Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
1 11 DEVELOPMENT SERVICES PERMIT #: ELR1999 -00109
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/30/99
SITE ADDRESS: 15660 SW PACIFIC HY A -1 PARCEL: 2S110DC -02200
W
SUBDIVISION: WILLOW BROOK FARM ZONING: C -G
BLOCK: LOT: 011 JURISDICTION: 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:
Owner: Contractor:
TIGARD CENTER LP ADT SECURITY SERVICES, INC
9777 WILSHIRE BLVD #609 703 NE HANCOCK
BEVERLY HILLS, CA 90212 PORTLAND, OR 97212
Phone: Phone: 503 - 284 -3265
Reg #: LIC 005994
ELE 26- 209CLE
FEES Required Inspections
Type By Date Amount Receipt Elect'I Final L J v *-1
PRMT BON 4/30/99 $40.00 99- 314989
5PCT BON 4/30/99 $2.00 99- 314989
Total $42.00 ORIGINAL
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 OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC 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:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: I. I /- DATE:
LICENSE NO:
Call 639 -4175 by 7 :00 P.M. for an inspection needed the next business day
, <.E tIVO-579 08.3- //�19—
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: 1
13125 SW HALL BLVD ApR 3 01999 Date Recd 3o - 1' i
TIGARD OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X30_4 Permit #: .1....R ���I' ODIU
uuMMUNITY DEVELOPMENT
F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project #2 / 37/ /o2— TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
i / / D �J / Restricted Energy Fee $40.00
/ d 1.4)-04,4 (/ (FOR ALL SYSTEMS)
JOB Street A• Ste # / tfrO Check Type of Work Involved:
ADDRESS A.5 60 (StJ • D l'
Ci /St n ip one # ❑ Audio and Stereo Systems
Na ❑ Burglar Alarm
OWNER Maili Address
❑ Garage Door Opener'
City /State Zip - Phone # ❑ Heating, Ventilation and Air Conditioning System*
Name ❑ Vacuum Systems*
ALIT SECURITY SERVICES. INC.
703 NE HANCOCK ❑ Other
CONTRACTOR Mailing Address PUKILANU, UK UZ1Z
(503) 284 -3265 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(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 Li # Exp. Date
expired in C.O.T. 599 4 Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp. Date -
0-6—go ❑ 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 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 licertsed 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; .
ITI Protective Signaling
5. Assume responsibility for calling for a final inspection when all of the
corrections are completed. ❑ Other
Permits are non - transferable and ' •n -r: ndable a • . pire if work is not
started within 180 days of issu ce • if work i : : - nded for 180 days. Number of Systems
The person signing • th': per it mus • - - applicant or a person • No licenses are required. Licenses are required for all other installations
rized to b' • • • - . • pl' •- .nt.
//11440 78.3 �J - FEES:
o ENTER FEES $ v '
Signatu -
5% SURCHARGE (.05 X TOTAL ABOVE) $ g f
Authority if other than Applicant TOTAL $ !/7 1h. •
i:\dsts\resele.doc 7/97
I
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
G BUP
Date Requested Z �� / AM PM BLD
Location / (o 600 Pa C Suite MEC
Contact Person 51ALIJ624 Ph (P - fl `7 PLM
Contractor /42 Ph SWR
BUILDING Tenant/Owner 401 1i(, iOOed /bd./ Q - ELC
Retaining Wall U ELR 199q-Doi 0 9
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Drywall on
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm r Q �
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
Service
Rough In
UG /Slab
(3
Low Voltage
Fire
• 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 reinspection RE: [ ]Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date li / 'p' Inspector de Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.