Permit •
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CITY T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
l � DEVELOPMENT SERVICES
PERMIT #: ELR2005 -00441
'�, II 13125 SW all Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 12/15/2005
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PARCEL: 2S112DD -00701
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SITEADDRESS: 15800 SW UPPER BOONES FERRY RD A -300 ZONING: I -
SUBDIVISION: OREGON BUSINESS PARK II LOT: JURISDICTION:' TIG
Project Description: Security Alarm.
A. RESIDENTIAL • B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: ME DICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES AMERICAN SECURITY ALARMS
15350 SW SEQUOIA PKWY #300 -WMI 541.1 SE MCLOUGHLIN BLVD ,
PORTLAND, OR 97224 PORTLAND, OR 97209
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Phone: • • ' " Contact #: PRI 503- 231 -0303
FAX 503- 230 -1044
FEES Reg #: LIC 58640
ELE 26- 283CLE
Description Date Amount
[ELPRMT] ELR Permit 12/15/200°. $75.00
[TAX] 8% State Surcha 12/15/200`. $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
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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 OUNCat 503-246-6699.
Issued By: J/ /7 A�� 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 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. .
This permit card shall be kept in a conspicuous place on the job site until completion of the project. •
Approved plans are required on the job site at the time of each inspection.
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Electrical Permit Appl FOR OFFICE USE ONLY
City of Tigard DEC 15 20'
I1 Y U Received
DetrJB Permit No.:6C� _
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13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 �ar4 r\ Date/ : Other Permit.
Inspection Line: 503.639.4175 C 1 l A . O J :• � _ � Date ReadyBy: ® See Page 2 for
Internet: www.ci.tigazd.or.u5 1 1 l DING lb ) 7 IS ' i ■ Notified/Method • I Supplemental information
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re, ��1�aS�L'.= 1 �3 is �t' 7..n,+ ifiRl a;3r7 L- -( 4 �k � �1y'K�}! L c: J ;SIVi1Vl "'r+ -fr. ef o- W ( _.'.� Rur .,�{7" i '>`7 '
L �:'f� N +.r y P•i � S F I f -ri' � l �y e.!..�(, • 1 t. � • r .4-;-,'.1:'.; ,
Zfd? �: iss, `?-r.1 r • i''i •,'4 #' <k i;•1'r?/. �� ? 4z . t2+w. ufit�" inN � i!, , IyL 3 ..-21 al.= 1.$ - • t, As Vtf � s '_� . 4.� t = 4 . .. - <<' , q; - --• .. - : '
❑ New construction ® Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: ❑Service over 225 amps, comm'l ['Hazardous location
nt fir'! ti 4 � �1 „�,�,an F' K' t t�° is t k ' feJ � T . ❑Service over 320 amps - rating ❑Buildngover 10,000 sq ft.,
Ftta t�a,_;i:: ; :', .,' c,;.: .. r i:nti° r 1, E. #1 ,,i,.^.: � sr i ts :La:lbl ' sleikt c'?2k �1� �s of 1 -and 2-family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
0 Multi-family Master builder Other: ['Building over three stories OFeeders, 400 amps or more
y ❑ ❑Occupant load over 99 persons ❑Manufactured structures or
"` r ' 1NQ \�` u r uo �� 4N - :;i ° ' ;ii' �iYc 'r ' �u irl Iy , ",?�' RV park
: !'�� ;6we; tu, ...'.; .,nC15.. x J .• ...,.)'�..:t� .)� ;tek,4r..fi•,•$2,etc ,..�n'Yrele .ixti
i'Sli.ufi tBIZ;;Ail ❑Egress/lightingplan
Job no.: NJ p Job site address: 15�t i T- I ( ❑Health -care facility ❑Other:
4 `' r j t .sia,.l' >.l Czh l Submit 2 sets of plans with any of the above
L�� <.. �i�
Cit /ZIP: , 7 ( 35 The above are not applicable to temporary construction service.
t �� \�� �C ` yam ,�"T •''�:t su �r
,J t p }I ? �b'.7 "• iv ... gigt a " u'_ •' -
Suite/bldg. /apt. no.: B � Project name: � V1P1 ff � " l �(.� 1 dA rc,3. - a.as ss,,.. •- •
v Description Qty. Bee. ` , - ,
Totol
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1�
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
P'Orr':'t .1 % iT .. x a tt��'r.0 »"' _.r, t: g(:, i -, s : rl i' n
VF ���..... , 'I:f 7 Cpl:` f ; F o1�/ L %a v(.,,.
fw - li§in -a..:1 r .' 14 :,hi�,�lCo.y,f a s r t O : 1 .rl i. A 1 .^;'P.A.: ,,ill ylz i11 ., ,. °�:5' ` 1, 4 E a ch manufactured or modular
e - dwelling, service and/or feeder 90.90 2
Inst al latjnn of )ei Kl:; 1A w4 \ z .).ipW 1 Services or feeders installation, alteration, and/or relocatio
200 amps or less 80.30 2
, 7 . 0 = 0 y; 11t °x•+ r
,krY sue,. a;`;I W r•?° fe.F V , -r,11� , ,�;_,Vi 201 amps to 400 amps 106 85 2
�!� ,�e` 1 r �?'�:�3i f<`•'�0 r.;t ._1 �.Y' {yL 4N,t r'J•�. 1��: , y.� } � !'•�; �' U `�'"c° °at'Jaa'iS-
thr it Y ,...j 'a:" �'. '7a •2 f .rW h4 t Y , H .+i: e�z=f ytu£ u.. k . ' atfaV
fir_. �.n:, 53r.c,C!'.ES'?:.`rl._'__.F •S', .C. hLY,ut.,•]��. .�i".r:>!. t_�� Ste 401 amps 10600 amps 160.60 2
Name: (' pk vL C t -1, i_,t i 5 601 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/ZIP: Temporary services or feeders installation, alteration, and/or
Phone: c" "2`l IIn, - f ax ( ) relocation
(,� U Y t� ,c � � '� l Fax: 200 amps or less 66.85 1
Owner Installation: This installation is being made on property that I own which 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
'�" . �
i pS:.•� �1� .:7� `�''jtrfh 7; rl ' ;yi Sc! r �' J'-' �tir C. % '.1�[ . ;
'. .`' � ? Z�.�. �.v - r•` T •
� ' K ' ' i x r' 4 '1i4:l?ic7li;!sef�M1! L c y �, „ i �{ 1�S VIP .:LiV /aG7� iit f / t ,t :. 7111 yy}, :1 :: A. Fee for branch circuits with
h. -: ,1 4N.1.e �. v __Y rr. .rt__. i!L. {Lckl'v.' !,V LA,._AR,4 �2 ..s1 : :i.,.:ia.i -i !'iLr`.:. :
service or feeder fee, each 6.65 2
Business name: American Security Alarms, Inc. bench circuit
B. Fee for branch circuits
Contact name: Sara Hyll an ri without service or feeder fee, 46 85 2
each branch circuit
Address: 5411 SE McLoughlin Blvd. Each add branch circuit 6.65 ' 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Portland. OR. 17202
Pump or irrigation circle 53.40 2
Phone: ( 50i 231 -n3n3 i Fax: ( 5fl3 ) 93fl -1n44 Sign or outline lighting 53.40 2
E -mail: sa a@as- ar I = Oil Signal circuit(s) or limited -
' Me TaaiA 'c.r. i.'fi M2 iX'A i SN3 i_14r rts,.'1 :g tt11: energy panel, alteration, or 1
extension. Describe: 1 Page 2 2
Business name: American Seetgriity Alarms. Inc. 1 -
Address: Each. additional inspection over allowable In any of the above
5411 SE Mcr ugh1in R1vd - Per inspection 62.50
City/ State/ZIP: Investigation per hour (1 hr min) 62.50
P- ortland. OR. 17202
Phone: ( ) F ax: ( ) Industrial plant per hour t 73 75
.t"ilfrd gii.I ,:C1 a P;=1'��'�G:�.�ry�d� l3' I +I di 7.. § ::K . .f_' .
��t�. �',nt.:' ���:.•1;�,.r..�-' h�
CCB Lic.: 58640 Electrical icy 26 - 283CL rv. Lic.:474JLE Subtotal 7 . 5 -
Suprv. Electrician signature, required: .. 7 (71.4'.‘._-- ---- Plan review (25% of permit fee) p\)) w
• � State surcharge (8% of permit fee) CQ
Print name: Date: 1 Z.3, r i/ � r,
.TAMPS I) T.i atnn / i TOTAL PERMIT FEE S I. OD
Authorized signature: ; / This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete
Print name: Date: • Fee methodology set by Tri- County Building industry Service Board
- •• Number of inspections per permit allowed.
`ltal'd`aa\P` l d am ' ° " " 1 6g1L'oN ' 0Ni 11N8V1V AlidA03S NVDIN]WV INVLC :OI gOOZ 'cl'080
CITY OF TIGARD
BUILDING DIVISION A PERMIT #: rLR' 05 - &'4 (
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 �o i
Inspection Requests (24 Hrs.): (503) 639 -4175 A- eh -
INSPECTION INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: (6 13obues 4) CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: (bp.Tfl- f •
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: c. PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description onfirm Contact # Message
1 t c ) Low VozT /r !hv 6 ° 167 - 51
Corrections /Comments /Instructions:
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3.
Iry
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40
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 618 Date: 1/21 Oi Phone #: (503) 718- 246