Permit CITYOFTIGARD
- �, DEVELOPMENT SERVICES —
-- '1 13125SW Hall Blvd ., Tigard, 0R97223(503)639-0171 RESTRICTED ENERGY
PERMIT #: ELR99 -0042
DATE ISSUED: 03/09/99
PARCEL: 2S112DC -00100
SITE ADDRESS...:157O5 SW 72ND AVE
SUBDIVISION -SOUTHERN PACIFIC TIGARD INDUST ZONING :I —L
BLOCK LOT •002 JURISDICTN: TIG
Project Description : Installation of entry access.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM BOILER • LANDSCAPE/ IRRI GAT. .
GARAGE OPENER • CLOCK • MEDICAL •
HVAC • DATA /TELE COMM..: NURSE CALLS -
VACUUM SYSTEM - FIRE ALARM • OUTDOOR LANDSC LITE:
OTHER: .. HVAC • PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER... :ENTRY ACC : :X
TOTAL # OF SYSTEMS: 1
Owner: FEES
TETRA PLASTICS type amount by date recpt
15705 SW 72ND AVEE PRMT $ 40.00 GEO 03/09/99 99- 313543
TIGARD OR 97224 5PCT $ 2.00 GEO 03/09/99 99- 313543
Phone #:
•
Contractor: —
HUSER INTEGRATED TECHNOLOGIES .$ !42.00 TOTAL
1313 NW 17TH AVE
REQUIRED INSPECTIONS
PORTLAND OR 97209 Low Voltage Insp
Phone #: 227 -6688 Elect' 1 Final
Reg #..: 67549
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 952-681-0010 through OAR 952-001 -0080. You may obtain copies of
these rules or dire, ques i .. to at (503)246 -1987.
I Issued •,� // .� Permittee Signature
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: 3` Fr
LICENSE NO:
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Recd by:
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW HALL BLVD Date Rec'd: -
TIGARD OR 97223 PRINT OR TYPE
V - 503t39-4171 X304 Permit #: FCR99- 00 R
F INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
,�+ � .. , ` t Restricted Energy Fee $40.00
I t t Fl (FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS I 'TO r
S , W ^ y z Check Type of Work Involved:
Cit /State i Phone # Audio and Stereo Systems
c -Pia.b i2Tzzcf ❑
Name ❑ Burglar Alarm
OWNER Mailing Address ❑ Garage Door Opener*
City /State Zip Phone #
❑ Heating, Ventilation and Air Conditioning System*
Name n Z ❑ Vacuum Systems*
_kvi sga .Jt r� ei� ❑ Other
CONTRACTOR Mailing Address
(?) (3 ,1/41 LO l-1 f10£ TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a Ci t to ,,`` Phone # Fee for each system $40.00
copy of all licenses ll� 2 � -Z_ 7 Gb kf (SEE OAR 918 - 260 -260)
are required if regon C ntr rd Lic. # Exp. Date
expired in C.O.T. 67,4 - 4 Check Type of Work Involved:
data base). Electrical Contr. Lic. # E D to
2,6- 5 1 t„,� / - 7 _ t ❑ Audio and Stereo Systems
C.O.T. or Metro Lic
1-1 � �- (p , � s0 �xp ateo ❑
Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT ❑ Data Telecommunication Installation
City /State I Zip I 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; ❑
Protective Signaling
5. Assume responsibility for calling for a final inspection when all of the r
corrections are completed. Other ' {�L �� ` 9 C. c/'L 5
c-
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:
1 ' 41 ""' ENTER FEES $
Signature ---,
5% SURCHARGE (.05 X TOTAL ABOVE) $ O�
Authority if other than Applicant TOTAL $ 4 fa
i:ldstskesele.doc 7/97 —
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
U BUP
Date Requested 16,11 AM PM BLD
Location (57d 5 72- s41)-ei Suite MEC
Contact Person P7 / j U al "(.' iO /' Ph 22- - (p(/$ PLM
Contractor Ph SWR
BUILDING Owner ELC /� / ,
Retaining Wall ELR �-/ -nhL
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing //✓)'LII
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling (C
Roof /VD Te- /A/SAA-L.L� S' GAL / ED Qe..1 K G .
Final
PASS PART FAIL 1 ^J K' f S,yA/
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
�LECTBI AP
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ 1 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk
Date
Other -�� - 9? Ins Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.