Permit •
CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
l DEVELOPMENT SERVICES PERMIT #: ELR1999 -00083
` r � I 1 1 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/20/99
SITE ADDRESS: 10498 SW KENT ST PARCEL: 2S114BB -14500
SUBDIVISION: SWANSONS GLEN NO.2 ZONING: R -12
BLOCK: LOT: 086 JURISDICTION: TIG
Project Description: Install a irrigation control.
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: OUTDOOR LANDSC LITE:
OTHER: IRRIGATION : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:.
TOTAL # OF SYSTEMS:
Owner: Contractor:
ANN TIDD CONCEPT LANDSCAPES INC
10498 SW KENT STREET OREGON CONCEPT LANDSCAPES INC
TIGARD, OR 97224 PO BOX 1583
BEAVERTON, OR 97075
Phone: Phone: 591 -5504
Reg #: LIC 11743
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT GEO 4/20/99 $2.00 99- 314687
PRMT GEO 4/20/99 $40.00 99- 314687
Total $42.00
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 you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by Permittee Signature
•
- - OWNER INSTALLATION ONLY — G
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: /(///q DATE: I7 ..20 9
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
RECEIVED
CITY QF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
'93125 "SW HALL BLVD n Date Rec'd:
TIGARD OR 97223 APR I bi 1992 PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #: s / - 75COffi
F - 503 - 684 -7297 COMMUNITY DEVELOPCA N OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
•
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee $40.00
(FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS in9QA sw lQ } ,� Check Type of Work Involved:
gasyState r � 2 i ip�� I Phone # ❑ Audio and Stereo Systems
116at C.�t' i C ` i c (-
Name ❑ Burglar Alarm
.R,n rt 1i n Garage Door Opener*
OWNER Mailing Address
1 d4 q SW 54. 1<en� n Heating, Ventilation and Air Conditioning System*
.,,c4y /State Z/i� } Phone #
‘bCi ®� y� fo Vacuum Systems*
o 03 C ,, .,65/ ` Other �I It�I *G' `
CONTRACTOR Maili Address ` v
r,. � TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a W/State Zi Phone # Fee for each system $40.00
copy of all licenses fx'Cd ft , aQ _ 9R-01-5 (140-5481 (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Brd Lic. # p. Date
expired in C.O.T. f '743 31 -91 , Check Type of Work Involved:
data base). Electrical Contr. Lic. # xp. Date ❑
Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date
❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT ❑ 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 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. ❑ 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 applic -nt.
FEES:
(
ENTER FEES $
Signature Q ,
/1_61 '46(2 0-6?-
5% SURCHARGE (.05 X TOTAL ABOVE) $c °'
Authority if othe than Applicant TOTAL $
i:\dsts\resele.doc 7/97 —
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
/ ! Date Requested "� - [ AM PM BLD
Location io q 'f' i4ii S` 1 Suite MEC
Contact Person (,r'W') (.110 Ph (o/( r PLM
Contractor Ph SWR
B,U `'; -:t Tenant/Owner ELC
Retaining Wall ELR –rp p
S
Footing Access:
Foundation FPS
Ftg Drain • SGN
Claw
Crawl Drain Inspection Notes: i (� „ a
Post & Beam (� � z ` �
SIT
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm / /
Susp'd Ceiling , C C Ia • Y's a ✓fl 6 b •
Roof
Misc: •
Final
PASS PART FAIL
( ( —
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL w;” R .° °.
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS__ PART FAIL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
e 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 "Zy —�
Other
Date 42-9 Inspector �_�� Ext
� /'rJ'I�JL�
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.