Permit (81) CITY OF TIGARD
� DEVELOPMENT SERVICES ELECTRICAL PERMIT
__ 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
RESTRICTED ENERGY
PERMIT #: ELR96 -0373
DATE ISSUED: 12/17/96
PARCEL: 2S115AB -01900
SITE ADDRESS...: 16200 SW PACIFIC HWY #H
SUBDIVISION • ZONING:C —G
BLOCK • LOT •
Project Description: add protective signaling
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: OU HVAC • PROTECTIVE SIGNAL..:X
INSTRUMENTATION.: OTHER..: ..
TOTAL # OF SYSTEMS: 1
Owner: FEES
POSTAL CONNECTION type amount, by date recpt
16200 SW PACIFIC HWY PRMT $ 40.00 TAT 12/17/96 96- 287844
STE H 5PCT $ 2.00 TAT 12/17/96 96- 287844
TIGARD OR 97223
Phone #:
Contractor: --
AAA ALARM CO OF OREGON $ 42.00 TOTAL
7865 SW CIRRUS DR REQUIRED INSPECTIONS
BEAVERTON OR 97008 Ceiling Cover Elect'1 Service
Phone #: 771 -7572 Wall Cover Elect'1 Final
Reg #..: 93892 /J
This permit is issued subject to the regulations contained in the �� i/ / 7.Ril .t'.�
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i e i gnat u r
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 t _ , AA/
than 180 days. Issaed By
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 for inspection — 639 -4175
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
, ,..,
13125 SW Hall Blvd. C__ 373
Tigard, OR 97223 PERMIT # 9� -
6 3
Awi P ` I i'l P FAX (503) 6847 297 DATE ISSUED
- - TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
16200 SW PACIFIC HIGHWAY SUITE H
Address RESIDENTIAL — Restricted Energy Fee $40.00
TIGARD, OREGON 97224 (FOR ALL SYSTEMS)
City State Zip Check Type of Work Involved:
PERMITS ARE NON - TRANSFERABLE AND NON - REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems
IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
180 DAYS. ❑ Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
AAA ALARM CO OF OREGON ELECTRICAL
Contractor I ype ❑ Vacuum Systems*
Address
7865 SW CIRRUS DRIVE, BEAVERTON 97008 ❑ Other
Date 12 -13 -96 COMMERCIAL — Fee for each system $40.00
(SEE OAR 918 - 260 -260)
Property Owner Check Type of Work Involved:
Contractor's Board Reg. No. ItlbaitifSZ 93892 ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone 646 - 2700
hone #
❑ Clock Systems
❑ Data Telecommunication Installations
3. OWNER APPLICATION
❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No
❑ Instrumentation
Address ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
City State Zip ❑ Medical
This permit is issued under OAR 918- 320 -370. This applicant agrees to make only ❑ Nurse Calls
restricted energy installations (100 volt amps or less) under this permit and to do the ❑ Outdoor Landscape Lighting*
following:
1. Only use electrical licensed persons to do installations where required. (Certain ® Protective Signaling
residential and other transactions are exempt from licensing. These have ❑ Other
asterisks(*). All others need licensing).
2. Call for an inspection when all of the installations under this permit are ready
for inspection at 503- 639 -4175. ❑ Number of Systems
3. Purchase 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. Assume responsibility for calling for a final inspection when all of the 5. FEES
corrections are completed.
The person signing for this permit must be the applicant or a person a. Enter Fees $ L /O
authorized to bind the applicant.
b. 5% Surcharge (.05 x total above) $ &.OD
Signature
(ACC M4 - T TOTAL $ �o�. (7C�
Authority if other than applicant
ENERGAP.CHP
5/10/99 Activities for Case #: ELR96 -00373
2:14:44 PM •
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRC001 Application Received 12/17/96 12/17/96 TAT 12/17/96
ELRC003 Permit Created 12/17/96 12/17/96 TAT 12/17/96
ELRC799 Elect'l Final 12/17/96 1/9/97 MJR PASS MJR 1/10/97
ELRC731 Elect'l Service 12/17/96 TAT 12/17/96
ELRC700 Ceiling Cover 12/17/96 TAT 12/17/96
ELRC720 Wall Cover 12/17/96 TAT 12/17/96
ELRC500 (F) Issue permit 12/17/96 _ TAT PASS TAT 12/17/96
ELRC800 Case finaled 1/9/97 MJR PASS MJR 1/10/97
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation EI
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: I
Date: i ( 9 l q i A.M. P.M. _ Entry:
Address: / 6. 2- O (2.461-Ai c) J L-��'
Tenant: 1---el-4-740 s Ste: H MST:
BUP:
Con /Own: MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: D
S P C 4 rr 5) 7 t--,,-.
Inspector: 27�J( c C i-� ( c' ! Date: d ,--„ ?z ? APPROVED DISAPPROVED /CALL FOR REINSP. CO
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