Permit ELECTRICAL PERMIT -
C ITY OF TI GARD RESTRICTED ENERGY
tyl DEVELOPMENT SERVICES PERMIT #: ELR2004 -00298
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 / DATE ISSUED: 9/16/2004
SITE ADDRESS: 15575 SW SEQUOIA PKWY 100 PARCEL: 2S112DD -01600
SUBDIVISION: PACIFIC CORP. CENTER / ZONING: I -P
BLOCK: LOT: - - JURISDICTION: TIG
Project Description: Limited energy for burglar alarm.
Job No. 7240127139
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:
PACIFIC REALTY ASSOCIATES HONEYWELL INC
15350 SW SEQUOIA PKWY #300 -WMI 15495 SW SEQUOIA
PORTLAND, OR 97224 STE 100
PORTLAND, OR 97224
Phone: 503- 624 -6300 Phone: 968 -3300
Reg #: SUP 941LEA
LIC 150191
ELE 26- 207CLE APP. SAYS CI
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 9/16/2004 $75.00 Elect I Final
[TAX] 8% State Surchart 9/16/2004 $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 t• • ow - - dopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
thr. ugh OAR 952 -0s -0100. .. m- obtain copies of these rules or direct questions to OUNC at (503) 246 -6699.
/ /
Is _ ued by : / £ / 4��` Permittee Signat .T ,
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
SEP-15-2004 10:07 HONEYWELL 503 968 3398 P.02/02
Ei€ elial P4mit Application cl x. Felt OFFICE USE ONI.V
City of Tigard Re p= F / 6% / permit No.: 41A:0 ' + 00 00 21?
13125 SW Hall Blvd., Tigard, OR 97223 .....
c I- , ,;, . Plan Review
Phone: 503.639.4171 Fax: 503.598.1960
CN ' '. ':.' ri'; . 1. '.: ' 0 1- Date/ay: Other Permit;
Inspection Line: 503.639.4175 .1 ,C. :3.._sar . - .L.. Date Ready/By; j** 0 See Paget for
Internet: www.ci.tigard-or.us CAI Notified/Method; - //0. Supplemental Information
a
;.. . .,it,;;;;;;e7. .s.-1..0.t l'1,!7 ‘....,;:i r , : : : :':' , .:: . .j.r' ; :' . :,i:. ':)... ' .: .': " . '
■,,,;,.4,. IT:r..r.qt.,,z.5_....„,.:_-,.. ; ,g,•1;;,"..t... . :,•:•`. ;.! :O..: • • , •-..4.;•."-Li; i• :f!'• •-•••• • • - • -•••..-... • • •• ..., ••• • • •
El New construction lEr Addition/alteration/replacement Please check all that apply;
°Service over 225 amps, comm'l DHazardous location
171 Demolition 0 Other OService over 320 amps - rating OBuildng over 10,000 sq. ft.,
r:Z A,1 t...- :..i.T. of I. and 2-family dwellings 4 or more new residential
.;..:..„: ,......:44 :11.4.5 ......• .. .. .1. • Lb. ..• .. ...., A- : ,S Ait!,'• •S .1:
o 1- and 2-family dwelling Er Commercial/industrial 1:3 Accessory building ElSystem over 600 volts nominal units in one structure
nBuilding over three stories OFeeelcrs, 400 snips or more
0 Multi-family . 0 Master builder ' 17 Other: Doccupant load over 99 persons DManufacrured structures or
4 ,r,g I r - ti r Mr1Z .." *, 1 tFOgN.' 13'6 : ' ' '' ... • .. 61 7:142. 1 .1 r 6 1 . 1 EV iro. DEgressilighting Plan RV park
Job no.r12-q0i2:7155 Job site address: 155 SIN Sega/11 R/-44.11 S eav D /I eal th • c a re facility °Other:
- Submit .a. sets of plans with any of the above.
City/State/ZIP: 1i)rt1i(Rri4 1 61.2. onsitt The above are not applicable to temporary construction service. .
'4..q". .!. ..: . .
. •
Suite/bldg./apt. no.: Project name: b Darin
...,,,,,.. 1 Qty. Fe - 1 - 7 - 7 - 077 - )1
Cross street/directions to job site: New residential single- or multi-family dwelling unit.
- Includes attached garage,
1,000 sq. ft. or less I I 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. B. or portion 33.40 I
Limited energy, residential
75.00 2
Tax map/parcel no,: • Limited energy. non-residential 75.00
2
r ?M'''''W.EiVI t re,?6*Ik't.g 7 i l it li btigOiX0 1. 5** * *ikcl ." I'M'N '4= Vg‘ 70::;; S 4 - rn - h rrnnufactured or modular '
r;.,,cilli e•". r;',i .;.0.- ...y-i-m- 'ci. . ......---,-- - -4'. ..-- - ‘, ,, ' . c
dwelling, service and/or feeder 90.90 _ 2
MA rrn ei/S-ferd Services or feeders installation, alteration, and/or relocation
. -
200 arrips or less _ I 80.30 2
: FU.‘Viicig , .litaki - 472 ' 1.1 16 .- " "." '. . r '':. : :" .,L ;V: . :. 1 .!Mi i ...,.. ki...,:itgic ■ '"/•;...7,..Z.: ;!':vii',10,....., 201 arnPe tc 40 amPs 106.85 2
:,...iFf:14j.•,:o.,... ... ........,:i......, ....1....:. , ...41...'./.•-dit. '.....•••••, .'r •::...'..:, ..;'...c...:: I.:. •• . 4 0 1 amps to 600 amps 160.60 , 2
Name: 16 A-c:1 - 72_ 0_4 601 amps to 1,000 amps 240.60 2
' -
Address: (5550 c 5ca_.) at. 41214.0 1 4- PICA0K • 5:::10 Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: PrL- a 4-- la 7 _ -P.. Si Temporary services or feeders installation, alteration, and/or
relocation
Phone: (‘b5) epAv , 5 Sep 0 Fax: ( ) 200 amps or less 7 66.85 ---1
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 •' 2
intended for sale, lease, rent, or exchangc, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
- -
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
•a ,.: . . ..•37 .q. T:51 A. Pee for branch circuits with
serricc or feeder fee, cach 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fcc; 46.85 2
each branch circuit _
Address: Each add'l branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not Included)
. Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( )
53.40 2
- . Sign or outline lighting
E-mail: Signal circuit(s) or limited-
;;;:.:0•".5. ,: ...i.5 • :••••!%:; ' energy panel, alteration, Or
..........-. ••• 1 - ''''-''' '...a.:. ‘. - ':''''' 4 '" .. ' '' ' '.4-.." '" .'• ....- ' ------'''''' extension. Describe; Page 2 is 2
Business name:
Address: 16 91 s S yN1 6eA 'top piktALI iv to 0 Each additional Inspection over allowable in any Of the above
.
. Per inspection 62 50
. _
City/State/ZIP: Po vliGinoll I OW_ Or17..7/4 Investigation per hour (1 hr min) 62,50
--- - 73,75
Phone: (r3)5) q us, 53 p 0 Fax: ( 5155) 61(1) g Industrial plant per hour
,,-.- .... --T....
?."• ff ItALt . • . .:.: • ' ' •:
CCB Lic.: 60 I I Electrical Lic.: V0-741eWSuprv. Lie.: Cl 1 41L-611 Subtotal --) 5
Suprv. Electrician signature, required: r Plan review (25% of permit fee)
Print name: s e. I N I. C, ' isAtirell'10/15>e r i lv--f State surcharge (8% of permit fcc) IV
- - TOTAL PERMIT FEE i I
....-
Authorized signature: .sK'..... ./' This permit application expires if a permit is not obtained within 180
• / days aftar it has been accepted as complete
Print name: 51 A I Date: 0/151D+ . Pee methodology set by Tri-County Building Industry Service Board
TOTAL P.02
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested ' \6N \-\ AM PM BUP
Location » 9 b z -c
U k. - Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ft Drain Access: t 0 N - ta� `�G L
Crawl Drain t \A lyINA �O `� ELR'�._
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 \11/17
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
RT FAIL
L
Rough -In
UG/Slab
Lbw - tage
ire Alarm
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE 0 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line /
ADA
4),
. �, /
Approach/Sidewalk D a t e Inspector / �i Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL