Permit ELECTRICAL PERMIT -
CITY TIGARD RESTRICTED ENERGY
,k DEVELOPMENT SERVICES PERMIT #: ELR2000 - 00128
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/5/00
SITE ADDRESS: 15830 SW UPPER BOONES FERRYRD BLD.0 PARCEL: 2S112DD
SUBDIVISION: ZONING: I -
BLOCK: LOT: JURISDICTION: TIG
Project Description: Install rpotective signaling.
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: Contractor:
PACIFIC REALTY ASSOCIATES BRINKS HOME SECURITY
15350 SW SEQUOIA PKWY #300 -WMI 8080 SW CIRRUS DR
PORTLAND, OR 97224 BEAVERTON, OR 97008
Phone: Phone: 641 - 0574
Reg #: SUP 2650JLE
LIC 00044421
ELE 34166CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT KJP 6/5/00 $60.00 0002693 Elect'l Final
5PCT KJP 6/5/00 $4.80 0002693
Total $64.80 G� AL
oR�
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 r = adopted by ie Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 - 0010 out 'AR 952 -00 ei80. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987. /
Issued b. • ' ' _ Permittee Signatur
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: v/ DATE: 6- -06
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
X693
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by:
13125 S,V .I -TALL BLVD • Date Rec'd:
TIGARD OR 97223 PRINT OR TYPE 1 '
V - 503 - 639 -4171 X304 f — ° -irnit #:tLtaaV - v/ 3 F - 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPLIC , s• • - Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee $60.00
(FOR ALL SYSTEMS)
JOB Street Address St #
ADDRESS SQ� V �
Check Type of Work Involved:
:var, i State SO � Z p Phone # ❑ Audio and Stereo Systems
Name ` 0 / ; - V u ❑ Burglar Alarm
5 / / 11 I 1 - OephPl, ❑ Garage Door Opener*
OWNER Mailing Address
City /State I Zip I Phone # ❑ Heating, Ventilation and Air Conditioning System*
Name ri Vacuum Systems*
B r a\ 4')/Y\e__—. LAr:ci -N1 ❑ Other
CONTRACTOR Marlin Address
,t,J C.Yrus - TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /State I Zip Phone # Fee for each system $60.00
copy of all licenses P.f^At 4or ■- q tagl -0(W. (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Brd Lic # � Exp Date
expired in C.O T. `7`7q4i 16- Oh Check Type of Work Involved:
data base). Electrical Contr. Lic # Exp. Date
3 f /0 _Oh n A udio and Stereo Systems
C.O.T. or Metro Lic. # c).14 Ex . Date
'� / 0 -OD ❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT n Data Telecommunication Installation
City /State Zip Phone # n F ire 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; n 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 n Outdoor Landscape Lighting'
inspector are done, and;
P rotective Signaling
5. Assume responsibility for calling for a final inspection when all of the
corrections are completed n 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 must be the applicant or a person * No licenses are required Licenses are required for all other installations
authorized to bind the applicant.
" 'A 01) adlLIIIAA—
FEES:
Signature E,tITER FEES $ (Oa ��0 op Q
Nii CO
SURCHARGE (4f5 X TOTAL ABOVE) $ L Oo
Authority if other than Applicant TOTAL $ /09- 8"V
r \dsts \forms \resele doc 3/98
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
7 4240 Date Requested /�/� n ' 0 On AM PM BLD
Location /58 3 0 ,5-60 U//'z /c 4A)L Suite MEC
Contact Person 1r r/1 ' NAP Ph 4a4—/9/ PLM
Contractor 2/1Jk l+0!`{G C J �AC,r E Ph /- / - D6/ SWR
BUILDING Tenant/Owner •
Retaining Wall 110O ' oo /9'O U
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab � E/ ,Jb 7? 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
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
ELECTRICAL
Service
Rough In
UG /Slab
w olta e
ire larm
Fin
SS, PART FAIL
ITE
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 1 Inspector Ext
Final
PASS BART FAIL I O NOT REMOVE this inspection record from the job site.