Permit (90) CITY O T I G A R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
11A1 DEVELOPMENT SERVICES PERMIT #: ELR1999 -00187
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 DATE ISSUED: 8/5/99
SITE ADDRESS: 16200 SW PACIFIC HY S PARCEL: 2S115BA -00101
W
SUBDIVISION: PP1994 -028 ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
Project Description: Add protective signaling.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LAN DSCAPE/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:
BIT HOLDING LTD SECURITY LINK FROM AMERITECH
BY FORUM PROPERTIES INC 12119 NE 99TH STREET
FIVE CENTERPOINTE DR WUITE 2094
LAKE OSWEGO, OR 97035 VANOCUVER, WA 98682
Phone: Phone: 360 - 25393113
Reg #: LIC 0005506
ELE 26- 514CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT GEO 8/5/99 $60.00 99- 317405 Elect'I Final
5PCT GEO 8/5/99 $4.20 99- 317405
•
Total $64.20
ORIGINAL
This Permit 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 OA 95 - 001 -s 80. You may obtain copies of these rules or direct que ns to OUNC at (503)
246 -1987. /
Issued by Permittee Signature
OWNER INSTALLATION ONLY
The installation is being made on operty I own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: 6A-7 _ DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD , R ESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
13125 SW HALL BLVD Date Rec'd:
TIGARD OR 97223 PRINT OR TYPE
V -. 503- 639 -4171 X304 AUG 0 4 l',-.;:',3 Permit #:Ezie M _ 6 0/$7-
P: 503 -684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Cail'd:
- CAMMui„, , .;,- ,__.,, WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
3 ocxb� s+e,- 6-,+e,--f-e.:,‘, „,r, Restricted Energy Fee $40.00
(FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS Check Type of Work Involved:
IC C Z.00 .5 Imo, C f4 W-!
City /State Zip Phone # ❑ Audio and Stereo Systems
p n
Name / El Burglar Alarm
Lam. �ock-. 6 „-,...,,Q.'1
OWNER Mailing Address El Garage Door Opener*
50/0 S.pn?.1..e...... nice_ S i ❑ Heating, Ventilation and Air Conditioning System*
City/State Zip Phone #
SS -, �,c ,, C.4 ` !!Z / ZZ ❑ Vacuum Systems*
Name �}
e- c- „r_:-* L
y'...�Ic CA.)...., !`t
,,.... N -e.. -tecJn ❑ Other
CONTRACTOR Mailing Address i
111n .NE 95 Si-. 5..r4e, Zo44-1 TYPE OF WORK INVOLVED.- COMMERCIAL ONLY
(Prior to issuance a City /State Zip Phone # Fee for each system G O , c0
copy of all licenses (,(�,, t ,,/,4 � oj5m Z , co- 253-3113 (SEE OAR 918 - 260 -260)
are required if Oregon Cont Brd Lic. # Exp. Date
expired in C.O.T. 005 Cam / S(On Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp. Date ❑
26- 5 4c-LC t II l ei Audio and Stereo Systems
C.O.T. or Metro Lic. # Up. 'Date
y o / S42 / I (c9 ❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT ❑ Data 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. ❑ Intercom and Paging Systems
These have asterisks('). All others need licensing;
❑ 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 El 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. 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.
. FEES:
Signature ENTER FEES $ 6 U • Uv
S
a
5Io SURCHARGE (.05 X TOTAL ABOVE) . $ 7 "
Authority if other than Applicant TOTAL $
i:\dsts\resele.doc 7/97
fi t.(..Zo
12/17/1999 Activities for Case #: ELR1999 -00187
3:05:08 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRC001 Application Received • 08/04/1999 GEO MAIL No Hold GEO 08/05/1999
ELRC003 Permit Created 08/05/1999 GEO No Hold GEO 08/05/1999
ELRC725 Low Voltage, Inspection No Hold GEO 08/05/1999
ELRC799 Elecfl Final 08/05/1999 08/05/1999 12/15/1999 BP PASS No Hold DGW 12/16/1999
ELRC500 (F) Issue permit 08/05/1999 GEO DONE No Hold GEO 08/05/1999
ELRC800 Case finaled 12/16/1999 HAP PASS No Hold DGW . 12/16/1999
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
v
Location /6200 Stovorde, o c Suite S MEC
Contact Person Rey Ph 3 51. • 5°0 D t PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR /149 -a) /F 7
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof Are5..
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 In
Gas Line
Smoke Dampers
Final
PASS �4RT FAIL •
LECT_R IC
j "1161C
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
ASS PART FAIL
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 /12 Date " /c % s
7 Inspector G7'r� /� Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.