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Permit CITY OF TIGARD _!��I��,I�I DEVELOPMENT SERVICES RESTRICTED ENERGY PERMIT #: ELR98 -0080 DATE ISSUED: 03/18/98 PARCEL: 18135DD -05000 SITE ADDRESS...:11975 SW PACIFIC HWY SUBDIVISION • ZONING:C —G BLOCK • LOT • JURISDICTN: TIG Project Description: Protective signaling. 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: .• HVAC • PROTECTIVE SIGNAL..:X INSTRUMENTATION.: OTHER..: .. TOTAL # OF SYSTEMS: 1 Owner: FEES RAINBOW PLAY STRUCTURES type amount by date recpt 11975 SW PACIFIC HWY PRMT $ 40.00 DLH 03/18/98 98- 304225 TIGARD OR 97223 5PCT $ 2.00 DLH 03/18/98 98- 304225 Phone #: 503 - 620 -2653 Contractor: ADT SECURITY ALARM SYSTEMS $ 42.00 TOTAL 703 NE HANCOCK REQUIRED INSPECTIONS PORTLAND OR 97212 Ceiling Cover Low Voltage Insp Phone #: 503 -282 -1549 Wall Cover Elect'l Final Reg #..: 000599 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 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 rule adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -081 -8010 through OAR 952-01 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)246 -1987. B Issued by Permittee Signature �Q�� 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: 44 LICENSE NO: +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY OF TIGARD ESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: .2) 13125 SW HALL BLVD �� 5// 7/9 8 D8' TY - 99 e I —°/ Date Rec'd: -.3/19/94 IS�. T RD OR 97223 / / PRINT OR P . V - 503 - 639 -4171 X304 Permit #: EL-/e 9f -00A0 F - 503-684-7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd: ape/9P WILL NOT BE ACCEPTED Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY A) /7 Restricted A LL SY Fee $40.00 �4 -, �i = (FOR ALL SYSTEMS) JOB Street Address re # ADDRESS ,' 9'7_5 ,5'aJ • l a Check Type of Work Involved: Ci /State K one • Audio and Stereo Systems • e ❑ Burglar Alarm OWNER M au�n9 Address ❑ Garage Door Opener* City /State I Zip I Phone # ❑ Heating, Ventilation and Air Conditioning System* Name ❑ Vacuum Systems' ADT SECURITY SERVICES, INC. ❑ Other 703 NE HANCOCK CONTRACTOR Mailing Address PORTLAND, OR 97212 45031284.3265 TYPE OF WORK INVOLVED - COMMERCIAL ONLY (Prior to issuance a City /State I 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. # 5 .7 f 4 Check Type of Work Involved: data base). Electrical Contr. Lic / _ Exp. Date ❑ (v Audio and Stereo Systems C.O.T. or Metro Lic. # Exp. Date ❑ Boiler Controls Owner's Name ❑ Clock Systems OWNER - Mailing Address APPLICANT [l Data Telecommunication Installation City /State Zip Phone # ❑ Fire Alarm Installation This permit is issued under OAE 91B-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: 0 Instrumentation 1. Only use electrical licensed persons to do installations where required. Certain residential and other transactions are exempt from licensing. ED 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 -r= ■ able and expire if work is not started within 180 days of '- suance o , ork is suspended for 180 days. Number of Systems The person signing for permit • st be the applicant or a person • No licenses are required. Licenses are required for all other installations authorized to bind th- . ••plicant. 4F ."-' p _ FEES: 7 v J ENTER FEES $ 4/1-0 ' Si ature 5% SURCHARGE (.05 X TOTAL ABOVE) $ Authority if other than Applicant TOTAL $ is \dsts\resele.doc 7/97 — `f - /52-S CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 Date Requested: 4- (7 J [ �� A.M. P.M. MST: Location: / 1 7 5 LO a L-L rC_ (�. BUP: Tenant: 12A (\ it L PtA- 1 . G' ' ,:i. Bldg MEC: Contractor: tact 2'1 C( / A Fir Phone: ,&& G-6, jm ,d(_ , PLM: Owner: 1 T > 6 ' o� (� 1 q" Phone: .)-(/ -- 1_&.s•3 ELC: p p r ELR: /e — DOJ • SIT: BUILDING BLDG (con't) PLUMBING MECHANICAL ,----CELECTRIC i SITE Site Post/Beam Post/Beam Post/Beam Cover/Serrice 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 �j� Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump �l;sw Vo a / .eQ 4 / , Approved Approved Approved r pprov 44 4 Approved Appr /Sdwlk Not Approved Not Approved Not Approved of • pproved Not Approved FINAL FINAL FINAL �" FINAL 1 / . 1 - . — • Al -' D t/c__, ' ,Q ,Q& nG. /)c4211(0)- 14pOrmq J` /D11 ain e___/ £ 10r — ye.._ N to i1 4 s 1.) vid 6� Y r____. — 9 a '_, 4P ej 7 / f4 Y1 /-- Aoss -1 /e f^i v 1 ) Y 0 Call for reinspectio Reinspection fee of $ required before next inspection 0 Unable to inspect C� Inspector: Date: — O — q exO Page of 1 •