Permit CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT ELECTRICAL PERMIT —
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 RESTRICTED ENERGY
PERMIT #: ELR95 -0193
DATE ISSUED: 11/07/95
PARCEL: 2S101DB -00901
SITE ADDRESS ° °.2 07145 SW VARNS ST
SUBDIVISION VARNS ACRES ZONING:C —P
BLOCK ° LOT •12
Project Description: HVAC system
•
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 ° °:
INSTRUMENTAT ION. : OTHER..: .°
TOTAL # OF SYSTEMS: : 1
Owner: • - - -- -- -- FEES - - - -- - -- —•--
FIRST PORTLAND LEASING type amount by date recpt
7145 SW VARNS PRMT $ 40 °00 JSD 11/07/95 95- 272616
5PCT $ 2.00 JSD 11/07/95 95- 272616
PORTLAND OR 97223 •
Phone #: 684 -3417
Contractor: • - - - --
MARKMAN, INC. $ 42.00 TOTAL
9955 SE ASH •
REQUIRED INSPECTIONS
PORTLAND OR 97216 •
Phone #: 503-255-9923 •
Reg #..: 102857 • _
This peroit is issued subject to the regulations contained in the i
Tigard Municipal Code, State of Ore. Specialty Codes and all other - rm 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 182 days of issuance, or if work is suspended for Dore ``� •
than 180 days. I sued •y
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 for inspection — 639 -4175
•
•
Ci_771(
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd. _____
/�
Tigard, OR 97223 PERMIT # EL'S Is O(1
As ,, Phone (503) 639 4171 j
II�I�I'I FAX (503) 684 -7297 DATE ISSUED ! /- _ —
- TDD No. (503) 684 -2772 ��
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY "
—..w
PLEASE COMPLETE ALL SECTIONS
• 1. LOCATION OF INSTALLATION 4. TYPE OF WORK
1 l LI, J s UJ V n.-S
Address RESIDENTIAL — Restricted Energy Fee $40.00
o o k R7 zz3 (FOR ALL SYSTEMS)
City State Zip Check Type of Work Involved:
PERMITS ARE NON - TRANSFERABLE AND NON - REFUNDABLE AND EXPIRE IF WORK . ❑ Audio and Stereo Systems*
IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
180 DAYS. ❑ Burglar Alarm
❑ Garage Door Opener*
2. CONTRACTOR APPLICATION Heating, Ventilation and Air Conditioning System*
Contractor) N . ." Type 1 a �S S ,� ❑ Vacuum Systems*
Address G &Sv\ � �"Cl r C�IA��.14 ❑ Other
Date — Q S COMMERCIAL — Fee for each system $40.00
( (SEE OAR 918 - 260 -260)
Property Owner t 5 h r\ - -tl l.� L ( Check Type of Work Involved:
Contractor's Board Reg. No. I'k c1 7 ❑ Audio and Stereo Systems*
❑ Boiler Controls
Phone # ..-CS Q- c( eL3 ❑ 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* I
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.
❑ c Numher of Systems
3. Purchase separate permits for all installations that are not ready for inspection
when the inspector is out to inspect under this permit. * No licenses are required. Licenses are required for all oth1 r 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 $ 1 4 1 9.
authorized to bind the applica .
� b. 5% Surcharge (.05 x total above) $ 2 —
S' nature ,
TOTAL $ 1.1 Z, D
Authority if other than applicant
ENERGAP.CHP
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested " S AM PM BLD
Location .7/ �s V ����iy��L, S��1X-E�� Suite MEC qs 6 333
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC 2
Retaining Wall ELR cl s-' -o iq 3
Footing A G am �, . ,;,E
Foundation NOT REQUEST D FPS
Ftg Drain
Crawl Drain FOUND DURING RESEARCH — SGN
Ir
Slab NO INSPECTION(s) IN FILE — SIT
Post & Beam
Ext Sheath /Shear — - -
Int Sheath /Shear
Framing
Insulation
Drywall Nailing I '�
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof C sC-
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
ECHANICAL •
Rough In
Gas Line
S e Dampers
'ART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk ��/ .� / �� ��
Other Date /( - r---- p Inspector Ext
Final
PASS PART - FAIL. DO NOT REMOVE this inspection record from the job site.