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Permit „ C I TY OF T I G A R D ELECTRICAL CTED ENERGY G - RESTRICTED ENERGY c 1 ��, . DEVELOPMENT SERVICES PERMIT #: ELR2000 - 00090 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 04/27/2000 SITE ADDRESS: 09575 SW LOCUST ST PARCEL: 1S126DC-04500 SUBDIVISION: LEHMANN ACRE TRACT ZONING: C - BLOCK: LOT: 007 JURISDICTION: TIG Project Description: Data telecommunications system A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: X NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: • HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: : TOTAL # OF SYSTEMS: 1 Owner: Contractor: VIPS MOTOR INNS INC . MICRO ELECTRIC VOICE + DATA 29757 SW BOON ES FERRY RD SERVICE WILSONVILLE, OR 97070 24501 S BARLOW RD AURORA, OR 97002 Phone: 503- 638 -9284 Phone: 503 - 266 -5847 Reg #: LIC 131543 ELE 3- 447CLE FEES Required Inspections Type By Date Amount Receipt Elect'I Service Elect'I Final Total • ORIGINAL to 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 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. 6 Issued by 'k.—' Permittee Signature ti , ' - &_% 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. ELECN: I \ k 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: .r.3 1 SW HALL BLVD Date Rec'd: 1-1-Z7 -z-d TIGARD OR 97223 PRINT OR TYPE V - 503 - 639 -4171 X304 Permit #:1- — 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 Restricted Energy Fee $60.00 ?kek9 1x' ,90 (FOR ALL SYSTEMS) JOB Street Address Ste # Check Type of Work Involved: ADDRESS }5 7 5 5.w. foc�•. City /State Zip Phone # n Audio and Stereo Systems 7790-1 L. ©r. `1722.3 ./.... Name n Burglar Alarm V/12 r140 Xpihf V n Garage Door Opener* OWNER Mailing Address n � � 99 7b 7 S+' ✓y n Heating, Ventilation and Air Conditioning System* City /State Zip Phone # Gci.'Ise-- rre.../' ct 7070 3a - 9 ?Sy n Vacuum Systems* Name "WC L/C) Ci -€C.. 2; . n Other CONTRACTOR Mailing Ad re s 3040S. � , cc• ,S..ALe. f Z0 TYPE OF WORK INVOLVED - COMMERCIAL ONLY (Prior to issuance a City /State Zip Phone # Fee for each system $60.00 copy of all licenses C'.-t y Cam. g 70/3 Attie-Alt/7 (SEE OAR 918 - 260 -260) are required if Oregon Contr. Brd Lic. # Exp. Date expired in C.O.T. /3/ 53/..3 ._ ,z.coZ, Check Type of Work Involved: data base). Electrical Contr. Lic. #{ Date n7 PI q.S R T .T 3 -_--- a x p ( — Z.P)V n ystems Audio and Stereo Systems or Metro Lic. # Exp. Date n Boiler Controls Owner's Name n Clock Systems OWNER - Mailing Address APPLICANT X Data Telecommunication Installation City /State Zip Phone # n 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: 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; n Landscape Irrigation Control* 2. Call for inspections when installation under this permit are ready for 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. EI 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. t d - , " ' FEES: !,�/�'� M� Signature ENTER FEES $ (�(J ` [ ^ g � � 8% SURCHARGE (.08X TOTAL ABOVE) $ 1 4' -0 UU Authority if other than Applicant TOTAL $ ( DU is \dsts \forms \resele.doc 3/98 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ,,hh BUP Date Requested ��is /./0 AM PM BLD Location qS ) S Lo QQ 1 I Suite MEC Contact Person r, 7) I l Ph / -- PLM Contractor Ph SWR _BUILDING. o.; : `.yu °° Tenant/Owner ELC r� Retaining Wall _.. ... ELR fl Q ?c 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 r Firewall --- Fire Sprinkler � Fire Alarm Susp'd Ceiling Roof Misc: Final (g.o' P ASS 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 PASS PART FAIL Serums Rough In UG /Slab Low Voltage Fire larm 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 reinspecti• RE: . ] Unable to inspect - no access ADA Approach /Sidewalk Other Date y / Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.