Permit - A. CITY OF TIGARD
DEVELOPMENT SERVICES ,.., =�= ��"�" "°"�"� " =�" "= "*��~� ELECTRICAL PERMIT -
.4111' 1L 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 RESTRICTED ENERGY
PERMIT #: ELR97-0019
DATE ISSUED: 01/15/97
PARCEL: 2S110AA-00300
SITE ADDRESS...: 14145 SW 105TH AVE
SUBDIVISION • ZONING:R-12
BLOCK • LOT •
Project Description: TIGARD CARE CENTER NURSE CALL
_ .
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 ^X
VACUUM SYSTEM ^ FIRE ALARM ^ OUTDOOR LANDSC LITE:
OTHER: :: HVAC • PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER..:
TOTAL #. OF SYSTEMS: 1
Owner: -------- FEES
TIGARD CARE CENTER ^ type amount by date recpt
14145 SW 105TH AVE PRMT $ 40.00 JSD 01/15/97 97-288951
5PCT $ 2.00 JSD 01/15/97 97-288951
TIGARD OR 97224
Phone #:
Contractor:
MOORE COMMUNICATIONS INC $ 42.00 TOTAL
20811 NW CORNELL RD
STE 700 REQUIRED INSPECTIONS
HILLSBORO OR 97124 Ceiling Cover Elect'l Final
Phone #: 617-9800 Wall Cover
Reg #. . : 007636
This petit is issued subject to tbe regulations, contained in the
Tigard Mmmici�lCede State Ore. y�dws and �ll�other ' tee__
applicable laws. All work will be done in accordance with f approvod plano Thim permit will expire if work iy m± st�ted
within 180 days of issuance, or if work is suspended for mmre �- -
than 180 days. Issued B
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 for inspection - 639-4175
01/09/97 09:37 17503 684 7297 CITY OF TIGARD 1.1002/002
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by: 4
13125 SW HALL BLVD Date Rec'd: C> r I Sc
TIGARD OR 97223 PRINT OR TYPE
V - 503 X304 Permit #: 7 / — ' 19
F - 503 -684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust_CaiI'd: C Z
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL
Restricted Energy Fee 54.0.00
(FOR ALL SYSTEMS)
JOB ' Street Address Ste*
ADDRESS 14t ( IS 3w j,6S-11'-, Check Type of Work Involved:
/ Stata Zip Phone # I I Audio and Stereo Systems
t (APB I O(t (
Name ❑
Burglar Alarm
— Ft g (AWE (.0.7TEe_
❑ Garage Door Openef'
OWNER Mailing Address
it 1_4 C 51r.1 10 S ❑ Heating, Ventilation and Air Conditioning System'
City /State Zi Phone #
T1 u'r n a "aa4 I il1(L LI Vacuum Systems
Name
igv Ursa 2/.1..) tuckluw n Other
CONTRACTOR Mailing Address
ciMI1 #4/V Wt - t✓t) 0, 4 7o0 TYPE OF WORK INVOLVED - COMMERCIAL
(Prior to issuance a Ity /rate p Phone # Fee for each system 540.00
copy of all licenses j'1 ���hjgp g11�iy (p (1'"i DW (SEE OAR 918- 260 -260)
are required if Oregon Contr. Ord Lic. # , E Date
expired in C.O.T. >•o� 4 t t v 1 Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp. Date
34 35((C LE. i2/ ii I ii 1 p Audio and Stereo Systems
G_O.T. or Metro Lic. # HSI O (111 !4r) ❑
Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT ❑ Data Telecommunication Installation
City /State 1 Zip Phone # ❑
Fire Alarm Installation
This permit is issued under OAE 918- 320 -370. This applicant agrees to
make only restricted energy installations (100 von 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 - 839 .4175; ❑ Medical
3. Purchase separate permits for all installations that are not ready for an
71
inspection when the inspector is out to inspect under this permit; Nurse Calls
4. Assume responsibility for assuring that all corrections required by the n Outdoor Landscape Lighting'
inspector are done, and;
❑ Protective Signaling
5. Assume responsibility for calling for a final inspection when all of the
corrections are completed, ❑ 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. Number of Systems
The person signing for this permit must be the applicant or a person " No licenses
are required. License* are required for all other inslallatlone
authorized to bind the applicant.
, i 7kl-e-fr-b------ ENZA:
Signakur ENTER FEES 5 '1 ^^ �.'
5% SURCHARGE (.05 X TOTAL ABOVE) $ o!•
Authority if other than Applicant TOTAL $ LP. C)
I:vesele,doc 12/98
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing Mec
PIbg.Und /FIr /Slab Plbg. Top Out Insulation -Elec
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: I /
Date: 3(3/ I q7 A.M. P.M. Entry:
Address: / / (Li / 0 9 �
Tenant: _144,Ciy0 Zet -Q) Ste: MST
BUP:
Con /Own: MEC:
PLM
fr0"'
EL . Ar
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: -- 7
.. __ e:3t I / d o e j—ej
Inspector: // . • -- .01 - Date: 7....
XAPPROVED _ DISAPPROVED /CALL FOR REINSP. p CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
Plbg.Und /FIr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: f G
Date: 1 1 �P (_l 7 A.M* P.M. Entry:
Address: /
' l (5 `4 S
Tenant: -Q. Ste: MST:
BUP:
Con /Own: El MEC:
PLM:
ELC: =
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:77_,. /y .
ZeiCell '' e . it 4c- 'f
I , ., ...0-____, �
_ . Air A.
Inspector: /0 C `7 •-P / X ew e Date: / -- -/ - 9 1 7
,APPROVED _ DISAPPROVED /CALL FOR REINSP. CF CO
i /