Permit 4-
CITY OF TIGARD ELECTRICALPERMIT -
RESTRICTED ENERGY
1d `�y� DEVELOPMENT SERVICES PERMIT #: ELR2000 -00094
13125 SW Hall Blvd., Tislard, OR 97223 (503) 639 -4171 DATE ISSUED: 05/03/2000
SITE ADDRESS: 14411 SW PACIFIC HWY PARCEL: 2S110AB -00200
SUBDIVISION: CANTERBURY PLACE ZONING: C -G
BLOCK: LOT: 1 -3 JURISDICTION: TIG
•
Project Description: low voltage installation.
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:
INSTRUMENTATION: OTHER: LOW VOLT X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
KOLVE, G C SUPERVISION
14389 SW PACIFIC HWY BUSINESS MACHINE CO
TIGARD, OR 97224 3811 SW BARBUR BLVD
PORTLAND, OR 97201
Phone: Phone: 503 - 224 -8181
Reg #: ELE 26- 796CLE
L{C 53029
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
•
PRMT GEO 05/03/200C $60.00 0001859 Elect'I Final •
5PCT GEO 05/03/200C $4.80 0001859
Total $64.80
()MIN
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 0 2 -0 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by ,� �ijL 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 SUPR. ELEC'N V / 1 4 9 - DATE: 1 2 -- 3-60
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
04 /28 /00 l;ltl 15:00 5U3 598 196U Cl'1'Y Ul% '1'1GAld1 IJJOU2
•
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CITY -OF TIGARD I . REERICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
13125 SW HALL
B 3 � �ti ,kiN' PRINT OR TYPE Date Rec'd:
TIGARD OR 97
V - 503 - 639 171 X304 A �� Permit #: QAoal, - X499
F - 503 - 598- 1960r' 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
(FOR ALL SYSTEMS) $60.00
JOB Street Address Ste #
ADDRESS SO P
C Check Type of Work Involved:
v
_fly/ /Stat [p Phone # .
Slat I9 'I da�l ��I� -iol ❑ Audio and Stereo Systems
Na S=
❑ Burglar Alarm
OWNER Mailing Address ❑ Oerege Door Opener
City /State I Zip I Phone # ❑ Hosting, Ventilation and Air Conditioning System'
Name - ❑ Vacuum Systems'
•
SI,A VIs1 ❑ Other
CONTRACTOR Mailing Add
3S I l I j TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to Issuance a y/S a a Zip Phone # Fee for each system $60.00
copy of all licenses rp{tlgn,� A,Ole 9i ao 1 aa4 _813' (SEE OAR 916 -260 -260)
are required if • Oregon Contr. Brd Lic. # Ex . ate /
expired in C.O.T. 5 3 1),9-al 0 2__ 3 1 v heck Type of Work Involved:
data base). Electrical Contr. Lic. # Ex t. ate
9 P - 1 q to C LE_ /p / d
,
00 Dom- ❑ Audio and Stereo Systems
C.O.T. or Metro Lio. # ' Erc . Date
0O0034a 4 b / oo ❑ Boiler Controls
Owner's Name
n Clock Systems
OWNER . , Mailing Address • , -: - --:-.• , , - • •.- - - . -
APPLICANT ❑ Data Telecommunication Installation
City /State I Zip I Phone # 0"
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 ❑ .1-MC
permit and to do the following:
ID 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;
2. Call for inspections when installation under this permit are ready for ❑ Landscape Irrigation Control* .
Inspection at 503.6394175; ❑
Medical
3. Purchase separate permits for all installations that are not ready for an
• inspection when the Inspector Is out to inspect under this permit; ❑ Nurse Calls
4. Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting`
•
Inspector are done, and:
5. Assume responsibility for calling fore final inspection when all of the Protective 1
corrections are completed. 1
Other I� of �) vc}1_ �t .c�l ! �� E l , , 4 r ab p► ,� _ •
Pe are non - transferable and non - refundable and expire if work Is not Li c e` �"'�
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:
L....� -/11L0
Signa ure VP ENTER FEES
$ loo , DO
91 RE-I— • 8% SURCHARGE (.08X TOTAL ABOVE) $ y . p 0 Authority if other than Applicant • TOTAL $ le, y , ?O •
I:ldstsVorms esele.doc 3/98
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested (/ AM PM BLD
Location Pi-4(U // r2�t'iL - v Suite MEC
Contact Person Pau) . n /,4 �e Ph ?D go ST PLM
Contractor ad/ Ph c /,C SWR
BUILDING Tenant/Owner Cla_SS(C,Ce-S ELC
Retaining Wall ELR 2 _ 66)°q
Footing Access: be,-(14)-. 3 /0 — pLe/A_St-CI -1A-- FPS
Ftg Drain
Foundation 0 r - l
c�n4
Crawl Drain Inspection Notes: J SGN
Slab C'A/vh_2✓G�. !/1'L "'S
Post & Beam P
Ext Sheath /Shear �j�.� ' c if
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 FAIL
e r CTRICA L J
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
ART 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 reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date ' r ' °V Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.