Permit CITY OF TIGARD r ELECTRICAL ENERGY
-
RESTRICTED ENERGY
f DEVELOPMENT SERVICES PERMIT #: ELR2000 -00201
'�I- 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/25/00
SITE ADDRESS: 09451 SW WASHINGTON SQUARE RD A -16 PARCEL: 1S126C0 -01107
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: ' LOT: JURISDICTION: TIG
Project Description: Installation of protective signaling.
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: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PPR WASHINGTON SQUARE LLC ADT SECURITY SERVICES, INC
P.O.BOX 21545 2815 SW 153RD DR
SEATTLE, WA 98111 BEAVERTON, OR 97006
Phone: Phone: 503469 -7100
Reg #: LIC 0059944
ELE 26209CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 8/25/00 $60.00 2720000000 Elect'l Final
5PCT CTR 8/25/00 $4.80 2720000000
Total $64.80
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 -001-0 ough OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 - 198',
Issued b J • Permittee Signature ,..11/14ii.,ZatOkta6 a.t2p
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
03/17/00 FRI 12:15 FAX 503 598 1960 503 598 CITY OF TIGARD
X1003
CITY dF TIGARD
Pla
% ® Electrical Permit Application
13125 SW HALL BLVD. Rs.er. ^a he
TIGARD OR 97223 v e y � Date Rec �1 d p -9 -5 O
Phone (503) 639 -4171, x304 AVG 2, - la •._� 1(16-�- Date to P.E. Inspection (503) 639 -4175 ENj vg Date to DST
Fax (503) 598 -1960 MMONO pE Print of Type Permit # � **eV 90/
CO Incomplete or illegible will not be accepted Called
•
1. Job Address: . 4. Complete Fee Schedule Below:
Name of Development , t OA ` dii L I - /
L. , - Number of Inspections per permit allowed
NAm (or name of business) C V
l Service included: Items Cost Sum
Address ! 1 : - • 1 /if! 1■ i f / 4a. Residential - per unit
City /State/Zip ` , g MM 1000 sq. R or less $ 117.75
7 Each additional 500 sq. ft. or 4
Commercial Residential U portion thereof $ 26.75 1
Limited Energy 1 $ 60.00
Each Manufd Home or Modular $60.00
2a. Contractor installation only: Dwelling Service or Feeder
(Prior to permit Issuance, applicants must provide contractor license $ 72.75 2
Information for COT data base).
Ins ns Services or Feeders
Electrical Contractor tallation, alteration, or relocation
ADT Security Services, Inc. 200ampsorless $ 64.25
Address 2815 SW 153rd Dr . 201 amps to 400 amps 2
$ 85.50 2
City RPavert State OR Zip 97006 401 amps to 600 amps $ 128.50 2
Phone No. (5 i) 469 -71 0 • 601 amps to 1000 amps $ 192.50 2
Job No. o. - r ` 6 - Over 1000 amps or volts $ 363.75 2
L Reconnect only $ 53.50 2
Elec. Cont. Lice. No.
26- 209CLE Exp.Date 10/2000 4C. Tempo
OR State CCB Reg. No. 59944 Exp.Date 5/07/01 Installation, a e Services o r cation er s
COT Business Tax or Metro No. xp.Date 200 amps or less
$ 53.50 2
201 amps to 400 amps 2
Signature of Supr. Elec'n ,iii,(_, ��
401 amps to 600 amps $ 100.00 2
8 1 SL E Over 600 amps to 1000 volts, $ 80.25
License No. E xp.Date see "b° above.
Phone No. ,5(),- Z.o9'_ a(T t r` . 4d. Branch Circuits
7- / New, alteration or extension per panel
2b. For owner installations: The fee for branch circuits
with Purchase of service or
Print Owner's Namdj r� q � �
k� `Par 1 S Each b r l
Address Each bran
ch circuit $ 5.35 2
City b) The fee for branch circuits
St t2 Zip without purchase of service
Phone No. 2_ - 3C) / -'- 2 First ci rcuit
• $ 37.50
The installation is being made on Each additional branch circuit $ 5.35
g property I own which is not 4e. Miscellaneous
intended for sale, lease or rent.
(Service or feeder not incuded)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting
$ 42.75
Signal circuit(s) or a limited energy
3. Plan Review section (if required):* panel, alteration or extension $ 60.00
Minor Labels (10) $ 100.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection
4 or more residential units in one structure the allowable In any of the b r
Service and feeder 225 amps or more Per inspection $ 50.00
System over 600 volts nominal Per hour $ 50.00
Classified area or structure containing special In Plant $ 59.00
described in N.E.C. Chapter 5 g peaal occupancy as
5. Fees:
* Submit 2 sets of plans with application where any of the above apply. Sa8 S eu t of above tees $ 6(1 00
Not required for temporary construction services. arge (.08 X total fees) $ /i . 80
Subtotal
NOTICE 6b. Enter 25% of fine 6a for
Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ 64.80
'S NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
'NORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
11 ANY TIME AFTER WORK IS COMMENCED.
Total balance Due $ 64.80
•
,d s is 1fo rm s\ c l e c U i c. d <i c
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 - Hour Inspection Line: 639 -417 Business Line: 639 -4171 _ MST -�
BUP
Date Requested /? O AM PM BLD
Location ?Crec/ �c.c.J • Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner • ELC
Retaining Wall V ELR 719— ®'O Zo 7
Footing Access:
Foundation FPS
Ftg Drain SGN
•
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall ,
Fire Sprinkler iii (' 4
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final _
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
SS PAt�11FAIL
CTRICALJ
Service
Rough In
UG /Slab
Low Voltage
• larm
PART FAIL
ITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date 9/97543 Inspecto Ext
Final
PASS PART FAIL DO RIOT REMOVE this inspection record from the job site.