Permit C ITY OF TIGARD RESTRICTED ENERGY
V.i ELECTRICAL PERMIT -
DEVELOPMENT SERVICES PERMIT #: ELR2000 -00220
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/22/00
SITE ADDRESS: 10349 SW 71ST AVE PARCEL: 1S136A6 -04900
SUBDIVISION: MAPLELEAF ZONING: R -4.5
BLOCK: LOT: 007 JURISDICTION: TIG
Proiect Description: Installation of landscape irrigation controller.
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::ONTROLLER : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
INMAN, DAVID S + CHERYL F OWNER
16622 SW 88TH PL
TIGARD, OR 97224
Phone: 503 -684 -5947 Phone:
Reg #:
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 9/22/00 $75.00 2720000000 Elect'I Final •
5PCT CTR 9/22/00 $6.00 2720000000
Total $81.00
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 OAR 952 - 001 -0080. You may obtain copies of these rul s or ire questio OUNC at (503)
246 -1987.
Issued by Permittee Signature
OWNER INSTALLATION ONLY
The installation is being m • e o pro ..i rty I y n ich is • of intended for sale. lease, or rent.
OWNER'S SIGNATURE: ,� - - — DATE: q- Z Z -00
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
CITY; OF 'TIGARD Restricted Energy Electrical Application Rec'd by: 7-� G 6(
1f125 SW HALL BLVD .. Date Rec'd: 9/2 z /c-T&
TIGARD OR 97223 Incomplete or illegible applications ,/ Permit #: ELi2 Z'7 -CV 2-Zt)
V - 503439 -4171 X304 will not be accepted 1 Cust.Call'd:
F - 503 -598 -1960
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL 0 Y
Restricted Energy Fee 75.00 j
JOB Street Address ddress 1- Ste # (FOR ALL SYSTEMS)
ADDRESS l O 3 `(/ 9 S w 7/ — / 1 a • Check Type of Work Involved:
City /Stat Zip Phone #
4 o✓d nr q 7Z z 5 ZV Y-o'Y3 ❑ Audio and Stereo Systems
e '
II El Burglar Alarm
ob,l;d .1 � >vta�
OWNER Mailing Address sf El Garage Door Opener'
/0 3 (141 5 71— )
City /State Zip Phone #
/ El Heating, Ventilation and Air Conditioning System'
rg�q � ` o N 97 z 3 ZYY
b� ❑
Na Vacuum Systems*
CONTRACTOR Mailing Address Other hut /4 C7Af772 f_1 - &
(Prior to issuance a City /State Zip Phone # TYPE OF WORK INVOLVED - COMMERCIAL ONLY
copy of all licenses
are required if Oregon Contr. Brd Lic. # Exp. Date Fee for each system $75.00
expired in C.O.T. (SEE OAR 918 - 260 -260)
database). Electrical Contr. Lic. # Exp. Date
Check Type of Work Involved:
C.O.T. or Metro Lic. # Exp. Date ❑
Audio and Stereo Systems
Owner's Name
❑ Boiler Controls
OWNER - Mailing Address
APPLICANT ❑ Clock Systems
City /State Zip Phone # ❑
Data Telecommunication 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 Fire Alarm Installation
permit and to do the following: ❑
HVAC
1. Only use electrical licensed persons to do installations where required.
Certain residential and other transactions are exempt from licensing. ❑ Instrumentation
These have asterisks(*). All others need licensing;
❑ Intercom and Paging Systems
2. Call for inspections when installation under this permit are ready for
inspection at 503 - 639 -4175; ❑ Landscape Irrigation Control'
3. Purchase separate permits for all installations that are not ready for an ❑ Medical
inspection when the inspector is out to inspect under this permit;
4. Assume responsibility for assuring that all corrections required by the Ell Nurse Calls
inspector are done, and; ❑
Outdoor Landscape Lighting*
5. Assume responsibility for calling for a final inspection when all of the f �
corrections are completed. ' I 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.
Number of Systems
T • . > on sign , g for this permit be the applicant or a person
utho ' - d to bi . the appli . nt • No licenses are required. Licenses are required for all other installations
1 ' FEES: 7
Sl: - ure
ENTER FEES $ / .0-7)
8% SURCHARGE (.08 X TOTAL ABOVE) $ fi � �,\
TOTAL $ C1 / . f/ (J
Authority if other than Applicant t 0 O
ildstsformstresele.doc 8 /00 3q . t
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST - z
24 Inspection Line: 639 -4175 Business Line: 639 -4171
�T/ BUP
-``
Date Requested Z AM PM BLD
Location l 0 l q 6CtJ '7 /s7/ Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ,�R) 2017 ®f,2 oz.()
Footing Access: C./
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall
Fire Sprinkler e
Fire Alarm
Susp'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
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL G t,�•�/ / ti •
Service
Rough In , y
UG /Slab ��
Low Voltage
Fire Alarm
Fi
PAS PART FAIL
tTl
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 einspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date /�� Inspector /, �� �` Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.