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Permit CITY OF TIGARD m „, DEVELOPMENT SERVICES ELECTRICAL PERMIT — 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171 RESTRICTED ENERGY PERMIT #: ELR98 -0195 DATE ISSUED: 07/28/98 PARCEL: 2S1O1AA -09800 SITE ADDRESS...:1257O SW 69TH AVE #101 SUBDIVISION :PP1996 -024 ZONING:MUE BLOCK • LOT •002 JURISDICTN: TIG Project Description: Executrain 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: FEES JT ROTH JR type amount by date recpt 12600 SW 72ND AVE PRMT $ 40.00 JSD 07/28/98 98- 307742 STE 200 5PCT $ 2.00 JSD 07/28/98 98- 307742 TIGARD OR 97223 Phone #: 639 -2639 Contractor: SONITROL PACIFIC $ 42.00 TOTAL 1975 SW 6TH AVE REQUIRED INSPECTIONS PORTLAND OR 97201 Ceiling Cover Low Voltage Insp Phone #: 223 -5822 Wall Cover Elect'l Final Reg #..: 000535 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 188 days of issuance, or if work is suspended f more than 180 days. ATTENTION: Oregon law requires you to follow r a.o.ted by the Oregon Utility Notification Center. Tho rules are set forth in OAR 952421-0910 through DAR 952 -001 -0080. Y.0 may ain „ es of these rules or direct question uu )246 -1987. dissow” -1r Issued by 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 +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd i. ■ _ 13,125 SW HALL BLVD Date Rec'd: ij(fi1DT TIGARD OR 97223 PRINT OR TYPE -� %'-'4/9.C.-- V - 503 - 639 -4171 X304 Permit #: i: �-6 / � F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd: WILL NOT BE ACCEPTED Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY EX .Q_C. L \ (\ Restricted Energy Fee $40.00 (FOR ALL SYSTEMS) JOB Street Address q Ste # ADDRESS t x5 '10 So (n I 10 \ Check Type of Work Involved: City /State Phone # El Audio and Stereo Systems -% Ci f-0 - (k ( 1'� . 1 41 n -3 Name ❑ Burglar Alarm / / ❑ Garage Door Opener* OWNER Maili�g��¢"re / /��',, l �y / 9 City /Scat _.0 �'� P � � '� Name ( (0 / El Heating, Ventilation and Air Conditioning System' � j aec Vacuum Systems* Sexl ∎ - \-yo I C). t U ❑ Other CONTRACTOR M�t'lin Addres 0 "1 S � D — TYPE OF WORK INVOLVED - COMMERCIAL ONLY (Prior to issuance a ly /State J Phone # Fee for each sy stem $40.00 copy of all licenses (r' �,� 4� a4I �3 -5$ (SEE OAR 918 - 260 -260) are required if Oregon Contr. Brd Lic. # expired in C.O.T. p�( — 310 0 I Q 7 2 ,i Check Type of Work Involved: • data base). lectrical Contr. Lic. # at S-3535 Ek 0r0 l ❑ Audio and Stereo Systems C.O.T. or Metro Lic. # Exp. Date ❑ Boiler Controls Owner's Name ❑ Clock Systems OWNER - Mailing Address APPLICANT ❑ Data Telecommunication Installation City /State Zip Phone # ❑ Fire Alarm Installation This permit is issued under OAE 918 - 320 -370. This applicant agrees to make only restricted energy installations (100 volt amps or less) under this ❑ HVAC permit and to do the following: ❑ Instrumentation 1. Only use electrical licensed persons to do installations where required. Certain residential and other transactions are exempt from licensing. ❑ Intercom and Paging Systems These have asterisks(*). All others need licensing; ❑ Landscape Irrigation Control* 2. Call for inspections when installation under this permit are ready for inspection at 503 - 639 - 4175; ❑ Medical 3. Purchase separate permits for all installations that are not ready for an ❑ Nurse Calls inspection when the inspector is out to inspect under this permit; 4. Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting* inspector are done, and; Protective Signaling 5. Assume responsibility for calling for a final inspection when all of the corrections are completed. ❑ Other Permits are non - transferable and non - refundable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. Number of Systems The person signing for this permit must be the applicant or a person * No licenses are required. Licenses are required for all other installations authorized to bi ., the applicant. / i / FEES: ,/ ENTER FEES $ S'• ire 5% SURCHARGE (.05 X TOTAL ABOVE) $ 2..."-/019 Authority if other than Applicant TOTAL $ 1 Z\ i:\dstsvesele.doc 7/97 i lq VW u 1 • CITY OF TIGA : ILDING INSPE' ION DIVISION MST 24 -Hour Inspection in :. 639 -4175 B iness Line: 639 -4171 BUP 5 10c133 Date Re • uested $ - 6 -q ; AM PM BLD Location 12 570 • � / Suite /0 MEC Contact Person F���� 7/ Mitko-e Ph 2 Z ?J �J $ Z. Z. PLM Contractor Ph SWR BUILDING Tenant/Owner ELC 9(5)-61q5 Retaining Wall ELR Footing Access: Q /� �) Foundation �/r � / I /�� W vl/ FPS Drain Ftg Drain ` l wU ^ SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler 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 PASS T FAIL ECTRICAL Service Rough In J(,I Iah ow Voltage) (S( o/ PASS PART FAIL SITE BackfilllGrading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin lease call for reinspection RE: CZ f — t919,s [2Jnable to inspect - no access Fire Supply Line ADA / �/ Approach /Sidewalk Date e. 6 - ? e Ins �� % Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.