Permit A CITY OF TIGARD
DEVELOPMENT ��� ��������
.,,,,,,„,,,,, w�x��v��n�o nmnx�x� m SERVICES ELECTRICAL PERMIT -
~ !J 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171 RESTRICTED ENERGY
PERMIT #: ELR98-0139
DATE ISSUED: 05/21/98
PARCEL: 29113AD-01900
SITE ADDRESS...:16630 SW 72ND 16630-40 AVE #B-10
SUBDIVISION....:ROSEWOOD ACRE TRACTS ZONING:I-L
BLOCK..........: LOT ....... ......:009 JURISDICTN: TIG
Project Description: Oregon Business Park Bldg 10
------------ ----- - --------------------------------------------
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: :: HVAC ^ PROTECTIVE SIGNAL..:X
INSTRUMENTATION.: OTHER..: ::
TOTAL # OF SYSTEMS: 1
Owner: ------------------ --------------------------- FEES -- -------
PACIFIC REALTY ASSOCIATES type amount by date recpt
15350 SW SEQUOIA PKWY STE 300 PRMT $ 40.00 JSD 05/21/98 98-305926
PORTLAND OR 97224 5PCT $ 2.08 JSB 05/21/98 98-305926
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 Cower Elect"l Final
Reg #..: 0@0599
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 i - ance with approved plans. This permit will expire if work is not s . '' within 180
days of issuance, 01' if work is suspend for more than 180 days. ATTENTION: Dregmm law requires you tofollow e./opted�
Oregon Utility OAR 952-001-0010 through DAR 952-001-0080. Y. ma obtain ries of
these rtles di�� ' to ^
°' y "=� ' ' PI
Issued by ~ ,40 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 _______DATE:
LICEMSE �Q: __
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
CITY OF TIGARD RESTRICTED ENERGY Ei.ECTRICAL APPLICATION Rec'd by: �,,,,/ il;
�
13125 SW HALL BLVD 46 3 1.5
54 Sr- $g' 03 Date Rec'd: > C/
TIGARD R OR 97223 �P / PRINT OR TYPE
V = 503- 639 -4171 X304 Permit #: v
F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
a sue. ! # % d (FOR ALL SYSTEMS) Restricted Energy Fee $40.00
4..Q_
JOB Stre ddress ' Ste # e -
ADDRESS 4630 si) 7o1 aae_., Check Type of Work Involved:
Cit State m 97 4 P4 3 7�p Audio and Stereo Systems
,
Na L //ro ❑ Burglar Alarm
OWNER MailingAdd ❑ Garage Door Opener*
City /State Zip Phone # ❑ Heating, Ventilation and Air Conditioning System*
Name El Vacuum Systems*
AOT SECURITY SYSTEMS, INC.
703 HANCOCK ❑ Other
CONTRACTOR Mailing Add/MILANO. OR 97212
(503) 284 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. Brd Lic. 7i • Exp. Date
expired in C.O.T. . -99 Check Type of Work Involved:
data base). Electrical Cor�l 9 Exp. Date ❑
��(p Audio and Stereo Systems
• C.O.T. or Metro Lic. # Exp. Date
❑ Boiler Controls
Own is Na �
L: � � t u ❑ Clock Systems
OWNER - Mailing Ad. /ss
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;
VI Protective Signaling
5. Assume responsibility for calling for a fin- sp: ion when all of the
corrections are completed. ❑ Other
Permits are non - transferable • d - • efun • : ble and expire if work is not
started within 180 days of is - ce , r if • rk is suspended for 180 days. Number of Systems
The person signi, - for th'< permit , ■ st be the applicant or a person • No licenses are required. Licenses are required for all other installations
authorized to • • f 'the . • •licant.
I FEES:
Si. atur- , ` e3 g� ENTER FEES $ 4 / 6 /
5% SURCHARGE (.05 X TOTAL ABOVE) $ i
Authority if other than Applicant TOTAL $ /
i:\dsts\resele.doc 7/97 — ,T -A i
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
�i BUP
[A) 7 Date Requested - � — � 9' 7a AM PM BLD
Location /6 2 S60 7c, ,)-n. Suite MEC
Contact Person 4,/ (/V CV Ph ,► / 6 77,7 PLM
Contractor �� i► Ph .6.0—(7)-3,11 SWR
BUILDING Tenant/ wner I ,, ELC (� /
Retaining Wall /���,�//f p�y . c2„1 :S"2tt'Z.:� ELR �0 — 0(37
Footing ACC ss: yl,••
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: ow I 0 � Q „ Slab r G'�1/0 SIT
Post & Beam
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
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
FAIL
Service
Rough In
I nw Voltan
,,F - VIP'
PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ,rte
Fire Supply Line [!/1Please call for reinspection RE: 2 /c.. / '— �� [ nable to inspect - no access
ADA /J
Approach /Sidewalk Date 7 —/f 9, Inspector -C.� il) Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the .job site.