Permit •
e
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2006 -10013
--- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/14/2006
PARCEL: 1S12600-00300
SITE ADDRESS: 09581 SW WASHINGTON SQUARE RD B8 ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Burglar Alarm. Job #083 - 20014 - 01.
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:
WASHINGTON SQUARE LLC ADT SECURITY SERVICES, INC
BY THE MACERICH COMPANY 2815 SW 153RD DR
9585 SW WASHINGTON SQUARE RD BEAVERTON, OR 97006
TIGARD, OR 97223
Phone: Contact #: PRI 503- 469 -7100
FAX 503- 469 -7110
FEES Reg #: ELE 26- 209CLE
LIC 59944
Description Date Amount
[ELPRMT] ELR Permit 4/3/2006 $75.00
[TAX] 8% State Surcha 4/3/2006 $6.00 REQUIRED ITEMS AND REPORTS
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: jz -Q
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.
03/13/2006 17:06 FAX 5034697110 ADT 'SECURITY II 001
• • lectlr cal An
E p\1 ED FOR OFFICE USE ONLY
City of Tigard Aare /R t � d 6 4_....A Permit No. • ` ' - o
13125 SW Hall Blvd., Tigard, OR 97223 MAR R i 20Q6
3'!H s *, A ti Plea Review
Phone: 503.639.417] Fax: 503.598.1960 n awg . OtherPerrmt:
Inspection line: 503.639.4 e = '' �„ Date Ready/By: H See Pppc for
Internet: www.ci.tigard,or.us CITY OF TIGAR Notincd/Method• Supplemental information
•�tj 7 1'Qwk,'rgl r l4l. �i ,��I I �h v �,�� Cl Ilt� i th "15J 5 j ��! (
1'N j� � i U• -`{ 1. r r l }I La 1 � .. I i f I I ! 1 u (� r , -. . f il , { ��l �r� " 1, '1;1: 1f' L'�`1i' r�i�,4IItppSyps zfla�,� >i+:tiM.'ACy� I 'I'5% . ''''''.1-;2'..,:',I. .� .w
,_^.s�+f`L. -;. rt�L,t�:Jl�!,...JI Jll!I t. _.a_fsI_ ..._..5 v � l_.:_I XJI : J�IJJ�7,1Tjru �IL�iZElY. 15t1k35 �Aa91T'•fLt:� "_'�.,'�r"tl�c .� *�. , ill ',' •-
,, ew construction 0 Addition /alteration/replacement Please check all that apply:
Li Demolition El Other: ❑Service over 225 amps, comm'1 ❑Hazardous location
-5` i 111 [ rrr 61 �: 7 , T 1 {fi G1
, S'i� -F Ir iR � tT rte¢ I t ~Y lu�S ['Service over 320 amps- rating ❑Buildng over10,000sq.it,
a. 12 :1,e-) ioAl i._.`,� .-rllf t°3.,°,rl 1lr.F,,i, " �...7f'i i,rt! , l ;1-. ,! 5 ° ,,I , tit0 i"'�� Aid Lihi,IL of 1- and 2- family dwellings 4 or more new residential
0 I - and 2- family dwelling VA Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
OBuildmg over three stones :Weeders, 400 arms or more
❑ Multi - family ❑ Master builder 1=I Other:
y „ri' T rl tii It' i K i' F r l � r '+ SpI r 7l 7 I .I �; .° ❑Occupant load over 99 persons ❑Manufactured structures or
.4 a l 7 '.:T C s i ANN I- 1. P'r tr,�f III 1i 1 Ill r't+ pU' 1L J 1+_ ` 11"{ ,(` +f 7 r, 1 , ,I
u- 4:,_.s.t. r .]L u crtr., �;i�r tY��!,_ � � • r, 0 r�:: Iltr .s,l� ; ,li l yl. ❑Egressaightin RV park
Job no.: J r ''y� � ob site address: 9n./ ❑ Health -care facility ❑Other:
` eubmit 2 sets of plans with any of the above.
City / State/ZIP; i k ` a fI , The above are not applicable to temporary conshucnon service.
Suite/bldg./apt no.: Project name: ` `. _. ` „tiI, il I r - - - vL,.l,,., l . .
tin a � i-i,7,, i744 ' . ,T :tilP'.ii 2 , •• t
DeKription Qty. Fee. ToTow ••
Cross street/directions to job site: gi 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. addl 500 sq. ft or portion 33.40 1
Tax map /parcel no.: Limited energy residential 75 -- 2
!rs �'� i t ! Ir ' t , t r , z ; - r 71'.:r. a! , s Limited energy, non - residential 75 00 2
5 ', F 7 ,IK12. 1 L &, !I alt. ' . { .i +IJf r,2/ 1 e- Z 1 OiI I 1 y . i J s..l . i7 'll is k E 1 r r.
54' I_.J . n r,.�.�....nr J „L'. +..L_PH � L.,..i1 i �...,r.l.lrlb ei\.I, . . Tech manufactured or u modular
n t/ ' + n r/r dwelling, service ond/or 90,90 2
Ll�f I i l Services or feeders installation, alteration, and/or relocation
200 amps or less 80 30 2
`r ilr,:. _fl -Tr l}8U'iyt.11p ,t' 3 1 1 � W ,d „i +,t. RT� -'7
i k �y� Jy f. � 1 � 1 1 13il � 'gIt I I- i >, 2VI.
F ml l y' in' q' A EI 201 amps [c 400 amps 106 85 2
�d�t {U LLi �!ll�S L : ! l!� . i.i?I,g„ ,S , r ! lL°h�r ll ";m I .�C�ilrYd
401 amps to 600 amps 160.60 2
Name: _ 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: ( ) F ( ) relocation
200 amps or less 1 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 Dare: Branch circuits - new, Alteration, or extension, per panel
^+ ^11 s. yy.ln.a(156-01-14''71.15:r1 t �, r , r i - , 4PT I{ Tr i 1 , �, l 'L k 07,. i ik - ---
y ' np tl` 1 IIVkl 1! t. I I : fr ,p , 1 [ 23 t , i � ,li IF ` A Fee for branch circuits with
.3S111 I!(d Ij IT ..:c 1 �I,I1iI`r '•: ":� i n , 4I _ _..,t , 1 ' r .
service or feeder fee, each 6'65 2
'Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fees 46.85 2
Address: each branch circuit
Each add'1 branch circuit 1 6.65 2
City / State/ZIP: Miscellaneous (service or feeder not included)
( ) I P te:: ( ) Pump or irrigation circle 53.40 2
Phone: Phone: Sign or outline lighting 53.40 2
E-mail:
a - an., r I° �,:, r _ _ _ _ Signal cieuit(s) or limited -
L ,15'i n1i�.�4 lfll I l ' 1'I_�l l t i i {: F 11r '! 1 l ;I � 1 i � 'ids r',Fil 191 ,tip• I irf d r fri�� yt I l[ ? 1 : ,j , energy panel, alteration, or
� .1.; d.E_ i.it__ h_ , t, I,....2/... _ a ..rf. z tu..,:3... I_ ...L,LGe _ _2.,2,Lri,r•i.
extension. Describe. 1 Page 2 76,D6 2
Business name: ADT SECURITY SERVICES, INC.
Address: 2E115S.W. 1b3rd DR. Each additional Inspection over allowable in any of the above
PiFA+ /ERJON._ IR tl7flflI _ Per inspection 62,50
City/State/ZIP. (503) 469.7100 Investigation per hour (1 hr min) 62.50
Phone: ( ) Fax ( ) Industrial plant per hour 73.75
CC)3 Lic.: :71;Ir�,;t;., .n I :����.�!;;:Lt�r' „�'E11'�4.'r. 1, v,vial -, , T:7'7476.1‘:.
.. ,wl,
5994y - Electrical Lic.: , -� etc . u p rv. Lit.: g e l LFA Subtotal
Suprv. Electrician signature, required: _ - Plan review (25% of permit fee)
A //. • t
Print name: ��� 1/r � Date: S I3 D
State surcharge (B% of permit fee) �,
1 � TOTAL PERavr FEE 81. po
Authorized signature: This permit applicadon expires If a permit i3 net obtained within too
days after it lull been accepted as complete
Print name: Date; • Fee methodology set by Tri County Building industry Service Gourd
- Nuinber of inspections per permit allowed.
I i Bui lding■ZermLuiELC PacmitApp.doc 12/03 440
n - %Cj'
CITY OF TIGARD EL IR
BUILDING DIVISION PERMIT #: — / (
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 /4ac' yl �l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: -( I w "` ' CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #: ,Sifyi..7 Inspection Request Scheduled For: Date: 3 - 3 0- 0 c Pour Time:
/ Code # Ins �ection De�c;iption Confirm # Contact # Message
L I � ��.
Correc ions /Comments /Instructions:
C
•
•
S.1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: ` v Date: 3, -110 O Phone #: (503) 718- Zq �L
CITY OF TIGARD °Lz- /2
BUILDING DIVISION PERMIT #: Z O06
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 0
Phone: (503) 639 -4171 4 4 4 10. . 3
Inspection•Requests (24 Hrs.): (503) 639 -4175 F,__..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
. SITE ADDRESS: C /5 — g/ Of)- , SO , CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3- - 3-0 Pour Time: ,- // 7
Code # Inspection Description Confirm # Contact # Message
/ 3d 0 60/ -79.
Gem. �ee
Corrections /Con$nents/ Instructions:
<6 e-V (ilv(tc\kdaa,6 1s
ICI PASS n'PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL r CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
�1
Inspector: N tg Date: A 13113 k Phone #: (503) 718 - 3- `1
0°