Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #: ELR95 -0204
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 DATE ISSUED: 11/13/95
PARCEL: 1S125DB- 06000
SITE ADDRESS...: 07130 SW SHADY LN
SUBDIVISION • SHADY DELL NO.2 ZONING:R -4.5
BLOCK • LOT •33
Project Description: Burglar alarm
A. RESIDENTIAL B. COMMERCIAL -
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM •X 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..: ..
TOTAL # OF SYSTEMS: 0
Applicant: •- FEES -
BRINKS HOME SECURITY type amount by date recpt
8059 SW CIRRUS DRNE PRMT $ 40.00 CJS 11/13/95 95- 272799
SPCT $ 2.00 CJS 11/13/95 95- 272799
TIGARD OR 97223
Phone #:
Contractor:
CONTRACTOR NOT ON FILE $ 42.00 TOTAL
REQUIRED INSPECTIONS
Ceiling Cover Elect' 1 Service
Phone #: Wall Cover Elect' 1 Final
Reg #.. :
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t e e Signature
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. Issued By
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: _9 7 Off, DATE: 1/- /3- 9S
LICENSE NO:
Call for inspection - 639 -4175
•
• Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT # EL/�gs 0 �Q�/
i 49, ' � 6(h�
Phone
FAX (503) 684 639-4171
297
T D 1 D No. (503) 684 -2772 DATE ISSUED //— /3 - ,- 95"
-- /
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY ("' a �es c A 7 /d/
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
2"(30 siu. .
Addres � RESIDENTIAL — Restricted Energy Fee $40.00
— U w (FOR ALL SYSTEMS)
Ci State Zip Check Type of Work Involved:
PERMITS
S OT STARTED WITIN NON-TRANSFERABLE 8 DAYS OF ISSUANCE OR IF WORK IS EXPIRE
S OFOR ❑ Audio and Stereo Systems*
180 DAYS. Bur Alarm
2. CONTRACTOR APP ICATIION ❑ Garage Door Opener*
..r / �/ VI6112.- � ❑ Heating, Ventilation and Air Conditioning System*
Contracto - ` Type l. �� /p/ ❑ Vacuum Systems*
Q�, �� af €Z, ❑ Other
Address EbSf Jeri , ` iie.L.Z.0
Date 1/ £ f ' S COMMERCIAL — Fee for each system $40.00
/ / / SCE (SEE OAR 918- 260 -260)
Property Owner / ' ( Check Type of Work Involved:
�
Contractor's Board Reg. No. Yo, ( ❑ Audio and Stereo Systems*
Phone# `� (
i // 0 7 1( ❑ Boiler Controls
❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No
❑ Instrumentation
Address ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
City State Zip ❑ Medical
This permit is issued under OAR 918- 320 -370. This applicant agrees to make only ❑ Nurse Calls
restricted energy installations (100 volt amps or less) under this permit and to do the ❑ Outdoor Landscape Lighting*
following:
1. Only use electrical licensed persons to do installations where required. (Certain ❑ Protective Signaling
residential and other transactions are exempt from licensing. These have ❑ Other
asterisks( *). All others need licensing).
2. Call for an inspection when all of the installations under this permit are ready
for inspection at 503- 639 -4175.
❑ Number of Systems
3. Purchase separate permits for all installations that arc not ready for inspection
when the inspector is out to inspect under this permit. * No licenses are required. Licenses are required for all other installations.
4. Assume responsibility for assuring that all corrections required by the inspector
are done, and
5. Assume responsibility for calling for a final inspection when all of the corrections 5. FEES
are completed.
The person signing for this permit must be the applicant or a person a. Enter Fees $ yo
authorized to bind the applicant.
b. 5% Surcharge (.05 x total above) $ _2-
Signature
A frliet TOTAL $
Authority if other than applicant
ENERGAP.CHP
3/7/00 Activities for Case #: ELR95 -00204
2:09:50 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRA003 Application received 11/13/95 CJS RECD TMP 11/13/95
ELRA010 Permit created 11/13/95 CJS RECD TMP 11/13/95
ELRA720 Wall Cover 11/13/95 TMP 11/13/95
ELRA730 Elect'I Service 11/13/95 TMP 11/13/95
ELRA799 Elect'I Final 11/13/95 ST 2/4/00 Inspection request for research
to Chuck D. 9/18198.
2/4/00- inspection request to
Hap
ELRA003 Application received 11/13/95 CJS RECD TMP 11/13/95
ELRA010 Permit created 11/13/95 CJS RECD TMP 11/13/95
ELRA700 Ceiling Cover 11/13/95 TMP 11/13/95
ELRA500 (F) Issue permit • 11/13/95 CJS PASS TMP 11/13/95
ELRA920 Miscellaneous action 4/26/99 AKJ DONE No Hold AKJ 4/26/99 inactivity letter sent
ELRA580 Expired by limitation 2/23/00 RB DONE No Hold AKJ 2/23/00
•
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
241-lour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location 7 Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR) 95 -o52,0(i
Footing
- Foundation NOT REQUESTED FPS
Ftg Drain - FOUND DURING RESEARCH ® SGN
Crawl Drain
Slab NO INSPECTION(S) FOUND IN FILE (Q1 �-d` SIT
Post & Beam 1 rr /,�
Ext Sheath /Shear - vl `�'�
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
TR
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm EX iRED
CFinal'
PPCS ' 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 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.