Permit CITY OFTIGARD
.
yi � ,�, DEVW L OPMENT � SERVI ELECTRICAL PERMIT - '
.. RESTRICTED ENERGY
PERMIT #: ELR97 -0305
DATE ISSUED: 10/29/97
PARCEL° 2S104CD -09900
SITE ADDRESS— :13684 SW TRACY PL
SUBDIVISION ° H I RE ESTATES NO. '2 ZONING: R-7 PD
BLOCK LOT. °o ° ° ° ° ° ° ° °° °:098 JURISDICTN: TIG
Project Description : Installation of residential backflow prevention tieing
device.
A. RESI DENT IAL--- ••_-- - - - - -- B. COMMERCIAL - - - -- ------ • .__7-- ..__- -. -.._
AUDIO & STEREO° ° °: AUD1'0 & STEREO ° °: INTERCOM & PAGING. °:.
BURGLAR ALARM BOILER LANDSCAPE/ IRRI GAT. °tX
GARAGE OPENER. ° : CLOCK ° MEDICAL °
. HVAC °• DATA /TELE COMM...: NURSE CALLS °
VACUUM SYSTEM. ° °.: FIRE ALARM OUTDOOR LANDSC LITE:
OTHER: °° HVAC ° PROTECTIVE SIGNAL ° °:
. INSTRUMENTATION.: OTHER..: OR
TOTAL ## OF SYSTEMS: 1
Owner: .- _. ._•..-
WINDWOOD HOMES type amount by date recpt
1407E SW BENCHVIEW TERR PRMT $ 40.00 DRA 10/27/98 97•- 300438
TIGARD OR 97224 5PCT $ 2.00 DRA 10/27/98 97- 300438
Phone. #: . . • • •
•
C ontractor: ---- - - - - -- - - - -- - ------- - - - - -- -----
CEDAR LANDSCAPE $ 42.00 TOTAL
14375 SW PATRICIA
- -- - - -- REQUIRED INSPECTIONS --
HILLSBORO OR 97123 Low Voltage Insp - _
Phone #: 628-3411 Elect' 1 Final
Reg #° ° : 0001ZI58 ,
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 rule adopted by the
Oregon Utility Notification Center. Those. rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0080. You nay obtain copies of
these rules 9p-direct questions to DUNG at (503)246 - 1987.. •
Issue y , &�N`C1 A, Permittee Signature] .�L .: ‘ •
d
- - -- -- OWNER INSTALLATION ONLY -• --- - The installation is being made on property 1 own which is not intended for
sale, lease, or rent.
OWNER'S SIGNATURE: ' DATE: , .
__.___._.._ .__..-------- .------ -CONT' •CTOR INSTALLATION ONLY---- --- •-- - - -_ -- -- _ .__-___
SIGNATURE OF SUPR. ELEC' N: i. I DATE: __
LICENSE NO: __ -_--_.
- F.+ + + + + + ++++ + ++ + + ++ + + + +++++++ + + +-I ++++ + + + +-F -I +++ +++..- 1- + + +++ ++ + + + + + + + ++++ + + +-I + +++++ +-1 (-
Call 639 -4175 by.7<00 P.M. for an inspection needed the next business day
- F-- •r +++ + + + + ++ + + + + + + + ++ ++ + + + + +-1 ++ + + + + ++ ++ ++++ +-1- + + +++-1 + + + + ++ ++ ++ + + ++ +++ + +-1- + +-h-1 -4 ++-1••+
•
•
1•
CITY I.
TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd : 4 a
13125 SW HALL BLVD Date Rec'd: ID
TIGARD OR 97223 PRINT OR TYPE /�
V - 503 - 639 -4171 X304 Permit #: ti,t 7
F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL
// / �j Restricted Energy Fee $40.00
/// / /Sh/QE EST. JoY � 0 (FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS /, 65 '1 514/ rRACy , Check Type of Work Involved:
City /State Zip Phone # ❑ Audio and Stereo Systems
T�A,er DQ 97 .223
Name ❑ Burglar Alarm
OWNER Mailing Address
El
Door Opener*
City /State Zip I Phone # ❑ Heating, Ventilation and Air Conditioning System*
Name ❑ Vacuum Systems'
CE'•ArQ 144ND SCi➢PE .Lw. ❑ Other
CONTRACTOR Mailing Address
/4�75 scd P.vraiclA FIVE TYPE OF WORK INVOLVED - COMMERCIAL
(Prior to issuance a City/State Zip Phone # Fee for each system $40.00
copy of all licenses ' /s4 j , 0,4, 97/ 64 3 // (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Brd Lic. # Exp. Date
expired in C.O.T. 5843 6 -97 Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp. Date
❑ Audio and Stereo Systems
C.O.T. or Metro Lic. it Exp. Date
❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT ❑ Data Telecommunication Installation
City/State Zip I 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;
IIK 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. 1 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.
C et,„,./-e.-- 6(.4-1-1 U 0
Signature ENTER FEES $ 4
ow
5% SURCHARGE (.05 X TOTAL ABOVE) $
.2
00
Authority if other than Applicant TOTAL $ 4 2.
iAresele.doc 12/96 _
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location /3&H -5G!/ 4Ce__ Suite MEC
Contact Person Ph PLM
Contractor / . ��/1 GCS 4 Ph ii 2J - .-? V/ // SWR
BUILDING Tenan Owner J �ae-,e4,,. ELC
Retaining Wall ELR 9 7- a3C5
Footing
Foundation
FPS
Ftg Drain I.OZREQUESTED SGN
Crawl Drain l i E�OUND DURING RESEARCH
Slab INSpECTION(s) IN FIL� SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler / !.! - ! • —�� - :.._ _
Fire Alarm
Susp'd Ceiling 2P-A%-v % i ( J
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 as In
Gas
a Line
Smoke Dampers
Final
PAS L ZART FAIL
ILECTRICAL,)
Service
Rough In
UG /Slab
Low Voltasld
Fire Alarm
1 i
PASS PART FAIL
SITE
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 - 0 /0 Inspector • Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.