Permit i- CITY OF TIGARD
��L 1!„, i DEVELOPMENT SERVES ELECTRICAL PERMIT —
13125 SW Hall Blvd., Tigard, OR 97223 RESTRICTED ENERGY
PERMIT #: ELR98 -0294
EXPIRED DATE ISSUED: 10/23/98
PARCEL: 28112DD -01600
SITE ADDRESS...:15495 SW SEQUOIA PKWY #130
SUBDIVISION ZONING:I —P
BLOCK • LOT • JURISDICTN: TIG
Project Description: Electrical TI
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
PACIFIC REALTY ASSOCIATES type amount by date recpt
15350 SW SEQUOIA PKWY PRMT $ 40.00 B 10 /23/98 98- 310253
STE 300 SPCT $ 2.00 B 10/23/98 98- 310253
TIGARD OR 97223
Phone #: 624 -6300
Contractor:
ADT SECURITY SERVICES INC $ 42.00 TOTAL
703 NE HANCOCK
REQUIRED INSPECTIONS
PORTLAND OR 97212 Ceiling Cover Low Voltage Insp
Phone #: 284 -3265 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 -001 -0010 through OAR 952-001-ONO. You may obtain copies of
these rules or direct questions to OUNC at (503)246 -1987.
Issued by tg..644jkllid Permittee Signaturel&G��' (�('GIJI ��f�V'1�tJ�l
11 �� rvittcf
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 : OPr DATE:
LICENSE NO:
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + ++ + + + + + + + + + + + + + + + + + + + + ++
lir 1-ti
o • V V
C, Y ( iE TIGARD 1( t RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
1125 SW HALL BLVD io 98 Date Rec'd: lO zi7-
TIGARD OR 97223 / PRINT OR TYPE • _
V - 503 - 639 -4171 X304 Permit #: - 1. 1� ; 2 214
F - 503 - 684 -7297 Q INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd: ilh a�a.IQ
08,3 - / 1p d / -d / WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee $40.00
ALI-7-1/ &NA . V� � (--1/71-€0'
(FOR ALL SYSTEMS)
JOB Street Address to #
r �S� •W3 Check Type of Work Involved:
ADDRESS
9 titija,Pkg Cit Stat e / Zp 7a1 # ❑ Audio and Stereo Systems
In y G�
Na ❑ Burglar Alarm EXPIRED
n Garage Door Opener'
OWNER Mailing Address
City /State Zip Phone # ❑ Heating, Ventilation and Air Conditioning System*
Name ❑ Vacuum Systems*
ADT SECURITY SERVICES, INC. ❑ Other
701 NE HANCOCK
CONTRACTOR Mailing Address PORTLAND, OR 97212
L ) 2R4 -12A5 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. BldJ,i 4 Exp. Date
expired in C.O.T. 5 y 7 Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp. Date
24 )-Q 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 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. ❑ 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
El 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 - a fi - I inspection when all of the
corrections are completed. ❑ Other
Permits are non -trans - - de d n. - refundable and expire if work is not
started within 180 • : s of uan or if work is suspended for 180 days. • Number of Systems
The person i• in. or is • - rmit must be the applicant or a person • No licenses are required. Licenses are required for all other installations
authori • ": .i. . the : • : scant.
FEES:
Sig = � � 3 �� �
'ENTER FEES $ l D
5% SURCHARGE (.05 X TOTAL ABOVE) $ c2 i
Authority if other than Applicant TOTAL $ 10 . DV
iAdsts resele.doc 7/97 —
03/29/2000 Activities for Case #: ELR98 -00294
12:03:48 PM
EXPIRED
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRC001 Application Received 10/23/1998 B RECD BON 10/23/1998
ELRC003 Permit Created 10/23/1998 B DONE BON 10/23/1998
ELRC700 Ceiling Cover BON 10/23/1998 •
ELRC720 Wall Cover BON 10/23/1998
ELRC725 Low Voltage Inspection BON 10/23/1998
•
ELRC799 Electl Final ST 02/04 /2000 2/4/00- inspection request to
Hap
ELRC500 (F) Issue permit 10/23/1998 B PASS BON 10/23/1998
ELRA845 Request inspection research • 03/24/2000 JMT DONE No Hold JMT 03/24/2000
ELRC580 Expired by limitation 03/28/2000 HAP DONE No Hold AKJ 03/28/2000
•
•
Page 1 of 1
4/11/00 Activities for Case #: ELR98 -00294
3:40:34 PM • tier,
•
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRC001 Application Received 10/23/98 B RECD BON 10/23/98
ELRC003 Permit Created 10/23/98 B DONE BON 10/23/98
ELRC700 Ceiling Cover BON 10/23/98
ELRC720 Wall Cover BON 10/23/98
ELRC725 Low Voltage Inspection BON 10/23/98
ELRC799 Elect'I Final ST 2/4/00 2/4/00- inspection request to
Hap
ELRC500 (F) Issue permit 10/23/98 B PASS - 'BON 10/23/98
ELRA845 Request inspection research, 3/24/00 JMT DONE No Hold JMT 3/24/00
ELRC580 Expired by limitation 3/28/00 HAP DONE No Hold AKJ 3/28/00
•
•
Page 1 of 1
8
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
4-! ur Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested A PM BLD
Location 1 5 � 95 S 4 (jWI^& e ro L/ Suite ) 30 MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC ��+ [ /
Retaining Wall ELR �l A -- 00C % "7
Footing
Foundation NOT REQUESTED FPS
Ftg Drain FOUND DURING RESEARCH SGN
Crawl Drain I
Slab NO INSPECTION(S) FOUND IN FILE SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation � `` i
Drywall Nailing (�" •
/L_ C i
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam EXPIRED
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
•
Se -
Rough In
UG /Slab
Low Voltage
Fire Alarm
CMr
*ASS PART FAIL
SITE
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 i 0 Inspector L Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.