Permit CITY OF TIGARD • ELECTRICALPERMIT -
RESTRICTED ENERGY
�4 DEVELOPMENT SERVICES PERMIT #: ELR1999 - 00132
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 DATE ISSUED: 5/25/99
SITE ADDRESS: 13543 SW LAUREN LN PARCEL: 2S104CA - 02700
SUBDIVISION: HILLSHIRE ZONING: R -
BLOCK: LOT: 027 JURISDICTION: TIG
Project Description: Landscape 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:
•
MOHSEN TORABI OWNER
13543 SW LAUREN LN
TIGARD, OR 97223
Phone: Phone:
Reg #:
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT BON 5/25/99 $40.00 99- 315651 Elect'I Final
5PCT BON 5/25/99 $2.00 99- 315651
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. maik,okr,____ Issued by 6- Permittee Signature
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale. lease, or rent.
j
OWNER'S SIGNATURE: — DATE:�C 2 S1
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
•
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: 6 MAd w
13125 SW HALL BLVD Date Rec'd: 2r - 2S
TIGARD OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #: rt_R vim - ODoz-
r - 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
"I�
^�— Restricted Energy Fee $40.00
1V4:1 115 (1\( (q42 6 0 6 ) (FOR ALL SYSTEMS)
JOB Street A dress Ste #
ADDRESS /" ci UV (4(Ad &�` Check Type of Work Involved:
Cit /State ; Zip Phone # �. \I) ❑ Audio and Stereo Systems
Names
-A-t-1._ 3 ❑ Burglar Alarm
"0 145. , R.Ar\i
❑ Garage Door Opener*
OWNER Maili ddress
13 5 3 .Stn/ L..AN R.7 Lo/ ❑ Heating, Ventilation and Air Conditioning System*
City /Sta a Zip P ne #
Nam - )dt � v � � 7 io l q�
v ❑ Vacuum Syst
�- -LZs
n Other
CONTRACTOR Mailing Address
‘141 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /State Zip Phone # Fee for each system $40.00
copy of all licenses I (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Brd Lic. # Exp. Date
expired in C.O.T. Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp. Date
n Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date
n Boiler Controls
Owner's Name
M-3 /4 &SW -Z) V./P \ n Clock Systems
OWNER - Mailing Address
APPLICANT 13510 ,hp,/ 4.01,0,44 LAT n Data Telecommunication Installation
City /State p � Zip Phone #
-- 1111 r� A� \� ��U� \n1 —�L Fire Alarm Installation
This permit is issued unde? AE 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. ❑ 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 n Outdoor Landscape Lighting*
inspector are done, and;
0 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: f� 00
ENTER 'FEES - -- -- - - -- - - $ V
Signature 00
5% SURCHARGE (.05 X TOTAL ABOVE) $
Authority if other than Applicant TOTAL $ L (2. 0 0
is \dsts\resele.doc 3/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
� 9- ` Q 1 AM PM BLD
Location I 79/ 7 L.d d Suite MEC
Contact Person 1('0 ¶Ord, Ph 6o2,(0-72S7 PLM
Contractor Ph y 67 7 SWR
BUILDING ° °;y °, Tenant/Owner ELC
Retaining Wall ELR 1 4: 11 6 / - {, 3Z
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: c ( Pn °
✓
Slab or 1)1,y
..� SIT
Post & Beam <
Ext Sheath /Shear 5 pr ,/� �,Y lC;ILA 5��'r•
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS _MI FAIL
Service
Rough In
UG /Slab
.
-ire • arm
Fi
PART FAIL
;SI.
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 d D i / ` 7 Inspector
Ext
Final
PASS PART FAIL • DO NOT REMOVE this inspection record from the job site.