Permit CIT' F TIGARD ELECTRICALPERMIT -
RESTRICTED ENERGY
�114 DEVELOPMENT SERVICES PERMIT #: ELR2000 -00082
Y. +
c ` - - ' 13125 SW Hall Blvd., Tigard, OR 97223 1Qj�f AL DATE ISSUED: 4/17/00
SITE ADDRESS: 15865 SW 74TH AVE 100 t % PARCEL: 2S112DC 01400
SUBDIVISION: CREEKVIEW INDUSTRIAL PARK ZONING: I -P
BLOCK: LOT: 004 JURISDICTION: TIG
Project Description: Installation of 5 restricted energy systems, audio /stereo, data telecommunications, fire alarm,
intercom /paging & protective signaling.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X INTERCOM & PAGING: X
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
• HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 5
Owner: Contractor:
PACIFIC AMERICAN PROPERTY EXCH GREENLINE INC
PACIFIC SANTA FE CORP PO BOX 230755
17700 SW UPPER BOONES FERRY RD TIGARD, OR 97223
PORTLAND, OR 97224
Phone: Phone: 968 -1978
Reg #: LIC 103033
ELE 34 -397CL
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
5PCT DEB 4/17/00 $24.00 0001476 Elect'I Final
PRMT DEB 4/17/00 $300.00 0001476
Total $324.00
•
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- u o foFk rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -061 -0010 throug OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246/1987.
Iss ed by k ■:4;, f ' i �! Permittee Signature � / (�a� � &
OWNER INSTALLATION ONLY
The installation is being made on property 1 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 by:
13125 SW HALL BLVD Date Recd: 1 / - 17 - 00
TIGARCS OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #: e t -E Z . k
F - 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
/— Restricted Energy Fee $60.00
l5 Rte14 Li a i C . (FOR ALL SYSTEMS)
JOB Street Address . #
ADDRESS i 5 B 5 SuJ - 79"' j00 Check Type of Work Involved:
City/We Zi
GF / orb Zip # 3 -- ❑ Audio and Stereo Systems
Name ❑ Burglar Alarm
OWNER Mailing Address ❑ Garage Door Opener*
City /State Zip Phone # n Heating, Ventilation and Air Conditioning System*
Name ❑ Vacuum Systems*
G PEEtJ x -r ole , T c. n Other
CONTRACTOR Mailing Address
P. D . c . 230755 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /State Zip Phone # Fee for each system $60.00
copy of all licenses 7t ft-2' , D i - 972.E i q -191b (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Brd Lic. # Exp. Date
expired in C.O.T. j r)30 35 l I 31 Ott Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp. Dote
"3 — 39 7 CLE (p1 N100 Er Audio and Stereo Systems
C.O.T. or Metro Lic. # ??YLTa D Exp. Date
LIZ 1 120 9/3 c/& 4 n • Boiler Controls
Owner's Name
n Clock Systems .
OWNER - Mailing Address
APPLICANT ar Data Telecommunication Installation
City /State Zip Phone # Fire Alarm Installation
This permit is issued under OAE 918- 320 -370. This applicant agrees to f � t
make only restricted energy installations (100 volt amps or less) under this l l HVAC
permit and to do the following:
n Instrumentation
1. Only use electrical licensed persons to do installations where required.
Certain residential and other transactions are exempt from licensing. Zi • Intercom and Paging Systems
These have asterisks( *). All others need licensing;
n Landscape Irrigation Control*
2. Call for inspections when installation under this permit are ready for
inspection at 503 - 639 -4175; n Medical
3. Purchase separate permits for all installations that are not ready for an n Nurse Calls
inspection when the inspector is out to inspect under this permit;
4. Assume responsibility for assuring that all corrections required by the n Outdoor Landscape Lighting*
inspector are done, and;
0 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. 5 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 bind the applicant.
/ FEES:
Siy - ... /�_
ENTER FEES $ 3CO • OCi el a/ a8
$- SURCHARGE (105 X TOTAL ABOVE) $ 2 . 00
Authority if other than Applicant TOTAL $Z� 00
is \dsts \forms \resele.doc 3/98
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175. Business Line: 639 -4171
BUP
Date Requested S7 AM PM BLD
Location 1 C 0 Lf 41fil Suite (00 MEC _
Contact Person - S(17 Ph (4q l r 3 o D PLM
Contractor `J P _ Ph SWR
BUILDING Tenant/Owner EL 7J)(90 .WO
Retaining Wall ELR ' 7,Q0(2"0tan (pS
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: Gc�
Slab - l �
SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing ,47 t U i _ - A L>.S
Firewall
Fire Sprinkler V L2 IT-i.
Fire Alarm
Susp'd Ceiling
Roof 6l , Z
Misc: �/C
Final iL� J] f /J "�.R , ;�� 9 Q � //
P ASS 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 PART FAIL
el into
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
! FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk 4,--7
Other
Date � /. '_f7 Ins Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
06/09/2000 Activities for Case #: ELR2000 -00082 , _
11:07:44 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRC001 Application Received 04/17/2000 DEB DONE No Hold DEB 04/17/2000
ELRC003 Permit Created 04/17/2000 DEB DONE No Hold DEB 04/17/2000
ELRC725 Low Voltage Inspection No Hold DEB 04/17/2000
ELRC799 Elect'I Final 05/31/2000 CD PASS No Hold AKJ 05/31/2000
ELRC500 (F) Issue permit 04/17/2000 DEB DONE No Hold DEB 04/17/2000
ELRC800 Case Finaled 05/31/2000 AKJ DONE No Hold AKJ 05/31/2000
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