Permit CITY OF T I G A R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
� I�' � DEVELOPMENT SERVICES PERMIT #: ELR2000 -00055
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 03/15/2000
SITE ADDRESS: 10751 SW 130TH AVE PARCEL: 1S133AC -08001
SUBDIVISION: KNOWLEDGE BEGINNINGS DAYCARE C ZONING: R -25
BLOCK: LOT: 001 JURISDICTION: TIG
Project Description: Installation of a fire alarm system in an existing commercial building.
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: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
• .TOTAL # OF SYSTEMS: 1
Owner: Contractor:
ADT SECURITY SERVICES, INC
2815 SW 153RD DR
BEAVERTON, OR 97006
Phone: Phone: 503469 -7100 •
Reg #: EL E 2620990 LE ORIGINAL
EL 2620C
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT KJP 03/15/200C $60.00 0000680 Elect'l Final
5PCT KJP 03/15/200C $4.80 0000680
Total $64.80
•
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 througb,OAR 952 - 001 -0080. You may obtain copies of these rules or direc questions to OUNC at (503)
246 -1987. I � / 1
Issued by Permittee Signature ?A /_ , _ . 0
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
503 598 1960
‘_ 02/11/00 FRI 13:23 FAX 503 598 1960 CITY OF TIGARD 0004
• Jot OS3 /22_ /6•C/
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
13125 SW HALL BLVD Date Recd:
IGARD OR 97223 PRINT OR TYPE
- 503 -639 -4171 X304 Permit #: i2 2�6 eaD,FS
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
Pz/ 1 +� 1. / 0031 Restricted SY Fee
u1 /� $60.00
(FOR ALL SYSTEMS)
JOB Street Address Ste #
•
ADDRESS D') 51 5143 Check Type of Work Involved:
�G�� Cit /State 4 Phone #
, /tD �7� El Audio and Stereo Systems
(JF- ❑ Burglar Alarm
OWNER Mailing Ad re ss� ❑ Garage Door Opener*
City/State I Zip )Phone #
ID Heating, Ventilation and Air Conditioning System'
Na r Vacuum Systems'
A. ]ne7 + / S 0)2.17Y VCS ❑ Other
CONTRACTOR Mailing Address
2.13).c „Sw I AD • TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /State Phone # Fee for each system
copy of all licenses YrA ,� - �1 1 (SEE OAR 918 -260 -260) 560.00
are required if Oregon Contr. Br Li # -
expired in C.O.T. '7. 4 ip 7 tJi Check Type of Work Involved:
. data base). Electrical Contr. Lic. # Exp D to
? H • 2 O- Q ( /.1110-0 ' ❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date
❑ Boiler Controls
Owner's Name
. OWNER - I Mailing Address E3 Clock Systems
APPLICANT ❑ Data Telecommunication Installation
City /State I Zip I 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; I--
2. Call for inspections when installation under this permit are ready for I t Landscape irrigation Control'
inspection at 503- 639 -4175; ❑
Medical
3. Purchase separate permits for all installations that are not ready for an
inspection when the inspector is out to inspect under this permit; ❑ Nurse Calls
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 ff 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 (he applicant or a person • No licenses are
authorized to bind the applicant. Licenses are required for all other installations
4 I/ LL ` 7 FEES:
• t , ature ENTER FEES $ 60
8% SURCHARGE (_08X TOTAL ABOVE) $ 4
•
•
Authority if other than Applicant TOTAL $ 64 ,80
is \dsts\formslresele.doc 3/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP
Date Requested 2�/ ) AM PM BLD
Location D) S / 1-- )a - ' � Suite MEC
Contact Person aeA V1l S Ph S90 "O d PLM
Contractor Ph SWR
i ,J Tenant/Owner ELC
etaining Wall ELR ',®i _L S S
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing EL, L 199? 9? '- (O 2-I
Insulation
Drywall Nailing EL2 /9f? - (90 7/0
Firewall
Fire S•ri ler E `,f ( / t/ # 9 o .. EL-4. ` 0T C.�l/
.s[. C„ EL2 - tr) d 0S9 u •' • Ceiling
Roof L / L /
Misc: ��� C
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
PAS PART FAIL
ECTRIC
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
• • SS PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date . ar/ Inspector
Final
PASS PART FAIL DO NO REMOVE this inspection record from the job site.
04/28/2000 Activities for Case #: ELR2000 -00055
8:46:04 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRC001 Application Received 03/15/2000 KJP RECD No Hold KJP 03/15/2000
ELRC003 Permit Created 03/15/2000 KJP DONE No Hold KJP 03/15/2000
ELRC725 Low Voltage Inspection No Hold KJP 03/15/2000
ELRC799 Elect'I Final 04/26/2000 CD PASS No Hold AKJ 04/26/2000
ELRC500 (F) Issue permit 03/15/2000 KJP DONE No Hold KJP 03/15/2000
ELRC800 Case finaled 04/26/2000 AKJ DONE No Hold AKJ 04/26/2000
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