Permit CITY OF TIGARD
DEVELOPMENT SERVICES SERV ICES ELECTRICAL PERMIT
RESTRICTED ENERGY
PERMIT #: ELR97 -0036
DATE ISSUED: 02/03/97
PARCEL: 1S135DD -03301
SITE ADDRESS...: 11945 SW PACIFIC HWY #123
SUBDIVISION • HOFFARBER TRACTS NO.1 ZONING:C —G
BLOCK . LOT -2
Project Description: Installing protective signaling.
INSTL PROTECTIVE SIGNALING
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
OOPS type amount by date recpt
PRMT $ 40.00 TAT 02/03/97 97- 289834
5PCT $ 2.00 TAT 02/03/97 97- 289834
Phone #:
Contractor: --
PHILLIPS ELECTRONICS DBA FOR $ 42.00 TOTAL
(DBA FOR MASTER ALARM L. L. C. )
1110 NW FLANDERS REQUIRED INSPECTIONS
PORTLAND OR 97209 Ceiling Cover Elect'1 Service
Phone #: 503 -227 -0571 Wall Cover Elect'1 Final
Reg #..: 000433
This permit is issued subject to the regulations contained in the c 4 2
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t e e i gnat ur e
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 sore ,l dA k Y
than 180 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 SUPR. ELEC' N : DATE:
LICENSE NO:
Call for inspection — ,639 -4175
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT # E, /A 97 (7 T p
Phone (503) 639 -4171
'II I FAX (503) 684 -7297 DATE ISSUED _� 9
T DD No. (503) 684 -2772 7
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY
PLF-45E. COMPLETE ALL „SECTION$
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
100 s St... P�c't( - - _ . ....._.
Address RESIDENTIAL — Restricted Energy Fee $40.00
yw d o q 7Z � (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*
I ❑ Heating, Ventilation and Air Conditioning System*
Contractor � I I; QS L LC*. Type PIC^^ S`(S k— ❑ Vacuum Systems*
Address I 1 W Nt"+ • eNov.d er> Qr3- • or • q 1-loci ❑ Other
Date 1 /2- / � COMMERCIAL — Fee for each system 40.00
D i
` (SEE OAR 918 - 260 -260)
Property Owner T 1 �o-�d 1 �+5 Check Type of Work Involved;
Contractor's Board Reg. No. ' ;` 1 ❑ Audio and Stereo Systems
_
El Boiler Controls
Phone # 2 Z 7 - 0S 1 1 ❑ 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:
1. Only use electrical licensed persons to do installations where required. (Certain Protective Signaling
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.
The person signing for this permit must be the applicant or a person a. Enter Fees $ T U V U
authorized to bind the applicant.
b. 5% Surcharge (.05 x total above) $ 2 • uo
Signature
TOTAL $ V-t • Ov
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 I ( 5 /ft _ _ ,/ — \_, _ Suite I Z-3 MEC
Contact Person /Ph PLM
Contractor AP i/ '" ,,a / . _ ;/ _,,A___ Ph 2 2Z —Z$`,3 SWR
/
BUILDING Tenant/Owner 7L/ 0 p /47g rX *45 ELC
Retaining Wall 1 L3 ELR 7- 6-c,4,
Footing Access
Foundation / - FPS
Ftg Drain SGN
Crawl Drain Inspection Note :
Slab
Pr _c"
i y.--) SIT
Post & Beam
Ext Sheath /Shear __
Int Sheath /Shear
Framing
Insulation
Drywall Nailing � ��_
Firewall Ir
I.
Fire Sprinkler —64.4.—E—
Fire Alarm
Susp'd Ceiling
Roof
0---C 67_,,,,
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
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire •
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 g -3 _5 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.