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Permit CITY OFTIGARD �� „ a,� ; ��� ; � �, DEVELOPMENT SERVICES ELECTRICAL PERMIT — `- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 RESTRICTED ENERGY PERMIT #: ELR97 -0211 DATE ISSUED: 07/29/97 PARCEL: 2S1O1BC -01200 SITE ADDRESS...:EZI8205 SW HUNZIKER ST SUBDIVISION....: ZONING:I -L BLOCK........... LOT...... ....... JURISDICTN: TIG Project Description : Install date telecommunication A. RESIDENTIAL B. COMMERCIAL------ - - - - -- AUDIO & STEREO... AUDIO & STEREO..: INTERCOM & PAGING..: BURGLAR ALARM....: BOILER..........: LANDSCAPE/ IRRI GAT— : GARAGE OPENER....: CLOCK............ MEDICAL— — — HVAC ...... ....s... DATA /TELE COMM— :X NURSE CALLS......... VACUUM SYSTEM....: FIRE ALARM......: OUTDOOR LANDSC LITE: OTHER: :: HVAC ...... .......: PROTECTIVE SIGNAL..: INSTRUMENTATION.: OTHER..: .< TOTAL # OF SYSTEMS: 1 Owner: ---- - - - - -- - - - -- FEES -- POWER RENTS type amount by date recpt 8205 SW HUNZIKER PRMT $ 40.00 TAT 07/29/97 97-297710 TIGARD OR 97223 5PCT $ 2.00 TAT 07/29/97 97- 297710 Phone #: Contractor: _- _ - -__ -_ ._ COLUMBIA TELEPHONE $ 42.00 TOTAL 808 SE 19TH - - - - -- REQUIRED INSPECTIONS PORTLAND OR 97214 Ceiling Cover Elect'1 Service Phone #: Wall Cover Elect' 1 Final Reg #..: 000995 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 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rule adopted by the Oregon Utility Notifi 'on Center. Th.,: rules are set forth in OAR 952 -001 -0010 through OAR 952 -1 -0080. You may obtain copies of these rules or dir t qu stions to /V. r•• (503)246 -1987. Issued by ` /. 4 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 : /4, DATE: LICENSE NO: .� /17 +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + ++ + + + + + + + + + + + + + + + ++ + + + + ++ Call 639 -4175 by 6:00 P.M. for an inspection needed the next business day + +-i +++++++++++++++++++++++++++++ + + + + + + + ++ + ++ + + + + + + +++ ++ + ++ ++ +-F + + +++ + + + + + + + ++ + +++ 'p CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: 13125 SW HALL BLVD Date Rec'd: TIGARD OR 97223 PRINT OR TYPE � / . V - 503 - 639 -4171 X304 Permit #: , -o�! F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd: WILL NOT BE ACCEPTED Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL 1 Restricted Energy Fee $40.00 ? © w e l/ 1. i✓t� i S (FOR ALL SYSTEMS) JOB Street Address Ste # Check Type of Work Involved: ADDRESS 820c 5 .1-1--L 411 1` / City /State Zip Phone # ❑ Audio and Stereo Systems 'I Q 122 2 i Name ❑ Burglar Alarm OWNER Mailing Address ❑ Garage Door Opener* City /State Zip Phone # ❑ Heating, Ventilation and Air Conditioning System* Name ❑ Vacuum Systems* 0 -'6 (bt 9 iin1 a- l t- pi Q Yt e ❑ Other CONTRACTOR Iskailing Addr s © , � X 0-1-1 TYPE OF WORK INVOLVED - COMMERCIAL (Prior to issuance a ity /St to Zip Phone # Fee for each system $40.00 copy of all licenses V Y D. ' 72-) 4 X' 3D - - - i? (SEE OAR 918 - 260 -260) are required if Ore on Contr. Brd Lic. # Exp. Date expired in C.O.T. C? 0 O Check Type of Work Involved: data base). Electrical Contr, Lic. # Exp. Date 2`( - 9II'D L,y, E 0 Audio and Stereo Systems C.O.T. or Metro Lic. # Exp. Date ❑ Boiler Controls Owner's Name ❑ Clock Systems OWNER - Mailing Address APPLICANT Er. 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 bind the applicant. FEES: �r4 jitlel $IlatUre t >J ENTER FEES $ 1 4 b 5% SURCHARGE (.05 X TOTAL ABOVE) $ - Authority if other than Applicant TOTAL $ y-2- ---- i: \resele.doc 12/96 _ 7/18/99 Activities for Case #: ELR97 -00211 6:08:17 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELRA003 Application received 7/29/97 7/29/97 TAT 7/29/97 ELRA010 Permit created 7/29/97 7/29/97 TAT 7/29/97 ELRC500 (F) Issue permit 7/29/97 TAT PASS TAT 7/29/97 ELRC700 Ceiling Cover 8/1/97 7/31/97 BRP PASS J *H 8/1/97 Supported well (telephone and low voltage data cable) ELRC720 Wall Cover 8/1/97 9/3/97 MJR PASS MJR 9/4/97 ELRC799 Elect'I Final 8/1/97 1/29/99 CD PASS CD 1/29/99 1/26/99 inspection request (research) to Chuck ELRC800 Case finaled 1/29/99 VLN 1/29/99 • Page 1 of 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested h� AM PM BLD Location ga �S 4-<-//1/9 Suite MEC Contact Person Ph PLM Contractor Ph SWR Tenant/Owner ELC Retaining Wall ELR 6) c9.- If Footing Access: -F 'T c 7 — ' 3 -( -GO o p Foundatio FPS Ftg Drain SGN Crawl Crawl Drain Inspection Notes:.--7� .l Slab /re; CA SIT Post & Beam 97-03i o 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 P T FAIL (ELECTRICAL) p 4 ]? ix CpNIC.P� Rough In UG /Slab Low Voltage Fire Alarm _ Final PART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] 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 / ` Z 9 - 99 Inspector Ext Final PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.