Permit '; s
CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
° ' �I DEVELOPMENT 5 SW Tigard, SERVICES OR (503) 639 -4171 DATE RMII #:
: ELR2004-00350
SITE ADDRESS: 10101 SW WASHINGTON SQUARE RD BOF A PARCEL: 1S135BA -00102
SUBDIVISION: OAKBURG ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
Project Description: Limited energy for CCTV.
Job No. 083 - 1082527
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: CCTV. X
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: 503- 620 -5515 Phone: 503- 469 -7244
Reg #: L503- 469 -99114
ELE 26- 209CLE
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 11/9/2004 $75.00 Elea! Final
[TAX] 8% State Surchart 11/9/2004 $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 to follow ___s adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010
throug AR 952- 1 -1 : 0. ou may obtain copies of these rules or direct questio o OUNC a (503), 4¢ -0699.
Issu d by _ /i // I ' ' Permittee Signa re _i• ` %� /ow .
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
11/08/2004 12:31 FAX 5034697110 ADT SE CUR ITY 001
11/05/2004 09 :29 .FAX 5035981960 CITY OF TIGARD Z
WA 002
11/424414.04 17:08 i'AX 5034$971111 ADT SECURITY m:......
!lectlricilP Beatk O � r- Orr-rcE usC (1NJ_l
C� of Tigard ��� n� \ n t t flat cA• . OM rat ELi 2x —a) . -44
t 131250W Hall *A..198ad. Q� „K' Y Otbcr P am'o
I: pfpa� .503.639.4171 Farr 503.59&1960 I. ' � ; i '-'1• { NCO M� 2 far
7r �tso ltd Soo.639d17f ®� +; , I l�p' . 3imdeoumtrd Inhumation
• iH.�...�- vPiYw.ot3eg>adlou ' -, K O ' I I 'I I 1::,. ' i 7 a ��'111 k I II I ` I� vft F 1j I �r, i � , rta� , :7 in •. ' r
r. 1 � ; II .
Q New 00128102t s " `- .' .- :on/replacement
avaver= , :camel sous low
Aetna d av OSavice oaa 3741 —* 8 C2�Bover 10,000 tai. ft.,
: 1, ,,, , _ i•I:,f " {_- dsvellin a or�ao now t�dmtisl
,• _ J : _ I ... I r . 'r I I gill : n . ' .' 1 I JI , I'I ' I ,t -:�{ , ,' i, I .. I + I ■i • =I. I IG {_ 1 Y �'
015ybtemov e
cr 600 voltt'nominal ottits in me mess
❑ 1- and?rfazdy dwe �i Co11 elh dt1512i01 CI Acceneritltu'lding over Moo staders L7 15 . 400 arnri aniwrc
❑ A iitaXd1 CV p setttamles
oriux: � ❑
1v1mt + ��aed
0 �I�orinalder ❑ � Oc�paniloaa ovor RV padc
W+ till-WO '�°• address; �' 71M1 1 I / 1• L► J� submit 2 oda of pfd with soy of tho Aw e
sw, The above ateaot apprumblo to coo nakeGezviee-
.. .. rla Lil !I. i�:
s:i! P`c ; '1
Ibbightpt Project 4, - ) A J Al1i / A / D ' `: > - l' ' .,: Om i Tod ..
QOM tJtrectlfiireagoms OS]ob oitc Neon s aidmsld Angle. or mold •fumiy dwellie6 unit
bdudea attacked wags.
1.000 sq. ft er 1me ' 14Y15 ' 4
Subdivide= _ Lotao.: Ea. add`1BE10a9• ft. orpordon 3340 1
Limited awry, n Media , 75.00 2
Ticcinsp/praoalnow • Ligsies l tawny. ampro idaalisl 75.00 z
I :;: � ' r .1: ' . F 1. : ' '+i:; h.. `i.1,. it. \-,-,- . .C:.',:: I i ` ' . _ _ - - , . . . ....... ..... ._ E a e h n o n n t autOd Or' _ •.. : .. ! ...... Cos r feeders lastauatlo andr
_. . aetvioa E/or fender 2 •
8
ervl o n. ttllerabon, or raloeglloa
200 to ions IIII 10.30 _ 2
*/ AIMEE= - _ ..
I _ _ �ii 20I t O40 0 ...".. 10655 2
I {.'I'�J J 4tlii _, [ Jn - I'... -:I = ,•'•I'j. ' I i + { %FJ I I..'II'' 401 �m OYY .�W� 1�.6t1 2 1 �.. l t ► [ '� oval
fve! 1.000 atoms or vole 4 NM
.1
C. gamma= only EMI ME 2
t ' •. r Templar" maybes or radon i sodfOP
r i l • ii /. g .. — — • relocation Fay ( ) 200 mobs or less 6685 1
Owl r lnstaDaelon: This ieetailalicn is beiagmede tat property t.... I own which is not 201 grops to 400 o 100.30 2
Wended tousle. lease, teat, or oxviumge, soeortg to ORS 447, 449, 670, and 701. ` a0f amp; to 600 IMP 133.19 z`
Date: ^
ow= lagaEscaM D Branch olreal s —star, alts radon, or evenslon. per panel
II • , R 1 ' , AFeofi�lantiahe�des,vrrh
6.65 2
` •• • 1 ? 8Qti'it.� o7ibtdef'E� cacti ciente
Bu b � Fee branch
branch times
Coulson a widow amigo or Exam fee, 46.65 2
each branch cira& :-ii
Addresc Bath add9 beanchcc 6.65
i finscalboasiis (service or (maw mot ludadod)
pump a•b'eigatron oitcle M. 53110 2
Phone: ( )
itaao : ( ) si or mane U :1 . s Ili no 2
8 -male-
Signal
ot limited.
_
.., I iI ` .l ' t +:,Y:�;l ;i,- = _I .. l _ _ rC .. "� _.
.. i_. 1_,-.:'.'_,',:.. I i_._ {.. { - L�S � �ialeman
om. Cir
MI 1 . + I atir+i l••� 2
Duet= MEW: ADT SECURITY SERVICES. INC.
,, - • ,,1_ Foch adJidonsr inspection over ineriya We hi any oethaabove
Address; J J . , .. ,1,: :rut: Perini cto1 62.50
m (503) 4E94100 htveedgsuion par boar (1 ermin) 62.50
....�� �/ .- , Eo "- w ial laze • - hour 73.75
p ( LL� II ��11�� i• Y . �' + I ..' ;ia . ir , l ? :.:n,.:) :-Ilro: i::f_i , 2
� :;1',4, ::.)7_ >..ti' '
`
i31_..
CC9 � alc�i117Cp1f x.10.: \( `1 i L l � Subtotal •
Suprv. ffiectti sipuli ttte, required: j , _ ` � - , a " Plan review (25%of porn&fe4 _
NM 5taoesurcharge Ca3 &remsit fee) ,1 ., •
Elate p.,. 6 i �� " TOTAL PEW= 7� 0
.. 1143 poroat appU� =pima If ■ permie i. oe. errs! . ...tea. ma Authofixtld Bi�a(1ixt,P days a•ttr to has Dom ocecpied 3§ =Mau
ste is Feeamogad�
el set brrrl�une/ Baldina (nduwrs�a eased
Print ma= 1 ?timber of Insomaons per peak allowed
IninnlainovernarosmatnnIAPPass 12ms ooasestltDlo7/manwm
1
CITY OF TIGARD
BUILDING DIVISION ' - PERMIT #: ELR2004 -00350
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/9/2004
Phone: (503) 639 -4171 �i u,m+�,1 I11
Inspection Requests (24 Hrs.): (503) 639 -4175 _ '
INSPECTION WORKSHEET FOR DATE: 5/212005 TIME: 7 :10AM PAGE: 78
SITE ADDRESS: 10101 SW WASHINGTON SQUARE RD BOF A CLASS OF WORK:
: OAKBURG #: 001
SUBDIVISION: LOT #. TYPE OF USE:
PROJECT NAME: BANK OF AMERICA
DESCRIPTION: Limited energy for CCTV.
Job No. 083-1082527
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 620-5515
CONTRACTOR: ADT SECURITY SERVICES, INC PHONE #: 503. 469 -7244
Inspection Request Scheduled For: Date: 5/2/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 005738 -01 503469.7234 N
Corrections/Comments/Instructions:
F
7 ,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
, I J
Inspector: I 4. , Date: ,`) Phone #: (503) 718-
.