Permit OF ELECTRICAL PERMIT — � RESTRICTED ENERGY
CoMMUNUTY DEVELOPMENT DEPARTMENT PERMIT #: ELR96-0223
13125 SW Hall Blvd. Tigard, Oregon 97223°8199 (503) 639-4171 DATE ISSUED: 07/10/96
PARCEL: 2S111BD-02700 •
SITE ADDRESS...: 14650 SW 97TH AVE
SUBDIVISION ' CLOUD CAP IONING:R-3.5
BLOCK..........: LOT ..... ........:9
Project Description:
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 --
TIGARD TUALATIN SCHOOL DIST type amount by date recpt
13137 SW PACIFIC HWY PRMT $ 40.00 CJS 07/10/96 96-281505
5PCT $ 2.00 CJS 07/10/96 96-281505
TIGARD OR 97223
Phone #: 684-2353
Contractor: — — —
SONITROL PACIFIC $ 42.00 TOTAL '
1974 SW 6TH AVE
REQUIRED INSPECTIONS --
PORTLAND OR 97201 Wall Cover Elect'l Final
Phone #: 503-223-5822 Elect'l Service ___
Reg #..: 53535
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permitee Signature
applicable laws. Al} work will be done in accordance with
approved plans. This peroit will expire if work is not started
within 180 days of issuance, or if work is suspended for norp
than 18W days. Issued By
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 GUPR, ELEC'N: YMC41 DATE:
LICENSE NO: _ _______ ___
Call for inspection — 639-4175
I
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT # et R96- C2 3
one (503) 63
7h�t Ph
FAX (503) 6847 297 DATE ISSUED 2;3/%0
TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY rho r- ler- S i4 a1; d - I r
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
%%G,ro jo 72 A,,,,, 00,4 , jti A-
Address RESIDENTIAL — Restricted Energy Fee $40.00
��• �� D'it 7,)-2, > (FOR ALL SYSTEMS)
City ( State Zip Check Type of Work Involved:
PERMITS ARE NON - TRANSFERABLE AND NON - REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems
IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
180 DAYS. ❑ Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener*
J /� ❑ Heating, Ventilation and Air Conditioning System*
Contractor��i/,�ii / �.c Type �'Ar7�1' �ii/��j�' ❑ Vacuum Systems*
g 614 (/ ❑ Other
Address //77 Lk 4 A ,Z6/ l at f
Date i ‘ COMMERCIAL — Fee for each system $40.00
p (SEE OAR 918- 260 -260)
Property Owner 1l ,_ %( 4 2J7' Check Type of Work Involved:
Contractor's Board Reg. No. k.5-3,..5-3 J ❑ Audio and Stereo Systems
172- ❑ Boiler Controls
a
Phone # 'L'
❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No
❑ Instrumentation
Address ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
City State Zip ❑ Medical
This permit is issued under OAR 918 - 320 -370. This applicant agrees to make only ❑ Nurse Calls
restricted energy installations (100 volt amps or less) under this permit and to do the ❑ OuTdoor Landscape Lighting*
following: 0 /
Protective Signaling
1. Only use electrical licensed persons to do installations where required. (Certain
residential and other transactions are exempt from licensing. These have ❑ Other
asterisks( *). All others need licensing).
2. Call for an inspection when all of the installations under this permit are ready
for inspection at 503- 639 -4175.
❑ Number of Systems
3. Purchase separate permits for all installations that are not ready for inspection
when the inspector is out to inspect under this permit. * No licenses are required. Licenses are required for all other installations.
4. Assume responsibility for assuring that all corrections required by the inspector
are done, and
5. Assume responsibility for calling for a final inspection when all of the 5* FEES
corrections are completed.
•
UD
The person signing for this permit must be the applicant or a person a. Enter Fees $ 5
authorized to bind e applicant.
urn
b. 5% Surcharge (.05 x total above) $
Signature 2 c,
TOTAL $
Authority if other than applicant
ENERGAP.CHP
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location /9C.5 27 Suite, MEC
Contact Person Ph PLM
Contractor S � / / Ph 00 S 2- SWR
BUILDING . ; Tenant/Owner /,i4,90,1 , / �� ELC
Retaining Wall ELR qq - 0132-z 3
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab K r - < SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall /
Fire Sprinkler 141 S ' P e PYt #0 0,e. 4 A,- I) 1,3 // "`-
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL G H ! 4 S S
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
PA FAIL
--
Service
Rough In
UG /Slab
irAlarm
_ 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 n
pec
Approach /Sidewalk D F /l/ Inspector Other • .l�f � �� Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
1
. � 9 ?- z
CITY OF TIGARD BUILDING INSPECTION DIVISION £.
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: _ 3 - / "- p d k) " ' � 7 , A.M. P.M. MST:
Location: / SD / 1,�{=r�/' 1' / • BUP:
Tenant: /'(... I Suite: Bldg: MEC:
Contractor: Se / itl-Ci 1 Phone: a 3 - 5" D-c-- PLM:
Owner: s� �_) I ' / .0.. / Phone: ,�,�} ELC:
..:D. I SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover • •+• Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C lab �, �,,,,��JJ,�
Shear /Sheath . Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volts lG�'!,C Y/ fil el
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
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� G.z
Q— Cat_ 3/0'.?
O Call for reinspection O Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: e l / Date: Z / Page of