Permit A. CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
44 4w1 4 " DEVE Hall O BMEN SERVICES
639 -4171 DATE ISSUED: IT 13125 /
SITE ADDRESS: 13939 SW PACIFIC HWY * ** PARCEL: 2S103DD -01000
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: Install 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: Contractor:
BC REAL ESTATE INVESTMENT GATES ELECTRONICS + SECURITY
BC NORTHWEST LP #707 PETER N GATES L
BY BURKE & NICKEL 6818 SW CAPITOL HWY O R r G C I\f Q
TULSA, OK 74135 PORTLAND, OR 97219
Phone: Phone: 246 -9951
Reg #: LAC 0076878
SUP 922JLE
ELE 34 -316CL
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT DST 06/28/200C $60.00 0003315 Elect'l Final
5PCT DST 06/28/200C $4.80 0003315
Total $64.80
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: Ore; on law
requires you to folio ru -s adopted by the Oregon Utility Notification Center. Those rules are set forth in AR
952 - 001 -0010 r gh 'BAR 952 - 001 -0080. You may obtain copies of these rules or direc uestion • •� NC at (503)
246 -1987.
Issued by 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:
CONT CTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N 7L, �C . 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:
13125 SW F-IALL BLVD EI Date Rec'd:
TIGARD OR 97223 Auf I R - ° ° c Z p PRINT OR TYPE .�
V - 503 - 639 -4171 X304 Permit i7; cie2600- QO IS
F - 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
R6 , � (FOR Energy Fee $60.00
/� (FOR OR ALL SYSTEMS)
JOB Street Address Ste # Check Type of Work Involved:
ADDRESS 43939 Al Jr,.4„� .
State , Phone # ❑ Audio and Stereo Systems
e _ Q v' 4 Z t7} .
af, ❑ Burglar Alarm
.96 6 -" ❑ Garage Door Opener*
OWNER ailing Address Address ,,�/ /�� //�
/ /ae //9 7 7 i� IL 4/O "� ❑ Heating, Ventilation and Air Conditioning System* I Ci St to Phone
` " '�' �/� ❑ Vacuum Systems`
Name -- ,[
�i i jeJi T/IYJ Y 17 ❑ Other
CONTRACTOR a Ad
1 i
..4 , , r � TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a S / /'f Phone # Fee for each system $60.00
copy of all licenses rta ' � 5 "���J (SEE OAR 918 - 260 -260)
are required if • - • • a � . Bic # Exp. at
expired in C.O.T. / ;f" •/ 7rS /o i Check Type of Work Involved:
data base). Electrical Contr. Lic. # ate
5V- : j /� ❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # ECp. Date
n Boiler Controls
Owner's Name
El C lock Systems
OWNER - Mailing Address
APPLICANT n D ata 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 ❑ 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 ❑ 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. n O ther
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 e applicant or a person * No licenses are required. Licenses are required for all other installations
authorized toto bind applicant.
FEES:
ec
/' � /� /�, ENTER FEES $ —-
Signature R �
8% SURCHARGE (.08X TOTAL ABOVE) $ �'
Authority if other than Applicant TOTAL $ f ""
is \dsts \forms \resele.doc 3/98
07/11/2000 Activities for Case #: ELR2000 -00159
2:13:19 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRC001 Application Received 06/28/2000 KJP RECD No Hold DST 06/28/2000
ELRC003 Permit Created 06/28/2000 KJP DONE No Hold DST 06/28/2000
ELRC725 Low Voltage Inspection No Hold DST 06/28/2000
ELRC799 Elect'I Final 07/06/2000 CD PASS No Hold CD 07/06/2000
ELRC500 (F) Issue permit 06/28/2000 KJP DONE No Hold DST 06/28/2000
ELRC800 Case Finaled 07/11/2000 HAP. DONE No Hold HAP 07/11/2000
Page 1 of 1
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 7- C AM PM BLD
Location / ? 'j 3 S 4 fa L f ` {4. / ' Suite MEC
Contact Person P4 km / Ph Z tI G — 9 / PLM
Contractor Ph Z3— C(o Cc/ SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR 2 " 40/5
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab r t ` ° -e-- • SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS _PART (ECECTRICAL_
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
4.40 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 reinspe tion RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date Ins .B �Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.