I nspec t o Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL