Permit CITY OF T I GA R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
:44," 11i4 DEVELOPMENT SERVICES PERMIT #: ELR2000 -00033
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/9/00
SITE ADDRESS: 15838 SW UPPER BOONES FERRYRD B D;G- PARCEL: 2S112DD -00701
I
SUBDIVISION: ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Protective signaling and CCTV
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: CCTV. X
TOTAL # OF SYSTEMS: 2
Owner: Contractor:
PACIFIC REALTY ASSOCIATES ADT SECURITY SERVICES, INC
15350 SW SEQUOIA PKWY #300 -WMI 2815 SW 153RD DR
PORTLAND, OR 97224 BEAVERTON, OR 97006
Phone: Phone: 503469 -7100
Reg #: LIC 0059944
ELE 26209CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT BON 2/9/00 $120.00 00- 321645 Elect'I Service
5PCT BON 2/9/00 $9.60 00- 321645 Elect'l Final
Total $129.60 ORI GINAL
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 • M,A �- Permittee Signature �LCAVI - AVIA(
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 ICI f'� DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD RESTRICTED ENERGY ELECTRICR IMPTION Rec'd by: E
131y ?6 SW HALL BLV - Date Recd: Z-/-24000 rIGARD��(��R 97223
\I - 503- 639 -4171 X304 lT / P RINT OR TYPVEB 9 2000 Permit #: EL eZa» 6113
- 503 598 - 1960 INCOMPLETE OR ILLEGI ��� PIV I N1 Cust.Call'd:
WILL NOT BE A
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
I^^ Restricted Energy Fee
Je) (� Y I ` IBC/ (FOR ALL SYSTEMS) $60.00
JOB Str Althea,
et Address 1 Ste #
ADDRESS / 3g stk.) ,�/ j „ ,,,k0A .- , , Type of Work Involved:
C, /...ate one #
�� � � � El
and Stereo Systems
`II ,.r17 /. //eRei I //�Iti - /• A-
7
art7e) n ❑ Burglar Alarm
OWNER Mailing M I - ❑ Garage Door Opener*
5� �� I / - Ventilation and Air Conditioning S
)ity/St e Zip Phone # ❑ Heating, 9 stem•
Y
17 VIII I bZ1-6
al
❑ Vacuum Systems*
Ah7&JAI Other
.CONTRACTOR Mailing Addre ,
4e6 � 3 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Prior to issuance a --Sity/State p 7,)6 �p s` P one # Fee for each system $60.00
copy of all licenses , 1J' � 4 7 1)d (SEE OAR 918 -260 -260) -
are required if Orego_ri Co tr. r Lic. # ExuD l
✓
expired in C.O.T. q4 -/7 d/ Check Type of•Work Involved:
data base). Elect cal Coonttr. Lic. # Exp ate
PJ 9
it) ,:t-U ❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # E . Date
❑ Boiler Controls
Owner's Name
OWNER - Mailing Address
•
❑ Clock Systems
APPLICANT ❑ Data Telecommunication Installation
City/State Zip Phone # ❑ ;
Fire Alarm Installation
nis permit is issued under OAE 918 -320 -370. This applicant agrees to
ake only restricted energy installations (100 volt amps or less) under this ❑ HVAC
lrmit and to do the following:
❑ Instrumentation
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; - .
Call for inspections when installation under this permit are ready for ❑ Landscape Irrigation Control*
inspection at 503 - 639 -4175; ❑ Medical
Purchase separate permits for all installations that are not ready for an
inspection when the inspector is out to inspect under this permit; ❑ Nurse Calls
Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting*
inspector are done, and;
Protective Signaling ,
Assume responsibility for calling for a final inspection when all of the ^ �'
corrections are completed. Other i
' are non - transferable and non - refundable and expire if work is not
3 rted within 180 days of issuance or if work is suspended for 180 days. Number of Systems
le person signing for this permit must b the applicant or a person • No licenses are required. Licenses are required for all other installations
, thorized to bind a applicant.
•
FEES:
9natUre ENTER FEES $ / 0,9
8 % SURCHARGE (.05 X TOTAL ABOVE) $ 7,21- _ lthority if other than Applicant TOTAL $ 411r11
;tslforms\resele.doc 3/98
3/6/00 Activities for Case #: ELR2000 -00033
8:58:22 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRC001 Application Received 2/9/00 BON DONE No Hold BON 2/9/00
ELRC003 Permit Created 2/9/00 BON DONE No Hold BON 2/9/00
ELRC725 Low Voltage Inspection No Hold BON 2/9/00
ELRC730 Elect'I Service 2/9/00 2/9/00 No Hold BON 2/9/00
ELRC799 Elect Final 2/9/00 2/9/00 2/22/00 BRP PASS No Hold AKJ 2/22/00
ELRC500 (F) Issue permit 2/9/00 BON DONE No Hold BON 2/9/00
ELRC800 Case finaled 2/22/00 AKJ DONE No Hold AKJ 2/22/00
•
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested Z /22 /0t� AM PM BLD
Location I S' G PfYY bO 6 Suite A _ MEC
Contact Person ryp Ph CO / 'Zi) 3173 PLM
Contractor Ph �7(pq'7Z/( SWR
BUILDING Tenant/Owner ELC
Retaining Wall R 2:C) 00 –6 3 3
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 , r 4 15
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
krEtTRICAC)
Service
Rough In
UG /Slab
Low Voltage
Fi
PASS P RT 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: Al [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date - 22 " ' Inspector A, Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.