Permit n CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
$1%*
- 13125 EVE H BMENq Tigard, ) 639 -4171 DATE ISSUED: 0%26/0 0089
2000
SITE ADDRESS: 09575 SW LOCUST ST PARCEL: 1S126DC-04500
SUBDIVISION: LEHMANN ACRE TRACT ZONING: C -P
BLOCK: LOT: 007 JURISDICTION: TIG
Project Description: Fire alarm installation
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: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
VIPS ENTERPRISES FIRE PROTECTION SERVICES
29757 SW BOON ES FERRY RD 15100 SW 139TH AVE
WILSONVILLE, OR 97076 TIGARD, OR 97224
Phone: 503 - 638 -9289 Phone: 503 - 590 -3732
Reg #: ELE 34- 488CLE
LIC 121039
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT BON 04/26/200C $60.00 0001716 Elect'I Final
5PCT BON 04/26/200C $4.80 0001716
Total $64.80
ORIGINAL
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 rough OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by - 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'N V`f 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:
1312.5 SW HALL BLVD Date Rec'd: - - 7.-C 7 0
TIGARD OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #: I z oV -evf,ce
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
FAE / - Restricted Energy Fee $60.00
� i � /j /1 (FOR ALL SYSTEMS)
JOB Street Address Ste # Check Type of Work Involved:
ADDRESS ''5 75 54) u5�
City /State J Zip Phone # n Audio and Stereo Systems
7 q J OR. 77achi
Name /� �i,� n Burglar Alarm
V s "" e-/ 7 zE s n Garage Door Opener*
OWNER Mailing Address
d;"" 7 57 54-a I r l// poi n Heating, Ventilation and Air Conditioning System*
City /State // Zip P hone #
Ctii / i 1 �/ Zip r i 7o7-6 u Yny
n Vacuum Systems*
Name ,,Q -�
f //',. / 4C7 d h E17/icY4 ❑ Other
CONTRACTOR Mailing Address
/ '(. O 5 ) /3' , 49.4 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /Sta e �Zio Phone # Fee for each system $60.00
copy of all licenses //779,/e4 Cite 'Z7 / 570- (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Brd Lic. # Exp Dat
expired in C.O.T. .0-ion ;3 a-10 9 Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp. Date
'347- 9 gCcE /rr,. n Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date
n Boiler Controls
Owner's Name
n Clock Systems
OWNER - Mailing Address
APPLICANT n, 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 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;
2. Call for inspections when installation under this permit are ready for
n Landscape Irrigation Control*
inspection at 503 - 639 - 4175; n 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;
n Protective Signaling
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. I 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.
/ FEES: Qi
Signature ENTER FEES $ ? �
8% SURCHARGE (.08X TOTAL ABOVE) $ L
t]
Authority if other than Applicant TOTAL $ 62 y
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 7 r3 U AM PM BLD
Location /. Z Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING �1:s =m Tenant/Owner ELC
Retaining Wall ELR 2.1a'it- d 6689
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: �'
Slab .4 7 , 2_ SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -
Roof
Misc:
i
Final CO
PASS PART FAIL
PLUMBING
Post & Beam Q \
Under Slab 61Y l Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
RT FAIL
ELECTRICAL
Service
Rough In
UG /Slab
ow'VoTfac ›
Fire Alarm
Final
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 !! ,r
Approach /Sidewalk Date -" - / .7' t✓ Inspector
Other Xt
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.
•