Permit CITY OF T I Ca A R® ELECTRICAL PERMIT -
RESTRICTED ENERGY
- 13125 Dw W Hall O MEN Tigard, O
SERVICES ISSUED: 1 639 -4171 DATE SUED: 1/3/2005 -00002
SITE ADDRESS: 07337 SW TECH CENTER DR PARCEL: 2S101 DC -04602
SUBDIVISION: ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Proiect Description: LV for burglar alarm.
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: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
MCCORMACK, WILLIAM L + DARLENE T ADT SECURITY SERVICES, INC
7190 SW SANDBURG ST 2815 SW 153RD DR
TIGARD, OR 97223 BEAVERTON, OR 97006
Phone: Phone: 503 469 - 7244
Reg #: L1O3- 4695391414
ELE 26- 209CLE
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 1/3/2005 $75.00
[TAX] 8% State Surchar€ 1/3/2005 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699.
Issued by c. Permittee Signature '
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
12/3 ONO 04 t6:21 FAX 5034697110 ADT SECURITY 11001 /003
.
Fr£CCtriC. .�e1�IlitA�1 l.t E D FOR USE,U]VL$
City of Tigard Received I -• _ - c) -∎ 1'4\ Permit (24,4204/ -OopQ;
13125 SW Hall Blvd.. Tigard, OR 97223 ,DEC 30 200 , plpa 12abfew -
Phone: 503.639.4171 Pay 503.598.1960 /r_7;i Other Permit
�' DatdB
Inspection Line: 503.639.4.175 q� ' II Date Re adyBy: 121 See Page 2 for
Internet; Www.ci- tigard-orus CITY OF TI = r� Notified/Method: Supplemental Informed on
_l: '; :• u.: 3i r•. , t 'n,. Mi ° 7 :12:0.M N i s
i7 �a �." , .t 1 d r t �, M1 , =l ^t„ �'.i Fr f�.,,r� sl (.- -'N:. ,
.' ∎ 1 y �' i ' 1 9. U 1, • i a „ r • i i d .i .; . J r .Ia,.tl'.i 1 r.:iJi.�'fr : sr�, • ..., � ' +; I�,s .._ i ...._.... ....._ _.. 'f .. I � � 1 ��5� � kC dl�� }: - d'ic �1i:� litiu�,:i:r�`... J sk' r *� ...
_., � � it � ...... . .� � .. i �Y, ; {_ � - -.li
1=I New construction 0 Addition/alteration/ lacement Please check that apply:
El Demolition p 0 Other ❑Service over 225 amps, comm °Hazardous location
µi r l l � r [Service over 320 auras - rating 0Buildng over 10,000 sq. ft.,
' i . ( t U 1 i t ). , 1 t J 11 , , , 4••ii i6 , I_ a, Val r. of 1 -and 2- family dwellings 4 or more new residential •
❑ 1- and 2 - family dwelling L' Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
ily ❑Master builder ❑Other; ldin srori
� 9 per8on8 M f ed structures or
das,
❑ Multi-family
�; Irj = 5.'4'0 1 � i iiG +t X 1 7 Pr {
[Occupant g load � 0 ❑ RV p3Tk
.__ ❑ 6b 6P
Job no.: cJ T /W6 r_ � ji Job site address: '. 1J ?- s 1: C ❑Health - care o fp EP then _
3ubmit� sets of p with any of the above.
City /State/ZIP: �Z�, J/( 9 g.75 The above are not applicable to temporary con service.
Suite/bldg. /apt.no.: rojeotname• /(Ay k ["J i0 0 . .. .._.... : �Li !•riti: ittUiii IfI Pi r ?
Description Qty. Bea Total
Cross street/directions to job site: • New residential single- or multi - family dwelling unit.
J Includes attached garage.
_, 1,000 sq. ft. or lass 145 :15 4
Subdivision: • Lot no.: Ea. add'1500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy. residential 75.00 2
r ! ' (. '1' ..... '4) r, ` Each manufactured ormo 75.40 2
.� , A� ALA4M dwelling, service and /or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
11 200 amps or less , 8030 2
1 106.85 2
.., .....,._ • ...:...._ r _..... . :..:,.::__:::.. ......:.::.. ... _,, .... ..:,.:.�...,) ... 401 m 600 160.60 2
Name: ` amps antes
At Gam / ��F FreregAIA.J 7 601 amps to 1,000 amps 240.60. 2
Address: / Over 1,000 amps or volts 454.65 2
/
Reconnect only 66.85 2
City /State/4P: Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( e') - 79. Fax: 200 amps or leas 66.85 1
Owner installation: Thin installation is being made on property that I own wb.ich is not 201 amps to 400 amps 100.30 2 -
intended for sale, lease, rent, or exchange, 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
' ' " , ' t A - Fee for branch cilt ui is wit?' ..., ..: _.... .....__., . .., _:.:. •,... r....,: : . st7vice or feeder fee, each
Business name: branch circuit 6.65 2
Contact name:
- 11. Foe for branch circuits
without service or feeder fee, 46.85 2
Address:
each branch circuit
Each add'l branch circuit I I 6.65 I I 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) ^ Fax: ; ) Pump or irrigation circle 53.40 . 2
Sign or outline lighting 53.40 2
.
E 7 Ij Signal circuit(s) or limited-
f. . _ It.,�. _ 'S t : ��t er . _ _ .. � '! 5. f i t ' cF; .; '.:F 4, l -..f. - 1, r r _ ! :! �y _ 111 ':.d ! j 0 u . , X 1 1 3 ' i, if:Al ,:a; 1 . , " _ hlrl s. A t:l,,,! 15 9 �_ energy panel. alteration, or
extension. Describe: Page 2 2
Business name: ADT SECURITY SERVICES, INC.
Address Z Each additional inspection over allowable in any of the above
RFAVp N, OR 97008 - Pcr inspection 6250
City/State /ZIP: (503) 469 -7100 Investigation per hour (1 hr min) 62.50
_ Phone: ( ) Fax (.11.7 7 ye 7' _ / Industrial plant per hour 73.75
(� � T � � 1_... .r � _ .lTr { . �,_ .. ra �,N`9 ' Y �1 F ' Vi r n ��
..� rli,a. '�Sr �Y.rr �, r G9i�,�1 ,1. ii i'•it'Jy�:ii1_'',Orj�P1' t t h -:'d''''''
CC13 Lie.: ie y,4 7 Electrical )✓ic_: 2q eke ;uprv. Lie,: gel Subtotal f.5 - '
Suprv, Electrician signature, required: 't. - Plan review (25% of permit fee)
i A .
Print name: K 1n kl®, Date: � �, • 4_____ State surcharge (3% of permit fee) (,
e- TOTAL fl RMIT PEE S
Authorized signature: This permit application expires It a permit is not obtained within 180
days after It has been accepted as complete
Print name: I Date: - Fee methodology set by Tri -County Building Industry Sorvlea Beard
" Number of inspections per pemnit allowed.
i : VSulidltitOcnditalBLC-PermitApp .doe, 12/03 1.i0. 4615T(10 /01/COM/WEt
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / ' ' AM PM BUP
Location 7 j - TI L &/A- Suite '/ MEC
Contact Person Ph ( ) 6 - 701.3`/ PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR (5 ..
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 C (V
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
oltage
❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
j PART FAIL
S r] Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line ,i a
ADA
Approach/Sidewalk Date I ° ` � Inspector `' V\ KS y 0 1 rv 4; ' Ext
Other:
Final DO NOT REMOVE this inspection record fr na the Job site.
PASS PART FAIL
•