Permit CITY OF TIGARD
^ oill DEVELOPMENT SERVICES ELECTRICAL PERMIT — Hall Blvd., Tigard, RESTRICTED ENERGY
PERMIT #: ELR97 -0281
DATE ISSUED: 10/06/97
PARCEL: 16136CD —CARTY
SITE ADDRESS...:1171O SW PACIFIC HWY
SUBDIVISION • ZONING:C —G
BLOCK • LOT JURISDICTN: TIG
Project Description : Adding two low voltage systems
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM • BOILER LANDSCAPE/ IRRI GAT. .:
GARAGE OPENER • CLOCK MEDICAL
•
HVAC • DATA /TELE COMM..: NURSE CALLS
VACUUM SYSTEM • FIRE ALARM •X OUTDOOR LANDSC LITE:
OTHER: :: HVAC PROTECTIVE SIGNAL. .:X
INSTRUMENTATION.: OTHER..: ••
TOTAL # OF SYSTEMS: 2
Owner: FEES
SECURITYLINK type amount by date recpt
5110 NE SANDY BLVD PRMT $ 80.00 DST 10/06/97 97—
TIGARD OR 97213 5PCT $ 4.00 DST 10/06/97 97—
Phone #: 288 -3430
Contractor:
SECURITY LINK FROM AMERITECH $ 84.00 TOTAL
5110 NE SANDY BLVD
REQUIRED INSPECTIONS
PORTLAND OR 97223 Ceiling Cover Low Voltage Insp
Phone #: 288 -3430 Wall Cover Elect'1 Final
Reg #..: 000550
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 wor ' not started within 180
days of issuance, or if work is suspended for sore than 180 days. ATTENTION: Oregon law requires yo , follow rule adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR -001 'ou "'stain .pie of
these rules or direct questions to OUNC at (503)246 -1987. ��
Issued by J 1 D.(1 / — P ermittee Sig atur � ,! /� > -
i
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 6:00 P.M. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + ++ + + + + + + + + + ++
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd. �� p G -� ai
S c.` Tigard, OR 97223 PERMIT # . / 2S
/�i�,� ; l
i h\ Phone (503) 639 -4171 DATE ISSUED �d /�7
FAX (503) 684 -7297 / �7
A . TDD No. (503) 684 -2772 m
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY a LL
PLEASE COMPLETE ALL SECTIONS .
1. LOCATION OF INSTALLATION • 4. TYPE OF WORK
/ 1 7 40 5ItS f o c, G Aw r .
Address-- R ESIDENTIAL — Restricted Enew. Fee $ 40.00
I t lord 0l 9.7 2.3 (FOR ALL SYSTEMS)
City ,/ State Zip Check Type of Work Involved:
PERMITS ARE NON - TRANSFERABLE AND NON - REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems
15 NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
180 DAYS. ❑ Burglar Alarm
2. CONTRACTOR APPLICATION // ❑ Garage Door Opener*
/ { C lo.s. �/Yle!'l , ❑ Heating, Ventilation and Air Conditioning System*
Contractor SCu��i l is nl� Type Low Ve I 142 c._ ❑ Vacuum Systems*
Address 57/0 A E csa✓td 2/4 F,421 -a 0� ` ? 13 . ❑ Other
Date /0 - Ce - g 7 COMMERCIAL — Fee for each system $40.00
//�� (SEE OAR 918- 260 -260)
• Property Owner Car Ty s Check Type of Work Involved;
Contractor's Board Reg. No. 045 60 ❑ Audio and Stereo Systems .
❑ Boiler Controls
Phone # 5 - Z$8 -3430 ❑ Clock Systems
• ❑ Data Telecommunication Installations
3. OWNER APPLICATION
g Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No
❑ Instrumentation .
Address ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
City State Zip ❑ Medical
This permit is issued under OAR 918- 320 -370. This applicant agrees to make only CI Nurse Calls
restricted energy installations (100 volt amps or less) under this permit and to do the ❑ Outdoor Landscape Lighting*
following:
[r Protective Signaling
1. Only use electrical licensed persons to do installations where required. (Certain
residential and other transactions are exempt from licensing. These have ❑ Other
asterisks(*). All others need licensing).
2. Call for an inspection when all of the installations under this permit are ready
for inspection at 503- 639 -4175. Z
❑ Number of Systems •
3. Purchase separate permits for all installations that are not ready for inspection
when the inspector is out to inspect under this permit. • No licenses are required. Licenses are required for all other installations.
4. Assume responsibility for assuring that all corrections required by the inspector
are done, and
5. Assume responsibility for calling for a final inspection when all of the 5. FEES
corrections are completed.
The person signing far this sermit must be the applicant or a person a. Enter Fees $ 80. DD
authorized to bi a :.. pl'', ant.
, 7 4 b. 5% Surcharge (.05 x total above) $ 4. 00
Signature /
TOTAL $ 6 1, 0 0
Authority if other than applicant
ENERGAP.CHP
‘ CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: ' • I 2 - 0 (_ q 1 A.M. P.M. K MST:
Location: 11 1 L - 1/k) d� �� BUP:
Tenant: c_A'9 -To y .s Suite: Bldg: MEC:
Contractor:, . JQlat 4 - Phone: PLM:
Owner: 2.4.1 iM Phone: ELC: �, (�
, / • J ELR: l + 7 - -8 I
SIT:
BUILDING BLDG (con't) PLUMB I G MECHANICAL /(ELECTRICAL) SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC. _
Masonry Ceiling Rain Drain A/C UG Slab ._
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump w o / t , ,Li / -'=
Approved Approved Approved Approved Approv: 1 :f,,
Appr /Sdwlk Not Approved Not Approved Not Approved ved Not Approved
FINAL FINAL FINAL FINAL FINAL
DA ss - L v 5 s?-
re
O Call for reinspectio D Reinspection fee of $ / required before next inspection O Unable to inspect
1 Inspector: Date: ! Z ` 0 /- 9 7 Page of
t