Permit • x
CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
Pak i DEVELOPMENT SERVICES PERMIT #: ELR1999 -00322
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/28/1999
SITE ADDRESS: 10330 SW SCHOLLS FERRY RD PARCEL: 1S134AB -03300
SUBDIVISION: ZONING: R -12
BLOCK: LOT: JURISDICTION: TIG
Project Description: Install burglar alarm. Job 991230903
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: ALARM X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
MUSLIM EDUCATION TRUST ISLAMIC BRINKS HOME SECURITY
PO BOX 283 8080 SW CIRRUS DR
PORTLAND, OR 97207 BEAVERTON, OR 97008
Phone: Phone: 641 -0574 ORIGINAL
Reg #: SUP 2650JLE
LIC 00044421
ELE 34166CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT KJP 12/28/199E $60.00 99- 320721 Elect'I Final
5PCT KJP 12/28/199. $4.80 99- 320721
Total $64.80
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 folio ules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 thro h AR 952 - 001 -0080. You may obtain copies of these rules or • • ect questions to O C at (503)
246 -1987. 1'
Issued by l Permittee Signature x
4
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 by:
13125 SWTIALL BLVD �// � Date Rec'd:
TIGARD OR 97223 hue 14q� PRINT OR TYPE I
V - 503 - 639 -4171 X304 J Permit #:Ft/f /if•• 00 31,1-
F - 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project / J (FOR ALL SYYSTESTE TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
MU /�n Eduda ,9 )1aX ru� Restricted Energy Fee $60.00
AMS)
JOB Street Address #
ADDRESS /03 0 ,14) Svio Check Type of Work Involved.
C as rd 1)97,1,13 444,21,2/ ❑ Audio and Stereo Systems
Name L ❑ Burglar Alarm
O
❑ Garage Door Opener*
OWNER Mailing Address
City /State I Zip I Phone # ❑ Heating, Ventilation and Air Conditioning System*
Name //� // ( ,, ❑ Vacuum Systems*
iir r?kl5 /4ThL cSei i,r /� ❑ Other
CONTRACTOR M in Address �'�
Q CP) drilij 1)Y TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a /State # Fee for each system $60.00
copy of all licenses �(�,�" �QV� h ne �, (SEE OAR 918 - 260 -260)
are required if Ore.. ontr Br i . # � . - q
expired in C.O.T 'if ° — l - 00 Check Type of Work Involved.
data base) Electrical Contr ic. p. D t?� ,/
c 9 / ` 1, M - 5U tIr ❑ Audio and Stereo Systems
C.O.T. or Metro Lic # Exp. gate
❑ 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 ❑ 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 j �,n
corrections are completed. \� Other ( /j'
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. I 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:
0`t) antad10--
Signature EN FEES $ ZOO
9 SURCHARGE (.95 X TOTAL ABOVE) $ 4 / • So OU o �
Authority if other than Applicant TOTAL $ 64.
i \dsts \forms\resele doc 3/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 2/I75 AM PM 00,
BLD
Location 1033D SCh '' 5 S •/) Suite MEC
Contact Person n W P�A Ph - 70g - 3(Y) PLM
Contractor f1 Ph SWR
BUILDING Tenant/Owner ti 5 t#1 T_ l l� ENAGA I - O A ELC
Retaining Wall GR ) / Jc 3ZZ
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: , 44 .L-
Slab �C / SIT
Post & Beam tn� —
Ext Sheath /Shear �/ - -- -
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler E q
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
Service
Rough In
UG /Slab
Low Voltage
Fir- • larm
PASS 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 7-og) Approach /Sidewalk Date Inspector G? VARZA / Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.