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Permit CITY OF TIGARD .,,,_, knu 1A DEVELOPMENT SERVICES ELECTRICAL PERMIT -'� ; 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 RESTRICTED ENERGY PERMIT #: ELR98 --0147 DATE ISSUED: 06/05/98 PARCEL: 1S126C0 -01107 SITE ADDRESS... :09522 SW WASHINGTON SQUARE RD SUBDIVISION....: ZONING :C —G BLOCK..........: LOT - .TURISDICTN: TIG Project Description: Electrical addition A. RESIDENTIAL B. COMMERCIAL----- - - -- AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..: BURGLAR AL-ARM....: BOILER..........: LANDSCAPE /IRRIGAT..: . GARAGE OPENER....: CLOCK - MEDICAL_ HVAC.e....... .... . DATA /TELE COMM..: NURSE CALLS......... VACUUM SYSTEM....: FIRE ALARM......: OUTDOOR LANDSC LITE: OTHER: 00 HVAC - PROTECTIVE SIGNAL-2X INSTRUMENTATION.: OTHER..: . TOTAL # OF SYSTEMS: 1 Owner: FEES BANANA REPUBLIC type amount by date recpt 9522 SW WASHINGTON SO RD PRMT $ - 40.00 B 06/05/98 98- 306314 , TIGARD OR 97223 5PCT $ 2.00 B 06/05/98 98- 306314 Phone #: Contractor: -- ADT SECURITY ALARMS $ 42.00 TOTAL 703 NE HANCOCK REQUIRED INSPECTIONS PORTLAND OR 97212 Ceiling Cover Low Voltage Insp Phone #: 284 -3265 Wall Cover Elect'l Final Reg #- - : 000599 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 rule 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 d questio s o OUNC at (503)246 -1987. • Issued b y ' `� Permittee Signature ms ikC IU � !� �� _ fr - 1 l 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 +++++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + +•+• • r 1 CITY OF TIGARD ESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: N 13125 SW HALL BLVD d 83 -/o / G 1' /ED Date Rec'd: " l u TIGARD OR 97223 • 6 / 1 /// g PRINT OR TYPE V - 503 - 639 -4171 X304 -- II�� IIC�II n � � 1998 Permit #: fig 4 --01 yl F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICA"110NS Cust.Call'd: WILL NOT BE ACCEPTEl I , , , , Name of Development Project TYPE OF Win I4(VOi_VED = RESIDENTIAL ONLY 0L � / � / ig � i Restricted Energy Fee $40.00 '�" !U�- ',�C_i / (FOR ALL SYSTEMS) JOB Street Address , Ste # ADDRESS 9, j S' ,e' 76- 4 / / Check Type of Work Involved: C' y /St a Zip/ P e Audio and Stereo Systems Nnte ❑ Burglar Alarm OWNER Mailing A n Garage Door Opener* City /State Zip Phone # Heating, Ventilation and Air Conditioning System* Name Vacuum Systems* ADT SECURITY SERVICES, INC. 703 NE HANCOCK Other CONTRACTOR Mailing AI/NU. UK 9121$ (503) 284-3265 TYPE OF WORK INVOLVED - COMMERCIAL ONLY (Prior to issuance a City /State Zip Phone # Fee for each system $40.00 copy of all licenses (SEE OAR 918 - 260 -260) are required if Oregon Contr. Bd d c. ,/ Exp. Date expired in C.O.T. / Check Type of Work Involved: data base). Electrical Contr. Lic. # Exp. Date c71-6''01/5 Audio and Stereo Systems C.O.T. or Metro 9 Lic. # Exp. Date ❑ Boiler Controls ,A, • � _,( ��•,_ ❑ Clock Systems OWNER - Mailing As 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 ❑ Outdoor Landscape Lighting* inspector are done, and; i p Protective Signaling 5. Assume responsibility for calling for a final inspection when all of the corrections are completed. ❑ Other Permits are non - transferable an. •n- refun• able and expire if work is not started within 180 day of is .ance or if •.rk is suspended for 180 days. Number of Systems The person signi , . . r thi . per ' ust be the applicant or a person * No licenses are required. Licenses are required for all other installations authorized to b'i : the ap. lic- . _ � FEES: / ‘......At 7 �i 3 7 L ENTER FEES $ y O . C Sign. ture — 7 6 5% SURCHARGE (.05 X TOTAL ABOVE) $ G"' Authority if other than Applicant TOTAL $ i:\dsts\resele.doc 7/97 — 0 Page No. 1 CASE HISTORY FOR CASE NO.: ELR98 -0147 BANANA REPUBLIC 09522 SW WASHINGTON SQUARE RD 07/02/98 Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By ELRC001 Application Received / / / / 06/05/98 RECD B 06/05/98 BON ELRC003 Permit Created / / / / 06/05/98 DONE B 06/05/98 BON ELRC500 (F) Issue permit / / / / 06/05/98 PASS B 06/05/98 BON ELRC799 Elect'1 Final / / / / 06/29/98 security system PASS CD 06/29/98 CD CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639-4171 G BUP ® Date Requested �— �© AM PM BLD Location q5 c3&( ) (/V Suite MEC Contact Person .A1 A alb Ph (j PLM Contractor Ph S6003,7 SWR BUILDING Tenant/Owner ' / r �/. �� Gt GiJ ELC Retaining Wall ✓ �;� ELR 7? Footing Access: 1 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 A✓b -Z-Ei� Roof Misc: Final PASS PART FAIL PLUMBING �I 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. --RA FAIL ELECTRICAL Service Rough In UG /S ow Volta Firre Ilarm - AS PART FAQ S E' Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ , required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin _ _ _ __ 11 Fire Supply Line [ Tease call for reinspection RE: ����� „� ] Unable to inspect - no access ADA (7) Otheoach /Sidewalk lag - ct - ' p ) Ext 3S Date q ,� Ins ector �.c Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.