7100 SW HAMPTON STREET (2) J
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CITY A(`./]F T'G A R D ---- ELECTRICAL PERMIT-
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT ELR2001-00088
13125 SW Hall Blvd., Tipard, OR 97223 (503) 639-4171 DATE ISSUED: 03/2.9/2001
PARCEL: 2S101 AC-01600
SITE ADDRESS: 07100 SW HAMPTON S r 130
SUBDIVISION: 'ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
Proie,,# Description: Burglar Alarm
A. RESIDENTIAL — B.COMMERCIAL
AUDIO & STEREO_ AUDIO & STEREO: 114TERCOM & 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: PROTECTIVE SIGNAL.: X
INSTRUMENTATION: OTHER:
_ TOTAL#OF SYSTEMS: 1
Owner: _—'—^-- -�—_�- --- Contractor. _� ---- _.�—_---
NEIMEYER, JOHN ADT SECURITY SEF,VICES, INC
25 82ND OR STE 200 2815 SW 153RD DR
GLADSTONE, OR 97027 BEAVERTON, OF, 97006
Phone: Phone: 503-469-7100
Req #: LIC 59944
ELE 26-209CLE
_ FEES Required Inspections
Type By Date Amount _Receipt — Low Voltage Inspection
PRN11 CTR 03/29/2001 $75.00 2720010000 Elect'I Final
5PCT CTR 03/29/2001 $6.00 2720010000
Total $81.00
This Permit is issued .,object to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. A;I o,ork 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 fo:law rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952 001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246-1987. ,
Issued by .Ct,1.�C-r1 �� c,f Permittee Signature ,�,Aj
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale. lease, or rent.
O'04NER'S SI SNATURE. DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N _ DATE.---..-
LICENSE
ATE _LICENSE NO'
Call 639-4115 by 7:00 P.M. for an inspection needed the next business day
Electrical Permit Application
- — Date received: ` Permit no.:
City of
Tigardt•-. Project/appl.no.: Expire date:
-
Cityof/7gad Address: 13125 SW Hall Blvd,TigAteV3i21 Date issued: By: Receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval
TYPE Ot PERMIT
U I &2 family dwelling or accessory U Commercial1industrial U MUlti-family U Tenant improvement
U New construction U Addition/alteration/rrplarrnrcnt U Other: U Partial
.1011 SITE INFORNIA1 ION
Jab address: - Bldg, no.: Suite no. C)I Tax map/tax lot/account no.:
Lot: I Block. Subdivision:
Project name: - / Dcsrtipn0 n mid ]-)c mien of wtlrk on premises.,'��r_6�„}u t
Istinnncd Elate of Coniplc n1/ins t^ct in:
Job no: Priv ntax
Business name. � OVA. 0 Description Vly. (ea.) Intel nu.tnsp
New residential-single.rmuld fandh Per
Address: r•_ dvvellingunk.Includes Winched ganege.
City: Beavfa<vil 11,9700611': Serviceincruded:
Phonc• Ly11--ax: V I E-snail: luau sq It_t less — 4 _
�/^�� C.�� Each additional 51)U sq.ft.or portion thcteot
CCB Ito,: L' rlec.bU�,IiC.Oo W Limiiedenergy,residential 2
Cit /metro lic.no.: Y I.tmitedenergy,non-residential 2
�(� /
t)j_ F.nch manufactured home or nodular dwelling
ignalure of supervising clod•i,inn(required_)__ Dat t”– Service and/or feeder 2
Sup.elect.name(nriuH: Lfccosc 11(1:-v 9:6ej Services orfeeders–installation,
alteration or relocation:
it 1111"U1101 R 200 amps or less 2
Name(print): 201 amps to 400 amps 2
----- ----- 401 amps to 600 amps 2
Mailingaddress:
6111 amps to 1000 amps 2
City: State: LIP: 0%er I01x1 umps or volts_ 2
Phone: V X: L.-mail: Reconnectonly _ I
Owner installation:The installation is being made on property I vwn Temporary services or feeders
which is not intended for sale,lease,rent,or exchange according to Installation,alteration orrelocation:
ORS 447,455,479,670,701. _2(x1 amps of less 2
201 amps to 400 amps 2
Owner's si mature: _ Date: 401 t.601 amps 2
Branch circutU-new,alteration.
or extension per panel:
LAd
A. ',cc for hrancn circuits with purchase of
service or feeder fee,each branch circuit 2
State: ZIP: B. Fee for branch circuits without purchase
or service or feeder fee,first branch circuit:i I ax: E-mail Each additional branch circuit:
Misc.(.Service or feeder not Included):
U Service liver 225 snip-. "nuuercial U Health-co--facility Each pump or irrigation circle 2
U Service over 120 amps-i acting of 1&2 U Hazardous location Each sign or outline lighting
family dwellings U Building over 10,000 square feet four or Signal circuil(s)or a limited energy panel.
U System over 6(x)volts nominal more residential units in one structure alteration.orexteusion' _ 2
U Building over three stories U Feeders,400 amps or more *Description:
_
U Occupant load over 99 persons U Manufactured structures or RV park FAch additional Inspection over the allowable In any of the above:
U Egress/lightingplati U Other: -- -- Per inspection
Submit__rets of plans with any of the above. Investigation fee
the above are not applicable to temporary construction service. Other
NM all jurisdictions accept credit cards,please call Jurisdiction for mom information Notice:This pernift application Permit fee.....................$ L1
U Visa U MasterCard expires if a permit is not obtained Plan review(at ` i $
Credit card number: _ _L�— within 180 days afler it has been State surcharge(8%)....
Expires accepted as complete. TOTAL . .........$ _.
Name of cardholder as shown on credit card
_ S
Cardholdet&4_natum ____-_ Antiouni 4.1(1d615(6A)WOMI
Electrical Permit Fees: Limited Energy Fees:
Complete Fee Schedule Below: Restricted
OF WORK INVOLVED -RESIDENTIAL ONLY
Restricted Energy Fee............................ ....
$75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total
Check Type of Work involved
Residential-per unit
1000 sq It or less - $145 15 .1 ❑ Audio and Stereo Systems
E-ach additional 500 sq-ft.or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular ❑ Garage Door Opener'
Dwelling Service or Feeder $9090 {
Services or Feeders [] Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less $80.30 7 El201 amp3 to 400 amps _ _ $106.85 2 Vacuum Systems`
401 amps to 600 snips $160.60 2 ❑
601 amps to 1000 amps �_�_ $240.60 2 Other
Over 1000 amps or volts $454.65 2
Reconnect only _ $66.85 2
Temporary Services or Feeders
TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Installation, .Iteration,or relocation
200 amps or less $66.85 1 Fee for each system.......................................................... $75 00
201 amps to 400 amps _ $10 .30 (SEE OAR 918.260-260)
401 amps to 600 amps _ $1..3.75
Over 600 amps to 1000 volts, Check Type of Work Involved:
see"b"above.
[� Audio and Stereo Systems
Branch Circuits
New,alteration or extension per panel F-1a)1 he fee for branch circults Boller Controls
with purchase of service or
feeder fee. ❑ Clock Systems
Each hranch circuit $661,
b,The'ee for branch circuits ❑ Data Telecommunication Installation
wr'.;rout purchase of service
or feeder fee. ❑ Fire Alarm Installation
First branch circuit $4685 _
Each additional branch circuit $6.65 ❑
HVAC
Mlscellancol!s
(Service or feeder not Included) ❑ Instrumentation
Each pump or irrigation circle $53.40
Each sign or outline lighth Ig $53.40F-1
Signal circuits)or a Ilmi:ed energy - L_ Intercom and Paging Systems
panel,alteration or extenslon $75.00 _
Minor Labels(10) $125.00 ❑ Landscape Irrigation Control'
Each additional inspection over u Medical
the allowable In any of the above
Per inspection _ $62.50
KIvr.^,e Calls
Per Hour $62.50 _-
In Plant _ $73.75 ❑
Outdoor Landscape Lighting'
Fees:
®
Protective Sfgna rng
Enter total of above fees $ _
[❑ Other_
8%State Surcharge $
_ --------__ ..---___---_�-------_-_ --
25%Plan Review Fee _-._____.__Plumber of Systems
See"Plan Review"sectiun on $
front of application No licenses are required licenses are reqjlred for all other Installations
Total Balance Due s Fees:
❑ Trust Account f! _ Enter total of above fees
CIO
- --__-_ _,-___- -- --_- --�--- _-_ Sia State Surcharge S �
Total Balance Due
uists\forms\eIc-fees,doc to 09/00
CITY OF TiGARD BUILDING INSPECTION DIVISION
MST
24-Hour Inspection Line: 639-4175 Business Line: 639.417'1 --- --- --
BUP
_Date Req-jested ' AM-- ____PM — BLD
Location. O 14m f l-, -)/ 13 6 Suite v MEC
Contact Person _ —__ / =* Ph 6; 7 Z Y/ PLM _
Contractor Ph __— SWR —
BUILDING Tenant/Owner ELC
Retaining Wall — ELR '?/y 1�_ vff_ 6_
Footing Access: _
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: — --- ---
Slab
SIT
Post&Beam --�- -- ----
Ext Sheath/Shear
Int Sheath/Shear i Framing
Insulation Insulation ---- ---- -- ---- __ ___ ,
Drywall Nailing
Firewall - -
Fire Sprinkler / _C
Fire Alarm
Susp'd Ceiling
Roof --- -- - - -- - -
Misc
Final
PASS FART FAIL --__-_--
PLUMBING
Post& Beam - — ---V
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
,ervi�
Rough In - `r
UG/Slab
-fxrrn;
P %PART FAIL
SITE
Backfill/Grading - -- —
Sanitary Sewer
Storm Drain [ )Reinspection fee of$ required before next inspection. Pa. at City Hall, 13125 SW Hall Blvd
Catch Basin i
ll f
Please call reinspection RE
Fire Supply Line ( p ( J Unable to inspect-no access
ADA
Approach/Sidewalk s r.
Other late U / T' Inspector _Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD PLUMBING FERMI T
DEVELOPMENT SERVICES
DEV PERMIT #. . . . . . . .. PLM98-0065
13125 SW,'iall Blvd, Pgard,OR 97223 (503)639.4171 DATE ISSUED: 03/12/98
PARCEL : 2SIOIAC-01600
5111-: ADDRE15S. . . : 07117117.1 SW HAMPTON 131 fl 1 1, 1
'SUBDIVISION. . . . : ZONING: MUE
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . .. . .. . JURISDICTION: TIG
-------------------------------------------------------------------------------------
CLASS OF WORK. . :ALT GARBAGE DISPOSALS. ., 0 MOB Ii_E HOME SPACES. : 0
TYPE OF USE. . . . :COM WASHING MACH. . . . . . : 0 BACKFLOW PREVN-IRS. . : 0
OCCUPANCY GRP. . :B FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . : 0
STORIES. . . . . .. . . : 0 WATER HEATERS. . . . . : I CATCH BASINS. . . . . . . : 0
F I XTURES---------.------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . : 0 URINALS. . . * * * " . . . . : 01 GREASE TRAPS. . . . . . . . 0
LAVATORIES. . . . : 0 OTHER FIXTURES. . . . :: 0
TUB/SHOWERS. . . 1 0 SEWER I INE (ft ) . . . : 0
WATER CLOSETS. : 0 WATER LINE (ft ) . . . 1 0
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . 1 0
Remarks: Installing a water heater
OvIller: ----------------------------------------------------- FEES ---------------
DORENE THOMAS type amount by date recpt
-1 —304032
-7100 SW HAMPTON VRMI $ 25. 00 B 03/12/98 98
GTE III 5PCT 1. 125 B 03112198 98-304032
TIGARD OR 972c!3
Phone #:
Ccintr-a^-far-------------------------------
GEORGE MORLAN PLUMBING & APLIANCES
9806 SW TIGARD STREET
CCB (EXP 6/2002)
'TIGARD OR 97223 --------------------------_----__..___--_.
Phone #: 624--6895 $ 26. 25 TOTAL
Reg #. . : 000027
REQUIRED INSPECrIONS
This permit is issued subject to the regulations contained in the Top—out Insp
Tigard Municipal Code, State of Ore. Specialty Cude3 and all other Final Inspection
applicable laws. All work will be done in accordance with
approved plans. This per,vil will expire if work is not started
within 180 days of issuanre, or if work is suspended for more
than 180 days. AIT410N: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. those rules are
set forth in OAR 952-000I-0010 through OAR 952-MI-0089. You may
obtain copies of these rules or direct questions to OLW. by calling
1503)246-1987.
Issued B y Permittee Signature
..................................IL .I......... ............I+ +++
Call 639-4175 by 7e00 p. m. for an inspection needed the next business day
..........................4......4................................4++.+++++4......4-+
MPR-12-199e 07: 12 GEORGE MORLRN P 02
Plumbing Permit Application
""°ey '� -)
:lTY OF TIGARD 9Data Rated I Z
3-425 5W HALL BLVD. Commercial and Residential oats le P.E.
]GARD, OR 97223 041910 -� —
503) 639.4171 Permit n : ►'�"q ;VAS
Print or Type Routed SWR s
Incomplete or illegible applications will not be accepted Called- — ---
Name of DaveroPMenVPrvlakl— On tack maleate,Wort Perfotsred try f{atLn.
Job L 1 MTURE3:(Ind'Mdual) PAiCI� ANT.
.�
Address Straa1 Addmsa • ' Sulle I Slnk 9.00
Bldgs Cttyfstate Zlp Tub or TublSndwer Comb. 9.Otl
l 6Afe o Z2. Shower Only
Nam „ ,- yyadpr 61-02 at 9.00
Owner
Mating i
AddG Suss Dlahwacn r
_ C�.Vwgs Disposal 9.00
Gtyrstale LP ne Wat:ning MacMne — 9.00
4.
Floor Dram 2• 9.00
Ne 3. 9.00
Occupant Malting Suite _ 4' 9-00
ter Master O oonvers on O like hind 9.00
Wa
City/State ZIP Phone laundry Room Tray p 00
Name --- Urinal 9.00
Ho other -Mural(Speufy) goo
Contractor 2 + s il, �' -� w, - 9.00
A. Wy *T ALL o0
Prior to parmlI CltyfSate tJp Phrnne -- ---- - - -- 8.00
rswsnk:e,a Copy ` _ Z (- -
9.00
of air ucxnses are Oregon Gonat.Cont_Board Lica Exp.Dau+ _r
30.0
required It 2 Savwt►. It 100' 0
explred In COT Plumbing tJr->r J D�ab� Sewer-e ch additional 100' 25.00
database &0 P13 �J—_1_9 _ waw Sarncs-1st too' 30.00
Name -- —
Water Service-each additions!200' 25.00
Architect storm s Rauh Drain-tat 100' 70 00 _
Mal'mg Address Suite 25.00
or
storm d Raln Dnin each aodctional 100' _
CI ISWs Zq - Phone Mobile Nome Soma — 23.00
Engineer ti — z�oo'
__ Commerdal ea naFlaw Prevention Devlas or And-
Describe work New O Addition O Allerafion O Repair O Puuutlon Device _ 15.00
to be done: Residential 0 Nuc n-residential O kinsg.
ntial Bse:Ikfow Prevention Device'
Additional description of work ap or Wasls Not Convected to a f=u L” 9.00
_ Basin 9 00
f Eslating Illumbing x0.00
arRhr
40
5peuauy Repuerttad Inspections A0
Esilthhy use of
budding or Pmpsrh_.---- Rain Drain,sktpkt hmdy dnellbip ✓-- 70.00
Proposed use of Grease Trtpa -- — 9.00
building or property
allANTM TOTAL
I hereby acknowledge that I have read this appllcmlon.Ihal the Information Immtvtc or raw jWjrxm.t rsqukw 4 OurUy Tool I. �1
given is Correct.that I am the owner or authorized agent of the ownfr,and 'SU1310TAL
1Mt plans submitted are W commslance w.lh OreVan Stats Laws.
Slgna el owner(A It r, D —�' 5%SURCHARGE
c rte'
=
PLAN REVIEW 2155'f4 OF SIIB,OTAL -•f;f '�.y� �='
tin on llama �� Phone urrsd an IilMs Qty.tolar la,a
_ S, R K(=
QA TOTAL l
'lntnlrttum permit fate is 325•516 sharharpe,swept Reafdarttiat Backflow
Prevenllon Dense,whlch 4 315 '%lundlar9e
cvtsavh*awrdoc&V
Zoo(Pj nVr-)I.L d0 A,LI3 0961 969 foe Av3 11 Z1 a-U 05/1iico
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -.----�- ---- -
E3UP _
~ Date Requested � � �' " ��,_AMPM BLD
7 _
Location 1106) V Suite MEC
Contact Person _ rte I�12� �7 /��1 Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner1� ELC
Retaining Wall ELR _
Footing Access: �� %� �j.'Bn ,,
Foundation de f?�1 ��:t--/1-�� �I�`C-G'• "'(.I'�i�Av� FPS -_----------
Fig Drain
Crawl Drain Inspection Notes: sGlu - ---
Slab ---- SIT
Post&Beam ----� _----
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall -
Fire Sprinkler -- - -
Fire Alarm
Susp'd Ceiling -- - . --- -
Roof � v
Misc: - - - - --- --
Final —
S-_15XT FAIL -- -- ----- _--- ---
P UMBING
i
Under Slab
Top Out
Wa►er Service
Sanitary Sewer
Rain Drains
FAIL ------ `—---- -- —
MECHANICAL
Rough In
Gas Line -------------
Smoke Dampers
P.P,SS PART FAIL
ELECTRICAL
Service
Rough In
UG/Slab
Low Voltage
Fire Alarm
Final
PASS DAR'T' FAIL. —_--SITE
RackfilUUrading - -----` —`
Sanitary Sewer
Storm Drain ( J Reinspection fee of E required before next inFppction. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ J Please call for reinspection RE:_ _ ( J Unable to inspect-no access
ADA
.-Approach/Sidewalk
Other Date -_ Inspector Ext
Final
C'ASS PART FAIL 00 NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Linc;: 639-4171 --
� —" 8UP
Date Requested �` AM PM _ BLD
Location 1�� Sl�l) � . 7�•` Alt. Suite ME C
Contact Person _ �� a Ph _ �� G:` PLM
Contractor Ph SWR
BUILDING _ Tenant/Owner ELC
Retaining Wall ELR
Footing Access ,i /�
T
Foundation � �/� �J C �f) FPS
FtgDrain n
Crawl Drain Inspection Notes Slab
Post
- --
Post&Beam SIT- - --
Ext Sheath/Shear
Int Sheath/Shear ��- '— ----- --
Framing ------- -------_-.. __
Insulation
Drywall Nailing -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling ___-_-- ------_---_----_—`
Roof
Misc: - - ------- -- — --
Final
PASS PART FAIL --- - ----_---�— __.
Fru-MBINO
Pos -S10 -- -- ----- ----- ----- ------
Under Slah
Top Out ---_
Water Service
Sanitary Sewer --
rains
Fina - — "�-
ASS PART FAIL __—
MECHANICAL - —
Post&Beam - ---
Rough In
Gas Line ---- ---------
Smoke Dampers
Final --------__----____ __
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG/Slab _
Low Voltage —
r7ire Alarm
Final �-
PASS PART FAILSITE
Backfill/Grading - -----
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ —required before next inspection. Psy at City Hall, 13125 SW Hall Blvd
Catch Basin Please call for reins Action RE:
Fire Supply Line ( ] p _ _ ( ]Unable to Inspect-no access
ADA f d
Otheoach/Sidewalk Date _ /�G Inspector! __— Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site,
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 ^-
BUP
Date Requested ��" �' __ _AM, �PM ^V_ BLD
Location 7/ 0� Suite ZZO MEC
Co•(tact Person C-A rl" Ph -57 3 -6 j -/ 71 PLM
Contractor T Ph -7 13 ye-- Z,/ SWR
BUILDING — Tenant/Owner EL C
Retaining Wall ELR
Footing Access:
Foundation ,Q L FPS
Fig Drain _ 5-& CGr/w-�.1 _'J(/U skJ / lei /�,"
uGN
Crawl Drain Inspection Notes:
Slab -- _ ------ — sN l i�� �OS 6V C&, 141 X lir. SIT
Post& Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Ndiiing
Firewall
Fire Sprinkler ---.- _��-------.-----_-_-- __ _
Fire Alarm /
Susp'dCeiling
Roof ----_.-------—-- - --_ -- —
Misc: ---
Final — - --
PASS PART FAIL - — - -- ------
PL.UMBING
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
Service
Rough In
UG/Sla -
c
fire Alarm
!19z��ART FAIL
SITE
Backfill/Grading -- -
Sanitary Sewer
Storm Drain [ )Reinspection fee of$_ required before next inipection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin i
ll f
Please call reinspection RE
Fire Supply Line [ [ p —� [ ]Unable to inspect no access
ADA
Approdch/Sidewalk Date/l�- - �"-"Qv Inn pector _ —Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
ELECTRICAL
MIT
CITY OF TIGARD RESTRICTEDE ER
RESTRICTED ENERGY
DEVELOPMENT SERVICES _ PERMIT#: ELR2000-00240
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 10/17/2000
SITE ADDRESS: 07100 S'JV HAMPTON ST 110
PARCEL: 25101 AC-01600
SUBDIVISION: ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
Proiect Description: Installation of burglar alarm.
N.RESIDENTIAL _ B.COMMERCIAL _
AUDIO & iTEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSJAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL.:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: BURG ALARM X
TOTAL# OF SYSTEMS: _
Owner: Contractor:
NEIMEYER, JOHN ADT SECURITY SERVICES, INC
25 82ND DR STE 100 2815 SW 153RD DR
GLADSTONE, OR 97027 BEAVERTON, OR 97006
Phone: Phone: 503469-7100
Reg #: LIC 0059944
ELE 26-209CLE
_ FEES _ _ Required Inspections _
Type By Date Amount_Receipt Low Voltage Inspection
PRMT CTR 10/17/2000 N^ $75.00 2720000000 Elect'l Finel
5PCT CTR 10/17/200C $6.00 2720000000
Total $81.00
This Perrnit 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
requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246-1987
Issued byPermittee Signature C'.-,
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
Q002
13125 SW NArFL BLVD �FCII Y OF: TIGk\RD �(�Rest {ated Energy Electrical Application Recd by: "AiL
� �
Date Recd: io
1IGARi� OR 97223 till OT
V -5fT?-Cs9-4171 X304 ,�1t1*1%1plete or Illegible applications Permit#:
I-' - 503-591f-1960 �ypwill not be accep(ed Cust.Call'd:
Name of Develo ro)ect TYPE OF WORK 7NVOL.VED -RESIDENTIAL ONLY
Res(rlraod Enc: F e.......... '�`-
gY a .............................. 175.00
JOR trent Ad�tross S1e 8 (FOIL ALL SYSTEMS)
ADDRESS W c) y,- t r,
C /State Chock Type of Ywotk Involved
} Phone
No ❑ Audio and Stereo Systems
ri-
A
Burglar Alarm
OWNER Mailing Address --- r
Gatage Door Opener'
City/Slate Zip Phone+4
❑ Healing,Ventilation and Air(;cndiliunirg System'
Name
ADT Security Services ❑ Vacuum Systems'
S W .1,53 RD
C;ONTRACTOIR Malting dress L Other___
___ B av n OR 9700E ---- -
J,tor to Issuance a Cfty/State lip u P n u TYPE OF WORK INVOLVED - COMMERCIAL ONLY
copy of all licenses 1I (1 �u _ _are required required if Ore on �--.Y/ _
Oregon r.�1d � Eyp.Dale Fee for each t
sysem..................•.... —
expired in C.O.T. 576.00
database) Eleclr' + �"" V (SEE OAR 918.260-200)
I Contt Lin, Exp.Date
�C C;•eck Type of Work involved
C.O.T.or Metro Lic.N i Ezp.Dale
- --
Owner's ae
❑ Audio and Stereo Systems
Nrn
OWNER- Mailing Address
❑ Boiler Controls
APPLICANT _ (� clock Systems
City/State �^ Zip Phone Ar
_ Cf Data Telecommunication InstalLih„n
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 ❑ Fire Alarm Installahnn
permit and to do the following:
1 Only use electrical licensed persons to do installations where required. HVAC
Certain residential and other transactions are exempt from licensing. ❑ Instrumentation
These have asterisks(') All others need licensing;
2. Call for inspections when Installation under thispemail are ready for ❑ Intercom and Paging Systems
inspection at 503-639-4176;
❑ Landscape litigation Control'
3 Purchase separate permits for all installations that are not ready for an
inspection when the Inspector is out to Inspect under this permit; 1J Medical
4. Assume responsibility for assuring that all corrections required by the ❑ Nurse Calls
Inspector are done,and;
❑
5. Assume responsibility for calling for a final inspection when all of the Outdoor Landscape Lighting'
corrections are completed. ❑ Protective Signaling
Permits are non-transferable and non-refundable and expire if work is not Other
started within 180 days of Issuance or if work is suspended for 180 days. --
The person signing for this permit must be the applicant or a person -- Number of Systems
authorized M bind the applicant. No licenses art reQulred. Licenses are req•dred ro,nit other installations
' FEES:
ENTER FEES $ 00
8%SURCHARGF(.08 X TOTAL.AROVF)
TOM
Authority if other than Applicant -
vlsrsvonnsvesete doe aroo