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_ 12298 SW ANTOL+ DR _
J,�q6 CITY OF TIGARD BUILDING INSPECTION DIVISION _
MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BUP
Date Requested
r ^ AM _PM BLU
Location Suite MEC ----------
Contact Person Ph PLM
Contractor Ph SWR
BUILDINGi� Tenant/Owner ELC
Retaining Wall _~----�-- -_ ELR _
Footing A NOTREQUESTED
Foundation FPS
Ftg Drain FOUND DURING RESEAR(-;I
Crawl Drain It NO INSPECTION(s) IN FII,E, :IGN
Slab — SIT
Post&Beam —
Ext Sheath/Shear
Int Sheath/Shy:ar
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler - - --_---..__-___—_ ___-----
Fire
___Fire Alarm
Susp'd Ceiling
Roof
Misc: - --
Final
PASS PAR r FAIL --- -- - - --
PLUMBING
Post&(seam
Under Slab _
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PARI FAIL
MECHANICAL
Post& Beam --_-
Rough In
Gas line - ---
Smoke Dampers
Final ---.. --- --
PASS PART : AIL
LECT I At_ -------- ___�
Rough In
UG/Slab -
Low Voltage
Firqhlarrn
incl/
SS FART 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 ( I Please call for reinspection RE: _ ( )Unable to inspect-no access
ADA
Approach/Sidewalk Date Inspector Ext
Other —
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
I -
CITY OF TIGARD
DEVELOPMENT SERVICES
13125,,.,*Hall Blvd., Tigard,OR 97223 (503)639.4171 ELECTRICAL PERMIT
RESTRICTED ENERGY
PERMIT #: ELR97-0016
DOTE T SSLIED: 01 /1.3/97
PARCEL: 1a1.34CR-17500
IT1= ADDRr=SS. . . : 1 L J`31R SW ANTON DR
SUBDIVISION. . . . : ANTON PARK II ZONING: R-7 FAD
111-OCK. . . . . . . . . . .. L_.o,r. . . . . . . . . . . . . . ..a
1=,roject Description: in ,t1. burglar alarm
I"1. RE5I DENT I AL–_--.----- B.
COMMERCIAt-
AUDIO R STEREO. . . : AUDIO R STEREO— : INTERCOM & PAGING. . -
BURGLAR
AGING. .BURGLAR ALARM. . . . : X BOILER. . . . . . . . . . : L-ANDSCAPE/T.RRIGAT. .
GARAGE OPENER. . . . . CI.-OCK. . . , . . . . . MEDICA. . . . . . . . . . . .
1-IVAf_'. . . . . . . . . . . . . DATA/TELE COMM. . . NURSE. CALLS. . . . . . .
VACUUM SYSTEM. . „ . : FIRE ALARM. . . . . . : OUTDOOR LANDSC LITE:
f)THER: . . HVAC. . . . . . . . . . . . . PROTECTIVE, SNAL.. . .
LNST RUMENTATION. : OTHER. . e . .
TOTAL # OF E;YE TEM S: 0
Owne+r . - - --_.______._____________._..___–___.__._._____.____________._ FEES
HIDEMAO KIMURA type amol.int by date recpt
12298 SW ANTON DR PRMT $ 40. 00 TAT 01 /1:3/97 9'7--,' Rflh, (
SPCT $ �='. 00 TAT 01/13/97 97-288846
1 I CARD OR 97223
1-shone #:
ADT SECURITY ALARMS $ 42. 00 TOTAL -
703 NE HANCOCK
------- REOUTRED INSPECTIONS
DOPTL..AND OR 9721' Ceiling (.over Elect' I Service
Phone #: 503--284- 3P6'7 Wall. Cover Elect' ]. Final
Reg #. . : 5994+
This permit is issued subject to the reguiatiors contained in the
Tigard Municipal Code, Starr of Ore. Specialty Codes and all other Permittee Signati.cre )
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 tore
+han 168 days. Issi.ied Ry
INSTALLF�7IOhd O1'4 � --__
,he i;istalla►tion is being made on property I ow, which is not intended for
-ale; Iease, or rent.
'i4l.EPI S SIGNATURE: — DATE: --. �-
__._ --_–_CONTRACTOR INSTAL-I_ATTON ONI Y----_.._._.... ..__ ........-___
.1 UNATURE. Or SUPR. ELEC' N: DATE::
ICENSE NO:
Call for inspection 639-- `+175
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd. �l
Tigard,OR 97223 PERMIT#
�L Phone(503)6.39-4171
FAX (503)684-7297 DATE ISSUED
TDD No. (503) 684-2772
CITY OF TIOARD Inspection (503) 639-4175 ISSUED BY _
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
/a >8 5iy a� zr, �Qu� _
Addres r N1 IAL—Restricted Energy Fee . . . . . . . . . 140.00y 7�.13 (FOR ALL SYSTEMS)
City Stdte Zip Check Type of Work Involved:
PERMITS ARE NON-TRANSFLRABLE AND NON-REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems
IS NOT STARTED WITHIN 100 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
trs0(JAYS rM Burglar Alarm
8141- //8 7'1-D 1( n Garage Door Opener'
2. CONTRACTOR APPLICATION
❑ Heating,Ventilation and Air Conditioning Syste n•
Contractor AM"Ctlttlflr INC- Type_— �4LO,1r►li_� ❑ Vacuum Systems"
703 NE HANCOCK ❑ Other
Address MRTt AND,OR 97211
--
Date�_ 1 Ci iMMERCIAL—Fee for each system . . . . . . . . . 140.00
(SEE OAR 918-260-4160)
Property OwnerC�rr►2C-41� _�__ 'heck Type of Work Involved:
Contractor's Board Reg. No. alG"':Ro ID ❑ Audio and Stereo Systems
r Boiler Controls
Phone # __ U Clock Systems
❑ Data Telecommunication Installations
3. OWNER APPLICATION
❑ Fire Alarm Installation
14den Ll & mttro -5�2'J 32y ❑ HVAC
Print Owner's Name Phone No ❑ instrumentation
I
Address Cl Intercom and Paging Systems
❑ Landscape Irrigation Control'
City State Zip ❑ Medical
This permit is issued under OAR 9111.320-370.This applicant agrees to make only ❑ Nurse Calls
restricted energy Installatinns H(H)volt amps of less)under this permit anti to do the ❑ Outdoor Landscape Lighting'
following
El Protective Signaling
1. ()n;y rise electrical licensed persons to do installations where required.(Certain
ro'dentlat and other tranuctions are exempt from licensing.These have ❑ Other _
asterisks(*).All others need lirensing).
2 t all for an inspection when all,`the Installations under this permit aro ready
�
fnr inspection at 503.634.417.1)'. ❑ _Number of Systems
3 Purrhaso 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 other installations.
4 Assume responsibility for assuring that all corrections required by the inspector
are done,and
5. Asswne responsibility for calling for a final inspection when all of the 5. FEES
corrections are completed
�s
The person signing for thi it must he the applicant or a person a. Enter Fees s_
authorized to bin the it �Ii nt.
rte, b. 5% Surcharge(.05 x total above) $ 2 t ��
Sfgnat TOTAL
Authority if other than applicant
ENE'<GAP.CHP