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,n CITY OF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 E1_FCTRTCAL PERMIT
RESTRICTED ENERGY
PERMIT #: ELR98-0331
DATE ISSUED: 12/14./98
PARCEL., .'S10_CP 4000
SITE ADDRESS. . . : 12985 SW GRANT AVE
SUBDIVISION. . . . :NORTH TIGARDVILLE ADDITION ZONTNG: R--t2
BLOC!'. . . . . . . . . . : LOT. . . . . . . . . . . . . :04 1. JURISDICTN: TIG
V'roi ect De script ion: CF rijaid Scrip Modular
—------- ---------------------------------
n. PESIDENTIAL---------- D.
AUDIO & STEREO. . . : AUDIO & STEREO. . : INTERCOM A. PAGIN13. . -
BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : I-ANDSCAPE/I RRI BAT. . :
GriRPSER OPENER, . . . - CLOrK. . . . . . . . . . . : MEDICAL. . . . . . . . . . . . ..
HVAC. . . . . . . . . . .. . . .. DATA/TELE COMM. . . NORSE C4LL3. . . . . . . . :
VACUUM SYSTEM....:: FTPE ALARM. . . . . . . OUTDOOR LPNDSC LITE:
(ITHER: I IVAC. . . . . . . . . . . . . PROTECT I VE 6 T.GNAL. . :Y
INSTRUMENTATION. : OTFIFR_ :
TOTAL # OF SYCI"E-MS: I
Owner: FEES
S)CHOL".)L DISTRICT #23 type amount by date recpt
PRMT $ 40. 00 JSD 12/14/98 98-311498
TIGARD OR 5PCT $ 2. 00 JSD 12/14/98 98--111498
Phoi)e #:
Contractor-: -----___—__--.___---_._________________________._---__
!IONITROL PACIFIC 42. 00 TOTAL
1975 SW 6TH AVE
REPUIRED INSPECTIONS
PORTLAND OR 97201 Ceiling Cover Low Voltage Insp
Phone #c 223-5822 Wall Cover Flert' l Final
Reg #. . - 000535
This permit is issued subject ti the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
&n.plicable laws. All wore will be done in accordance with approved plans. This permit will expire if work is not started within 180
days of issuance, or if w,irk ii suspended for aore than 180 days. ATTENTION: Oregon law requires you to follow rule adopted by the
Oregon Utility Notification renter. -Those rules ar _4#t._ikrth in OAR 952-001-0010 through W 9521-00I-0080. You may ob in copies r
these rules or direct questipm at (502)246'-1987,
T F,S U e(f 5Y
Permittee Signatu,
INSTIALLATTON
The installatian is being made on property I own which is not intended for
sale, lease, or rent.
OWNER' S SIGNATURE: DATES
...... INSTALLAT.70N ONLY---.--
SIGNATURE OF S1JPR. ELEC9N: DPTF.-
LICENSE NO:
....++4+f+4•.......i++++++++4.................4......4.........4.....................
Call 639-4175 by 7-00 P. M. for an inspection needed the ne)(t business day
+.++++++-o..................................4-4............................4............
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CITY OF TIGi RD RESTRICTED ENERGY ELECTRICAL. APPL.ICATiON Recd by _10
13125 SW HALL BLVD Date Recd / c'/ ✓ S
TIGARD OR 97223 PRINT OR TYPE Ll
�i
V- 503-639-4171 X304 Permit# b - ;
F -503-684-7247 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'o > �—
WILL NOT BE ACCEPTED '
Name of Development Prolet_ "TYPE OF WORK INVOLVED -RESIDENT:AL ONLY
i v`+ Y'i t l Restricted Energy Fee........................................ $40.00
ii:YIQCkLj,Vw (FOR ALL SYSTSMS)
JOB Street Address Ste#
ADDRESS ' C �� j(y�C",j CL V-.,t l� Check Type of Work Involver
C;ty1S'at Gly►fip a Phone# ❑ Audio and Stereo Systems
Name ❑ Burglar Alarm
OWNER Mailing Address ❑ Garage Door Opener-
City/State Zip Phone# I J Heating,Ventilation and Air Conditioning System'
Name ` - ,, ❑ Vacuum ivstems'
ISIQ C_k__0 � ❑ Other ---- -- - --
CON TRACTOR Mailing Address
C c &U3 �c�- (i .1+�_ TYPE. OF WORK INVOLVED -COMMERCIAL ONLY
(Prior to issuance a ylState Zi Phone#� Fee for each system.............................................. $40.00
copy of all licenses til _� _k\ `(aCA � a3- c�-. (SEE OAR 918-260-260)
spa required If Oregon Cpntr.Bid L'9 # Exp.Date
expireo In C.O.T. �j.3�� Check Type of lVork Involved:
data base) Electrical Contr. ic.#,,,, Exp.Date
❑ Audio and Ster,io Systems
C.O.T.or Metro Lic.# Exp.Date
❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT ❑ Da`a 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. ❑ -ntercom and Paging Systems
These have asterisks('). All others need licensing;
❑
2 Cali(rr inspections when installation under this permit are ready for Landscape Irrigation Control'
inspection at 60?•639-4176; ❑ 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 finni 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
authorit to bind the app ant.
ature ENTER FEES s6o .
6%SURCHARCE(.06 X TOTAL ABOVE) S
Authority if other than Applicant TOTAL
i Wststresele doc 7197
s
V 8 y_ Z2 sy—
' CITY OF T►GARD BUILDING INSPECTION DIVISION
24-Hour Inspection Linc: 639-4175 Business Phone: 639-4171
[)ate Requested: A M. P.M. I MST:
Location: y ' e
/ ---—-- BUP',�� I
Tenant: Suite: Bldg: MEC:
Contractor: 1f�.E !/V,/ ~�r •pKone: 7 - (Q�5tiJ�5L PLM:
�+ r 4
Owner: S�"" Phone: ELC:
ELR:^ '
_ SIT:
BUILDING / LDG(cop't) PLUMBING r MECHAN*1C ELECTRICAL SITE
Site P'osvheam Post/Beam os Cover/Service fewer/Storm
Footing Roof UndFI/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furrece Temp Service MISC.
Masonry Ceiling Rain Drain A/C UC(Slab
Shear/Sheath Fire Spklr/Alm CrawUFound Dr Heat Pump Low Volt _
Approved Approved ppro Approved Approved
Appr/Sdwlk Ng1App�oved Not Approved roved A7ot Approved Jot Approved
`FINAL �) FINAL FINAL M�tvAl, FINAL
k
4F -s..e�.J
Call for reinspection C7 Reinspection fee of S required before next inspection O linable to inspect
Inspector:____�--- — Date: %t'' 2 7 Page___,_of