Permit CITY OF TIGARD
A
„, DEVELOPMENT SERVICES ELECTRICAL PERMIT —
- 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639.4171 RESTRICTED ENERGY
PERMIT #: ELR98 -0216
DATE ISSUED: 08/27/98
PARCEL: 2S101DC- 03900
SITE ADDRESS...:07150 SW SANDBURG ST
SUBDIVISION -SALEM FREEWAY SUBDIVISION ZONING:C —P
BLOCK LOT °004 JURISDICTN: TIG
Project Description: Electrical addition
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 •X PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER..: ..
TOTAL # OF SYSTEMS: 1
Owner: FEES
PACIFIC WESTERN BANK type amount by date recpt
PO BOX 15144 PRMT $ 40.00 B 08/27/98 98- 308651
WORCESTER MA 01615 5PCT $ 2.00 B 08/27/98 98- 308651
Phone #:
Contractor:
AMERICAN HEATING $ 42.00 TOTAL
1339 SW GIDEON ST
REQUIRED INSPECTIONS
PORTLAND OR 97202 Ceiling Cover Low Voltage Insp
Phone #: 239 -4600 Wall Cover Elect'1 Final
Reg #..: 000331
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 -m1 -0080. You may obtain copies of
these rules or dir questions to OUNC at (5 3)246 -1987.
I 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: 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 byr'
13125 SW HALL BLVD Date Recd: $ — ( o
TIGARD OR 97223 PRINT OR TYPE /
V - 503 - 639 -4171 X304 Permit : • — "' • i -'
F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cu ' all'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED- RE'SID.€NTIAL /
��` �� Restricted Energy Fee - $40:00 )
,�nsv. r'Gj ( L (FOR ALL SYSTEMS)
JOB Street-Address Ste #
ADDRESS 9 ISD Sw ard, buff Check Type of Work Involved:
C_ ity_LState Zip Phone # ❑ Audio and Stereo Systems
Name ❑ Burglar Alarm
7 A ' t- c cas '""" ❑ Garage Door Opener'
OWNER a o t (Sly'
ty /Sta a Zip Phone #
I ❑ Heating, Ventilation and Air Conditioning System*
U Ul6 Int (C IS l ❑
Name I p Vacuum Systems*
Amer'iaun (i;T L (2 ❑ Other
CONTRACTOR Mailing Address
9
13. S9, G t d� i ee
53 - i - TYPE OF WORK INVOLVED - COMMERCIAL
(Prior to issuance a ty /State �jP Pho ne # Fee for each system $40.00
copy of all licenses I { `� � ��-� {f) (SEE OAR 918 - 260 -260)
are required if Oregon ontr. Brd L c. # Exp. Date
expired in C.O.T. ;j3) 3S� (o -ItC -C1) Check Type of Work Involved
data base). Electrical Contr. Lic. # Exp. Date ❑
Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date
❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT El 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 ❑ 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. ❑ Other
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 I ust be the applicant or a person • No licenses are required Licenses are required for all other installations
authorized to bind the appli t
0 4 &AA/ r ..- 1 , FEES: akdrr\--e
Signature ENTER FEES $ 'a)
5% SURCHARGE (.05 X TOTAL ABOVE) $ a.OD
`r
Authority if other than Applicant TOTAL $ I C) DI)
I \resele.doc 12/96 _
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
/O /O 37i Date Requested 1 . / — 9 � AM PM BLD
Location 7 "5a U
SCO Q�d.. I lik ›dir Suite MEC
Contact Person ?AA-6r Ph 23 9- 4600 PLM
Contractor CQnt.PA X Ph SWR
BUILDING Tenant/Owner 6/4144.4/02/4.4./AAaAt « ELC p•
Retaining Wall
oi"D �O ' f n Jn/ /6
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab 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 O �
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
P FAIL
CTRICAL
Service
Rough In
UG /Slab
/ "l Voltages
rm
A SS 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 / � i Ext
Other Date f /1�/9 Inspector
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.