Permit A �� ELECTRICALPERMIT -
CITY OF TIGARD
RESTRICTED ENERGY
wlj" DEVELOPMENT SERVICES PERMIT #: ELR2000 -00199
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/24/00
SITE ADDRESS: 13110 SW WELLINGTON PL PARCEL: 2S104DB -03400
SUBDIVISION: AMESBURY HEIGHTS ZONING: R -4.5
BLOCK: LOT: 034 JURISDICTION: TIG
Project Description: Installation of an all encompassing restricted energy 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: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
J MICHAEL MCWHIRTER ELECTRONIC PROTECTIVE SERVICE
25570 SW LABROUSSE RD 2865 SE HARRISON ST
SHERWOOD, OR 97140 PORTLAND, OR 97214
Phone: 625 -5830 Phone: 233 -5260
Reg #: ELE 26- 1013CLE
LIC 128562
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 8/24/00 $60.00 2720000000 Elect'l Final
5PCT CTR 8/24/00 $4.80 2720000000
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
require • • • • • low rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0% 1 -0010 thro OAR 952 - 001 -0080. You may obtain copies of these rules or dire uestions to OUNC at (503)
246-1z 87.
Issue. by d .►'/' I Permittee Signature x
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
13125 SW BALL BLVD Date Rec'd:
TIGARD OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #: ea Q 0o!
F - 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS 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 Ste #
ADDRESS / 3 Ho 560 Check Type of Work Involved:
ii //State Zip Phone # Audio and Stereo Systems
Name � Burglar Alarm
OWNER Mailing Address
El
Door Opener*
City /State Zip Phone # F Heating, Ventilation and Air Conditioning System*
Name ❑ Vacuum Systems*
'L�i (-4C �5'�� C j
� ) p Other
CONTRACTOR Ztti c b- kKAA sow
J r TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a /State zip Phone # Fee for each system $60.00
copy of all licenses i�t"Z- 8-,4"� ? 7'Zt (7 23, -5 (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Brd Lic. # E x Date
expired in C 0 T / Z 4Z 7 S-2 2_ Check Type of Work Involved.
data base). Electrical Contr. Lic # xp. Date
L w
i 3 C 6,-1-0 / p ( p ❑ Audio and Stereo Systems
C.O.T. or Metro Lic # E p. Date
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,
El 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 must be the applicant or a person • No licenses are required Licenses are required for all other installations
authorized to bind the applicant
FEES: °
a ire ENTER FEES $ W O'O
8% SURCHARGE (.08X TOTAL ABOVE) $ 4/ ' 0 U
Authority if other than Applicant TOTAL $
i \dsts \forms \resele doc 3/98
CITY OF TIGARD BUILDING INSPECTION DIVISION • MST
- 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
tr �6 BUD
r rA 1471-1- Date Requested AM PM BLD
Location /71 /v 5 to al- 7 Suite MEC
Contact Person Ph 233 3 5 ' PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR aq0a�di
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 A1/4
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
Et;'TRRCAL
Service
Rough In
UGUG /SI
Fire Alarm
F'
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
Approach /Sidewalk Date Inspector „,„„,,L _ _
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.