Permit (97) CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
41 DEVELOPMENT SERVICES PERMIT #: ELR1999 -00294
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/07/1999
SITE ADDRESS: 16200 SW PACIFIC HWY S PARCEL: 2S115BA -00101
SUBDIVISION: PP1994 -028 ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
Project Description: Data telecommunication installation in existing commercial building.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: •
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
GE CAPITAL GATES ELECTRONICS + SECURITY
621 SW MORRISON PETER N GATES
SUITE 448 6818 SW CAPITOL HWY
• PORTLAND, OR 97209 PORTLAND, OR 97219
Phone: Phone: 246 -9951 ORIGINAL
Reg #: LIC 0076878
SUP 922JLE
ELE 34 -316CL
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT DST 12/07/199E $60.00 99- 320239 Elect'l Final
5PCT DST 12/07/199E. $4.80 99- 320239
Total $64.80
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 thro AR 952 - 001 -0080. You may obtain copies of these rules or direct •ons to O C at (503)
246 -1987.
Issued by Permittee Signature x
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:
•
CONT - • TOR INST; L • ION ONLY
SIGNATURE OF SUPR. ELEC,N �� , - ��� DATE: \ C,/ -- / �'�
LICENSE NO: 3`f 31 (o C
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION . Rec'd by:
13125 SW HALL BLVD Date Rec'd:
TIGARD OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #: at - /97 O0'27/
F - 593-598-1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
■ WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
JAW/A, 1��� (FOR Energy
STE Fee $60.00
!/ (FOR ALL SYSTEMS)
JOB Street.Address Ste #
ADDRESS /F _94/n ' A,, s Check Type of Work Involved:
7� j tag, Ox S Z'. /, Phone # ❑ Audio and Stereo Systems
NNme 2?/- ❑ Burglar Alarm
C ct- et T' -(-- ❑ Garage Door Opener
OWNER Mailing Address
i2 i a-( S' or r is or? S'n i Li Heating, Ventilation and Air Conditioning System*
ty/ t o I Zip Phone #
Name
��[ I l�( s zvq l
El Vacuum Systems*
5 . 7e 'f'Dh /.C.3 9:5e.e vf/ ❑ Other
CONTRACTOR �rc' D l TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a C i St 0 ( . - • Zi p / ' Phone # Fee for each system $60.00
copy of all licenses 54 L/ Q,l 97 -2f9 lf,/(— 9 (SEE OAR 918 - 260 -260)
are required if Ore Contr. Brd Lic. # E to •
expired in C.O.T. !� Check Type of Work Involved:
data base). EIe� r I C o n . Lic. # E to
, / 1 � l ❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # E . Date
❑ 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:
9
ENTER FEES $ •
Signature /p Or k,J ,3
,M (,9
SURCHARGE 5 X TOTAL ABOVE) $ /
Authority if other than Applicant
TOTAL $ l0 ` 8U
is \dsts \forms\resele.doc 3/98
12/17/1999 Activities for Case #: ELR1999 -00294
3:05:22 PM
•
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level • By Updated Notes
ELRC003 Permit Created 12/07/1999 KJP DONE No Hold DST 12/07/1999
ELRC001 Application Received 12/07/1999 KJP RECD No Hold DST 12/07/1999
ELRC725 Low Voltage Inspection 12/07/1999 DST No Hold DST 12/07/1999
,ELRC799 Elects Final _ 12/07/1999 12/07/1999 12/15/1999 BP PASS No Hold DGW 12/16/1999
ELRC500 (F) Issue permit 12/07/1999 KJP DONE No Hold DST 12/07/1999
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
Location /Z .2- .SO Red. l ?/ //-w Suite 3 MEC
Contact Person 124 Ph olne SO G PLM
y
Contractor Ph SWR
BUILDING Tenant/Owner ELC l/
Retaining Wall ELR /y 0 °`a P 249v
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
S
usp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL \l e
Post & Beam u
Rough In
Gas Line
Smoke Dampers
P I P T FAIL
LECTRICAL
Service
UG /Slab
Low Voltage
Fir -_•
'ART 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 / -4f
Approach /Sidewalk Date / - [ Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.