Permit CITY OF T I GA R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
��w DEVELOPMENT SERVICES PERMIT #: ELR2000 -00042
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 02/23/2000
SITE ADDRESS: 11686 SW PACIFIC HY PARCEL: 1 S136CD -01700
W
SUBDIVISION: V ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: Install protective signaling in new commercial building.
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: V Contractor:
MAGNOLIA HI Fl HONEYWELL INC
11686 SW PACIFIC HWY 15495 SW SEQUOIA
TIGARD, OR 97223 STE 100
PORTLAND, OR 97224
Phone: Phone: 968 -3300 ORIGINAL
Reg #: SUP 941 -JLE
LIC 00057824
ELE 26207CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT KJP 02/23/200C $60.00 00- 321823 Elect'I Final
5PCT KJP 02/23/200C $4.80 00- 321823
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 follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 throu h AR 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: DATE:
LICENSE NO:
Call 639 -41.75 by 7:00 P.M. for an inspection needed the next business day
z0., d.> 4101 Re tie \l ° • CITY OF TIGARD RSiTED ENERGY ELECTRICAL APPLICATION Rec'd by:
13125 SW HALL BLVD �� ‘Z' Date Rec'd:
TIGARD OR 97223 F eMEN PRINT OR TYPE
V -
F - 503-59503-638-19-4960 X304 GOMM� O INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd: ��� c�0
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee $60.00
Maq viol ta. 41
i1 _ F (FOR ALL SYSTEMS) .
JOB StreeVAddress Ste #
ADDRESS 1 t (0 %6 SW Tlx (, ft C, } i/ Check Type of Work Involved:
City /State p ( Phone # Eli Audio and Stereo Systems
TI .,a‘ an:It / Q e.. , 9 722,3
Na 1 ❑ Burglar Alarm
NA Ti L
' ` a � 1 (Q - Ft ❑ Garage Door Opener
OWNER Mailing dress
(12 555 "2—'51s Ske ' D Heating. Ventilation and Air Conditioning System'
c Kev In/ 140AZ Phone#
� ❑ Vacuum Systems'
Name t
--! nnP_i we Ai ❑ Other
CONTRACTOR Mailing Add reds
i 54g 5 SW Se VD1A?knv Stet )D TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /State t Phone # Fee for each System 560.00
copy of all licenses 'Por4V)J\C4 /Q1 7 Z Q f ic.s�0 (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Brd Lie. # • 7 ,,,D 7 at •
expired in C.O.T. O 5i 7 ' 2-, n._..
Check Type of Work Involved; •
data base). Electrical Contr. . to 9-‘, _ p 7. . L Qt) ❑ Audio and Stereo Systems
C.O.T. or Metro Lie. # Ear a
0 000 ( 7 4. 67 /e) / / / Di7 ❑ Boiler Controls
• Owner's Name
❑ Clock Systems
OWNER - Melling Address
APPLICANT ❑ Data Telecommunication Installation
' City /Stale r Zip I Phone* ❑
1 Fire Alarm Installation
This permit is issued under OAE 918-320-370. This applicant agrees to ❑ HVAC
make only restricted energy installations (100 volt amps or less) under this
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 licansIng; •
❑ Landscape Irrigation Control'
2. Call for inspections when Installation under this permit are ready for •
Inspection at 503 - 6394175; ❑ Medical
3. Purchase separate permits for all installations that are not ready for an ❑ Nurse Calls
inspection when the inspector is out to inspect under this permit;
4. Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting* ,
Inspector are done, and;
Vj 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 ant or a person • No licenses are required. Licenses are required for all other Installations
authori ,. to bind the applica
FEES: nn
DE
Signature R FEES d8 $
t) SURCHARGE (.ffi C/ X TOTAL ABOVE) $ 4 . O D
Authority if other than Applicant TOTAL $ le I r' 0
i:ldstsVormsVesele.doc 3/98
?O/ O ' d 8622 896 20S 1131'1A3NOH 9 Z : V T OOO -2E -Gad
05/18/2000 Activities for Case #: ELR2000 -00042
3:27:16 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRC001. Application Received 02/23/2000 KJP RECD No Hold KJP 02/23/2000
ELRC725 Low Voltage Inspection 02/23/2000 02/23/2000 No Hold KJP 02/23/2000
ELRC003 Permit Created 02/23/2000 KJP DONE No Hold KJP 02/23/2000
ELRC799 Elect'I Final 02/23/2000 02/23/2000 04/28/2000 . BRP PASS No Hold AKJ 04/30/2000
ELRC500 (F) Issue permit 02/23/2000 KJP DONE No Hold KJP 02/23/2000
ELRC720 Wall Cover 03/23/2000 BRP PASS No Hold AKJ 03/23/2000 rough in
ELRC800 Case finaled • 04/30/2000 AKJ DONE No Hold AKJ 04/30 /2000
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested t i/ (90 AM PM BLD
Location Pa-e- Htbl Suite MEC
Contact Person (Ilin C;2 Ph 7 D I - & 1L/ PLM
Contractor - Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR — 000 La-
.
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
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
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 tv�„
Smoke Dampers
Final
PASS PART FAIL
,zoi gotta
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
PASS PART FAIL
SITE
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 � 7i Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.