Permit CITY OF TIGARD
I l
DEVELOPMENT L SERVI ELECTRICAL PERMIT —
RESTRICTED ENERGY
PERMIT #: ELR97 -0183
DATE ISSUED: 07/01/97
PARCEL: 1S136CC -00100
SITE ADDRESS...:11765 SW PACIFIC HWY
SUBDIVISION • ZONING:C —P
BLOCK • LOT • JURISDICTN: TIG
Project Description: install protective signaling
A. RES I DENT I AL 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: :: HVAC • PROTECTIVE SIGNAL..:X
INSTRUMENTATION.: OTHER..: •.
TOTAL # OF SYSTEMS: 1
Owner: FEES
GENERAL MOTORS TRAINING type amount by date recpt
11756 SW PACIFIC HWY PRMT $ 40.00 GEO 07/01/97 97- 296639
TIGARD OR 972223 5PCT $ 2.00 GEO 07/01/97 97- 296639
Phone #: 639 -6191
Contractor:
ADT SECURITY ALARMS $ 42.00 TOTAL
703 NE HANCOCK
REQUIRED INSPECTIONS
PORTLAND OR 97212 Ceiling Cover Elect'1 Final
Phone #: 284 -3265 Wall Cover
Reg #• .: 000599
This perwit 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 peruit will expire if work is not started within 180
days of issuance, or if work is suspended for wore than 180 days. ATTENTION: Oregon law requires you to follow rule adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR 952-001 -0010 through OAR 952- 001 - You way obtain copies of
these rules or direct 'uestii. a r. at (503)246 -1987.
Issued by A , / `.�.`,,; 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 SUP R. ELEC' N: DATE: F
LICENSE NO:
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 P.M. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
is
• - c1 , 7 / / g / 9 7 3 3 / - � 6
CIJY 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 #c[ / 'F9 -0/
F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL
Restricted Energy Fee $40.00
(FOR ALL SYSTEMS)
JOB Street Address , #
ADDRESS // 76 Check Type of Work Involved:
S -5'w r '
Ci /State Z i 3 # (9 p Audio and Stereo Systems
t� �� D� 7aa sod 39
N. a re , ❑ Burglar Alarm
i .
OWNER aili Address + ❑ Garage Door Opener
/1 7lo S S fa- / El Heating, Ventilation and Air Conditioning System'
Ci /State n iel Zip Gf �02 I Phon / l oZ (/ ❑ Vacuum Systems'
ADT SECURITY SERVICES, low.
703 NE HANCOCK ❑ Other
CONTRACTOR Mailing Address PORTLAND. OR 97212
(503) 284-3265 TYPE OF WORK INVOLVED - COMMERCIAL
(Prior to issuance a City/State Zip Phone # Fee for each system $40.00
copy of all licenses (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Brd Lic. , # Exp. Date
expired in C.O.T. 59 9 / 7 Check Type of Work Involved:
data base). Electrical Contr. Lic. Exp. Date
6 - g- 9 ❑ 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 I 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. 0 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,. d •'- refundable and expire if work is not
started within 180 days of�fua;, or if work is suspended for 180 days. Number of Systems
The person signing fo is • rmit must be the applicant or a person • No licenses are required. Licenses are required for all other installations
authorized to b'• • . = ap. cant.
/ FEES:
Si. / 1 3 J7 F .
-ture ENTER FEES $ `7 0
5% SURCHARGE (.05 X TOTAL ABOVE) $ /
Authority if other than Applicant TOTAL $ if ,
i:\esele.doc 12/98 —
•
7/26/99 . Activities for Case #:.ELR97 -00183
1:52:08 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRC001 APPlication Received 7/1/97 7/1/97 • GEO 7/1/97
ELRC003 Permit Created 7/1/97 7/1/97 GEO 7/1/97
ELRC799 Elect'I Final 7/1/97 9/17/97 MJR PASS MJR 9/30/97
• ELRC500 (F) Issue permit 7/1/97 GEO PASS GEO 7/1/97 •
ELRC800 Case finaled 9/17/97 MJR PASS MJR 9/30/97
•
•
•
•
•
Page 1 of 1
•
"•-.--465(
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: /_ 6 1-6-97 � A.M. P.M. MST:
Location: - / ry 6 5 _ i% ` . �l j BUP:
ir
Tenant: .`'./�/_ t ,/ . a .�� i 1 ./ Suite: B1 : MEC:
Contractor. 22 (7 Q� Phone: -- PLM:
Owner: Phone: / d �[ ■■ N1 /...:41/ - 97 7,4
9 1 1 7 / ELR: 9 7'��3
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL C 1 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 U
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump .w It te
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved roved Not Approved
FINAL FINAL FINAL FIN FINAL
ic-97- 0 1 &Clier? K;e. M aoe _ c I
411
S-fZ -97- 0/83 £w >o a,
•
O Call for reinspection O Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: �� f -e ( /«-�c( Date: � ? -Z?-?7 Page ( of 7