Permit ELECTRICAL PERMIT -
CITY TIGARD RESTRICTED ENERGY
jib DEVELOPMENT SERVICES PERMIT #: ELR2000 - 00028 •
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 02/07/2000
SITE ADDRESS: 08015 SW HUNZIKER ST PARCEL: 2S101 BD 00300
• SUBDIVISION: ZONING: I -
BLOCK: LOT: JURISDICTION: TIG
Project Description: Data telecommunication installation.
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:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
HOWARD LOS LI, TRUSTEE ALLEN /FALK INC
BY PERFORMANCE CONTRACT 9020 SW GEMINI
CHARLOTTE, NC 28217 BEAVERTON, OR 97008
Phone: Phone: 646 - 0533
Reg #: LIC 47238
SUP 781JLE
ELE 34258CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT GEO 02/07/200C $60.00 00- 321602 Elect'I Final
5PCT GEO 02/07/200C $4.80 00- 321602
Total $64.80 ORIGINAL
•
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 through O' ' 95� -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by A / i/ /��, �j vL— 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: Am_ DATE: 0 97- 7 -b
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD REC :-1ICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
13125 SW HALL BLVD Date Rec'd:
TIGARD OR 97223 FEB 4 2OEP PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #:f - OM 28'
F - 503 - 598 -1960 LETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
�J{�1V�TY DEVE�b�i WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee $60.00
e)(-Co (IvlQne_e_ Cry ,, (FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS a s sw NLenztke r Check Type of Work Involved:
Y /State Zip Phone # n Audio and Stereo Systems
,�Ct►O OR ¶ teal -5
Naa e / ❑ Burglar Alarm
110 , L /) � r ❑ Garage Door Opener*
OWNER M n
� 4,es. (-6,01, ❑ Heating, Ventilation and Air Conditioning System*
City /State Phone #
DHOW -4/ � 10c Of "/
Name i n Vacuum Systems*
A I Itx\ rQ I L I(nc . n Other
CONTRACTOR Mailing Address
cltzr 9. 62.YrVI el I Dr. TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a y /State Zip Phone # Fee for each system $60.00
copy of all licenses nen %p2r1 1 1700a toil b-0B3-3 (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Brd Li c._# Ex ate
expired in C.O.T. ti ` 1 �3 t4 / r,V Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp. pate
3f-.I - a5$ CL-E. to P ► ❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp./Date
3655 II 00 n Boiler Controls
Owner's Name
n Clock Systems
OWNER - Mailing Address
APPLICANT X Data Telecommunication Installation
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:
n Instrumentation
1. Only use electrical licensed persons to do installations where required.
Certain residential and other transactions are exempt from licensing. E 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 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;
❑ 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 - - applicant or a person * No licenses are required. Licenses are required for all other installations
authorized to bind the applica .
I/ ��� .,,Z FEES:
Signature ENTER FEES $ ( Oa OD
Or, SURCHARGE (.05 X TOTAL ABOVE) $ I • 80
Authority if other than App (cant TOTAL $ (DLL 80
is \dsts \forms \resele.doc 3/98
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -H'aur Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 9 I - 00 AM PM BLD •
Location €30/c (4U�t '�-1 /�L Suite MEC
Contact Person TO `e Ph 02 '7 PLM
Contractor Ph SWR
BUILDING w - a'� . Tenant/Owner /q99' 0065
Retaining Wall a 0 26(} d " 0 GC2 z
Footing Access:
Foundation / � Ce FPS
Ftg Drain /T4'�C..i �'�', SGN
Crawl Drain InspeC I, ote,Fp
Slab v 1S C// /e( i 7 SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler / Fire Alarm
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
ECTRICAI
Service
Rough In
UG /Slab
Low Voltage
Fir- Alarm
. in- .
PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ I Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other
Date Zi` 7671) Inspector Fxt
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.