Permit i
• CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
ib, DEVELOPMENT SERVICES PERMIT #: ELR2000 -00177
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/3/00
SITE ADDRESS: 15865 SW 74TH AVE 105 PARCEL: 2S112DC -01400
SUBDIVISION: CREEKVIEW INDUSTRIAL PARK ZONING: I -P
BLOCK: LOT: 004 JURISDICTION: TIG
Project Description: Installation of data telecommunication system and protective signaling system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 2
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
PRMT DEB 8/2/00 $120.00 HAND RCPT Elect'I Final
5PCT DEB 8/2/00 $9.60 HAND RCPT
Total $129.60
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 -00 : •ugh OAR 952 - 001 -0080. You may obtain copies of these rules or direct question to OUNC at (503)
246 -19: .
Issue. by .. ' t Permittee Signature LL , , „�'1�� iJ -. ' . -
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. ELECN: J�/ �� DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGAR D %TOTED ENERGY ELECTRICAL APPLICATION Rec'd by: Macy
13125 SW HALL BLVD R� Date Rec'd: 7-,«0
TIGARD OR 97223 PRINT OR TYPE
V - F - 503 - 598960 X304 Al NCO ® M � 1 TE OR ILLEGIBLE APPLICATIONS Cust #: G
Call'd �2o'toc0�OU /77
i ttai DEVE-WILL NOT BE ACCEPTED
Name of DevVropment Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
M r � Restricted Energy Fee $60.00
� AIN X. (FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS 15$65,SW r i 1+1- AVE- I L1-0 Check Type of Work Involved:
City /State Zip Phone # ❑ Audio and Stereo Systems
1 q'7a
Name P ,AG(Fic- � _ Li V v n Burglar Alarm
PACA
3 h � t w a t r t'� ❑ Garage Door Opener*
OWNER Mailing Address . 00
1 TI60 SO ANS f ? ° -/ n Heating, Ventilation and Air Conditioning System*
Cit /State Z Phone #
r r o R 4r/ aa4 (7 o -4 n Vacuum Systems*
Name v� �,�. e
G E b Li iv 6 J J J n Other
CONTRACTOR Mailing Address
po I3ox ,230 - !5 S TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /State Zip Phone # Fee for each system $60.00
copy of all licenses Ti 0 lC n 'I�ag I qui -iq7$ (SEE OAR 918 - 260 -260)
are required if Oregon Con Brd Lic. # Exp. pate
expired in C.O.T. 100 .-3'3 1 i /gam Check Type of Work Involved:
data base). Electrical Cot, Lic.# _ Exp. Da e
3`4'- -ii I6 j 1 / n Audio and Stereo Systems 1 eed 'er 4
C.O.T. or Metro Lic. # Exp. D to M �"'`�' l
4 a» i 20 ci . n Boiler Controls pp i � IV
Owner's Name IJ49 ' �(,
❑ Clock Systems , J
OWNER - Mailing Address �, �'" i�,,ee��!! I
APPLICANT p Data Telecommunication Installation i rJ-f
City /State Zip Phone # n
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 n 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. n Intercom and Paging Systems
These have asterisks(*). All others need licensing;
/ -
2. Call for inspections when installation under this permit are ready for
n Landscape Irrigation Control*
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 ❑ Outdoor Landscape Lighting'
inspector are done, and;
a Protective Signaling
5. Assume responsibility for calling for a final inspection when all of the
corrections are completed. n 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 bind the applicant.
/ r-- FEES: 1
i
•
d , "� L L.-d, FEES:
FEES $ 1�Z0
Igna Soho
5 6' p /
o
SURCHARGE (.@5 XX TOTAL ABOVE) $ ` , c
Authority if other than Applicant TOTAL $ / 1. 6C
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 — ! ( AM PM BLD
Location () o'C/ 5 '✓ 7 S uite /0) MEC
Contact Person Ph 94 /9 7 d C/ PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR – 00 / 7
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation kl<7--h /� Drywall Nailing Firewall l
Fire Sprinkler e ( ( Q
Fire Alarm S
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 PART FAIL
!;°EC�CTRIC
Service
Rough In ,,
UG /Slab (.li
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before n- . inspection. Pay at City Hall, 13125 SW Hall Blyd
Catch Basin
Fire Supply Line [ a Please call for reinspection RE: / [ ] Unable to inspect - no access
ADA /
Approach /Sidewalk ; .
Other Date ao Inspector — /./4 Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.