Permit ELECTRICAL PERMIT -
Airk CITY O F TIGARD RESTRICTED ENERGY
�� DEVELOPMENT HO BMENT Tigard, 1639 -4171 DATE R MII #: E 7/19/2004 00214
9 2004
SITE ADDRESS: 10124 SW WASHINGTON SQUARE RD A -7,8 PARCEL: 1S135BA -00102
SUBDIVISION: OAKBURG ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
Project Description: Limited energy for CCTV.
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:
Owner: Contractor:
PPR SQUARE TOO LLC ADT SECURITY SERVICES, INC
BY MACERICH COMPANY 2815 SW 153RD DR
9585 SW WASHINGTON SQUARE RD BEAVERTON, OR 97006
TIGARD, OR 97223
Phone: 503- 639 -8865 Phone: 503- 469 -7244
Reg #: LIC 59944
ELE 26- 209CLE
FEES Required Inspections
Description Date Amount
[ELPRMT] ELR Permit 7/19/2004 $75.00
[TAX] 8% State Surcharl 7/19/2004 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699.
Issued by - RZP1 . z Permittee Signature
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
07/15/2004 08:09 FAX 5034697110 ADT SECURITY Ii11001
Electrical PermitApplication
.. D ate received. I
:.. � '/ � y emtit no- `- // y i0_ / r • ,_ l` � 1! City of Tigard RECEIVED ProJeci/appl. no.: Expire date: •
City of Tigard ,Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 i 0 2004 Date issued: By: Receipt no..:
Fax: (503) 598 -1960 Jul_ V Case file no.: Payment type:
Land use approval: c',►TY OF TIGARD 1 t Cr
O 1 & 2 family dwelling or accessory Commercial/industiial NG ij /1SIOP1 O Multi - family O Tenant improvement
U New construction 0 Addition /alteration/replacement O Other. 0 Peal .
.)011 5171: li\'FORill,CfION
Job address: 0 2 ,Illarll ti ,a'Ulifa Bldg. no.: Suite no.: Tax map /tax lot/account no.: •
Lot: Block: Subdivisi.: - --
Project name: 10)g • Description and location of work on premises: •
Estimated date of cam letion/ins tion:
Job no: D$.5 - Z S9 — 06 Fee Max
Business name: p - ' Description Qty. .(ea.) Total no. (nap
Address: 28 IS 84 /S3 Newtaidmti en
al -t -single or
dwellIng>mit.lnelodesattaehedgarage.
City: Bewver o St ate: 6) lr
,12' IP 4 7606 Sersicebrciudeek •
Phone *t�6lj *`71 FaxS. 1.7J mail: 1000 It or less
CCB no.: 4"47 /� I Elect bus. lies Hach additiotta1500 sq. R orportion thereof .4
City /met lie. no no: �6 ��C�.F Limited energy, reitdenHal 2
Limited ,non - residential. 2
sue.[ -,Q_/ oh manufact home or modular dwelling
Signs of supery g electrician (required) Date Service and/orfeeder 2
Sup. elect. sum (print): CM A US !I LEA 381 Services or feeders—Installation,
alteration or relocation:
d / 200 amps or less 2
Name (print): (Ji}fr ('f - /(4 !Grad ' % n S 201 amps to 400 amps 2
Mailing address: • • , W 401 amps to 600 amps 2
• 601 amps to 1000 amps
City: 3 Stat ZIP: over t000° amps orvolts 2'
Phone: 1-i 3JFax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders - • ' •
which is not intended for sale, lease, rent, or exchange according to huttallation , alteration, orrelocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: __ Date: 401 to600am.s 2
ENGINEER Blanch drains -new, alteration, -
Name: or extension per panel:
A. Pee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2 •
Phone: Fax: 13
Each additional branch circuit:
l'I,AN Ill; '$'11;11' (!'lease check all tlt:lt :girl) eftJ sc. (Service or feeder not included): •
O Service over 225 amps - commercial O Health -care facility Each pump or irrigation circle 2
O Service over 320 amps -rating of 1&2 0 Hazardous location Each sign or outline lighting 2 .
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O + more Systemover 600voltsnominal more residential units In one structure /S
ure alteration, or extension* I 75 2
O Building over three stories 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable In any of the above: •
O Bgress/lightingplan O Other. Per inspection
Submit sets of plans with any of the above. . - Investigation fee I I I e I
•
The above are not applicable to temporary construction service. Other
Not all Jurisdictions accept credit cards. please WI Judsdictlon for more Information.' Notice: This permit application Permit fee $ 7S .CO
O Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
• Credit card number: / / within 180 days after it has been State surcharge (8%) .... $ a
Name of cardholder as shown on credit cord
expires accepted as complete. TOTAL $ $ O
$
Cardholder signature Amount 440 -4615 (6/00/COM)
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 /0 / L i 1 i'+ Suite MEC
Contact Person Ph ( ) 4 /6' PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 1C1 �l�C.o ELC
Footing ELC
Foundation Access: 4
Ftg Drain ELR ° D ' 06 a- I "
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation G C TV Sys 7 l AM(/' Vim) Ppit, FIKtt
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
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
Low Voltage
Alarm
PASS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA ? p �� n
Approach/Sidewalk Date 8 3 v inspector I [) ?7 raf i Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL