Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
o , .� 1i6 DEVELOPMENT SERVICES PERMIT #: ELR2000 -00088
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 04/25/2000
SITE ADDRESS: 14865 SW 74TH AVE PARCEL: 2S112AC 01200
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: 020 JURISDICTION: TIG
Project Description: 1 Fire Alarm Installation and 1 Landscape Irrigation Control System in existing commercial building.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: X
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 2
Owner: Contractor:
FANNO ACRES BUS.PARK/KNHS DEV QUADRANT SECURITY
26262 S MERIDIAN ROAD PO BOX 14833
AURORA, OR 97002 PORTLAND, OR 97293
Phone: Phone: 234 -5558 OR1G1NA1
Reg #: SUP 1211JLE
LIC 00096806
ELE 26565CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT KJP 04/25/200C $120.00 0001695 Elect'I Final
5PCT KJP 04/25/200C $9.60 0001695
Total $129.60
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 throw AR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 =1987.
Issued by X Permittee Signature Lc( —
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
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: .
12125 SW HALL BLVD Date Rec'd:
TIGARD OR 97223 PRINT OR TYPE
V 503-639-4171 X304 Permit #: aleD. l i0,- 0 0?
F - 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
/51-A7N AGr1 5 6 vS/N /
Restricted Energy Fee $60.00
(FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS N`66‘. $ Li -7e AJ&--- Check Type of Work Involved:
City /State Zip Phone # n Audio and Stereo Systems
T/G 414. n d /Z_ 9 72 ,67V r
Name n Burglar Alarm
OWNER Mailing Address n Garage Door Opener*
A do x. rg'g
City /State Zip Phone # n Heating, Ventilation and Air Conditioning System*
, )1( cKA Olt. 970o1... 671r ir
Name n Vacuum Systems*
C�uA �), O /J 7 SE / A2L
n Other
CONTRACTOR Mailing Address
O a 130 a ( P /33 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /State Zip Phone # Fee for each system $60.00
copy of all licenses P 2 7c - ,i 0 O+C_ 972-9 3 '2.315* 5 (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Brd Lic. # E � Dat�
expired in C.O.T. �r 9-0,-..C. �3i o > Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp. D
Z s G -` e ic) / d n Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. a
n Boiler Controls
Owner's Name
Gg u& p70 1 ,19 - A M.7 b G/LF &K 4c,a-5 n Clock Systems
OWNER - Mailing Address
APPLICANT e? (, , ' 8o)< / n Data Telecommunication Installation
City /State Zip Phone #
/9- (J/toK.,4 o 5'70c 93 c / . - 5s7 Fire Alarm Installation Coo F/'Z sLieiirs -5/0N 5 7
This permit is issued under OAE 918- 320 -70. This applicant agrees to
make only restricted energy installations (100 volt amps or less) under this n HVAC
permit and to do the following:
n Instrumentation
1. Only use electrical licensed persons to do installations where required.
Certain residential and other transactions are exempt from licensing. n 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; pi Medical
3. Purchase separate permits for all installations that are not ready for an n Nurse Calls
inspection when the inspector is out to inspect under this permit;
4. Assume responsibility for assuring that all corrections required by the n Outdoor Landscape Lighting*
inspector are done, and;
.1; tMg
5. Assume responsibility for calling for a final inspection when all of the
corrections are completed. n 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. - 2-- - -. 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.
y FEE S:
ENTER FEES $ /aO
Signature b0
'/ /,, q� 8% SURCHARGE (.08X TOTAL ABOVE) $
F14/40 //< g J , G'G-� TOTAL $ ia �J. O
Authority if other than Applicant
is \dsts \forms \resele.doc 3/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/�/ BUP
Date Requested "1/ 21 00 AM PM BLD
Location / '1 v� c 7 91A- Suite MEC
Contact Person hdL Ph 6 13q - 5 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR 2"c8 d
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
Susp'd Ceiling
Roof
Misc:
Final 0/---/ l - C �`
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
CE P SS ART FAIL
CTRICA
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before - t inspection ay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA � Approach /Sidewalk i.17---/9
Other Date Inspecto *W .. 4). _ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.