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Permit t A CITY OF TIGARD 0/9/ E LECTRICAL PERMIT - RESTRICTED ENERGY '�, tl'� DEVELOPMENT SERVICES PERMIT #: ELR1999 -00310 '' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 G� DATE ISSUED: 12/17/99 SITE ADDRESS: 10751 SW 130TH AVE " I PARCEL: 1S133AC -KNOW1 SUBDIVISION: KNOWLEDGE BEGINNINGS DAYCARE C i ZONING: R -25 BLOCK: LOT: 001 JURISDICTION: TIG Project Description: Installation of protective signaling. Job No. 083 - 12008 -01. 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: Contractor: GRABHORN, BURTON E ADT SECURITY SERVICES, INC 11493 SE 82ND 2815 SW 153RD DR PORTLAND, OR 97266 BEAVERTON, OR 97006 Phone: Phone: 503469 -7100 Reg #: LIC 0059944 ELE 26209CLE FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT DEB 12/17/99 $60.00 99- 320499 Elect'l Final 5PCT DEB 12/17/99 $4.80 99- 320499 Total $64.80 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-fo low rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -00 010 throu OAR 9 - 001 -0080. You may obtain copies of these rules or direct questio s to OUNC at (503) 246 -1 7. Issued y /� �j�� Permittee Signature i��� � 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 • : ' 13125 SW HALL BLVD RECEIVE Date Rec'd: 1.2.—/& -9 IP TIGARD OR 97223 / 'JAG / PRINT OR TYPE /a6 p ` O J v- 303- 639 -4171 X304 �/ Ds - O ( Permit #: &e/799-00?./e) F - 503 - 598 -1960 ID 16 19 COMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd: r�t�� ���i DCVCI T WILL NOT BE ACCEPTED Na a opmen rolect TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Restricted Energy Fee $60.00 (FOR ALL SYSTEMS) JOB Street Address / Ste # i ADDRESS / Q 75/ 5 /yea., aote Type of Work Involved: City/�tate D Zi 7la Phone # I Audio and Stereo Systems Nam I Burglar Alarm OWNER Mailing Address Garage Door Opener* City /State Zip Phone # I Heating, Ventilation and Air Conditioning System* Name I Vacuum Systems* ADT SECURITY SERVICES, INC. 2815 S.W. 153rd DR. I Other 3ONTRACTOR Mailing AddregAVLK IUN, OR 97006 (503) 469 -We TYPE OF WORK INVOLVED - COMMERCIAL ONLY Prior to issuance a City /State Zip Phone # Fee for each system $60.00 ;opy of all licenses (SEE OAR 918 - 260 -260) are required if Oregon Contr. Brd Lic. # Exp. Date �� expired in C.O.T. 599 Check Type of Work Involved: data base). Electrical Contr. Lic. # Exp. Date 26 -;-09 I Audio and Stereo Systems C.O.T. or Metro Lic. # Exp. Date I Boiler Controls Owner's Name I Clock Systems • OWNER - Mailing Address APPLICANT I Data Telecommunication Installation • City /State Zip Phone # I Fire Alarm Installation his permit is issued under OAE 918 - 320 -370. This applicant agrees to lake only restricted energy installations (100 volt amps or less) under this I I HVAC • srmit and to do the following: n Instrumentation Only use electrical licensed persons to do installations where required. Certain residential and other transactions are exempt from licensing. [1 Intercom and Paging Systems These have asterisks( *). All others need licensing; Call for inspections when installation under this permit are ready for I I Landscape Irrigation Control* inspection at 503 - 639 - 4175; I I Medical Purchase separate permits for all installations that are not ready for an inspection when the inspector is out to inspect under this permit; Nurse Calls Assume responsibility for assuring that all corrections required by the I I Outdoor Landscape Lighting* inspector are done, and; Protective Signaling Assume responsibility for calling for a final inspection when all of the corrections are completed. I I Other 'rmits are non - transferable and non - refundable and expire if work is not irted within 180 days of issuance or if work is suspended for 180 days. Number of Systems , e person signing for this permit • yst be the applicant or a person ' No licenses are required. Licenses are required for all other installations thorized to bind the applicant . ; / gc.",„: ' / / FEES: E. -7` g < - ENTER FEES $ ‘)10t r d8 - b"/ SURCHARGE (.05 X TOTAL ABOVE) $ 1 4 lthority if other than Applicant TOTAL $ (o y, ' ;ts \forms \resele.doc 3/98 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 / BUP 2�/ Date Requested q 00 AM PM BLD Location 1D / 3Y Suite MEC Contact Person 0_0n Vl l S Ph Sq© r7 'in PLM Contractor Ph SWR : 1 Tenant/Owner ELC • etaining Wall ELR rl cOQ S Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing EL/L / Q9 ,_ 0 0 2S Insulation Drywall Nailing EL2 /'?'?9 - (9 0 3/ 0 Firewall Fire S•ri 4 ler ELI- Z4$) 1990 q ( 0-/-v,90.) 7 /E--4a u o's Ceiling E L& — d VS Roof Lf1 Zc� (? -- s3 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 PAS PART FAIL ECTRIC Service Rough In UG /Slab Low Voltage Fire Alarm • SS PART FAIL 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 reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date Ar/ Inspector - Ext Final PASS PART FAIL DO NO REMOVE this inspection record from the job site. 04/28/2000 Activities for Case #: ELR1999 -00310 8:45:41 AM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELRC001 Application Received 12/16/1999 DEB DONE No Hold DEB 12/16/1999 ELRC003 Permit Created 12/16/1999 DEB DONE No Hold DEB 12/16/1999 ELRC400 (F) Ready to issue 12/16/1999 DEB DONE No Hold DEB 12/16/1999 ELRC725 Low Voltage Inspection 12/16/1999 DEB No Hold DEB 12/16/1999 ELRC799 Elect'I Final 12/16/1999 12/16/1999 04/26/2000 CD PASS No Hold AKJ 04/26/2000 ELRC500 (F) Issue permit 12/17/1999 DEB DONE No Hold DEB 12/17/1999 ELRC800 Case finaled 04/26/2000 AKJ DONE No Hold AKJ 04/26/2000 Page 1 of 1