Permit CITY OF T I G A R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
aw4'" DEVELOPMENT SERVICES PERMIT #: ELR1999 -00287
�' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/03/1999
SITE ADDRESS: 11660 SW PACIFIC HY PARCEL: 1S136CD -01500
W
SUBDIVISION: TIAGARD BOWL • ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: Burglar alarm and camera system
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:
INSTRUMENTATION: OTHER: : X
TOTAL # OF SYSTEMS: 2
Owner: Contractor:
SCHULZ, DAVID TR ADT SECURITY SERVICES, INC
KERR, GLORIA TR 2815 SW 153RD DR
11649 VIA MONTANA BEAVERTON, OR 97006
YU MA, AZ 85367
Phone: Phone: 503469 -7100
Reg #: LIC 0059944
ELE 26209CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT BON 12/03/199E. $120.00 99- 320149 Elect'I Service
5PCT BON 12/03/199E $9.60 99- 320149 Elect'I Final
Total $129.60
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 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by Permittee Signat r1 . fa (CGCC — LL1„ J
■
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: N1 f ' DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
r
CITY O TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: e
13125 SW HALL BLVD Date Rec'd: �'7�r M
TIGAR'b OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #: ( 6 1 - opal
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
1 i W O (FOR ALL SYSTEMS)
JOB Street Address x A qte #
ADDRESS f+ $5W 7 kelFIC 1.01. Check Type of Work Involved:
C jSe to _ 4 0 Zh n a to ❑ Audio and Stereo Systems
Name -(2c� ! 7.��j
�,�7� J �j Burglar Alarm
Gn O � L ❑ Garage Door Opener'
OWNER D Mai ing Address) t i t G
t 1lPW /Sae J Zi P o e ❑ Heating, Ventilation and Air Conditioning System*
Name Vacuum Systems'
ADT SECURITY SERVICES, INC.
CONTRACTOR Mailing AddiBltsS.W. 153rd DR.
BEAVERTON. 0 97006 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /State (503) 469 7Ogip Phone # Fee for each system $60.00
copy of all licenses I (SEE OAR 918- 260 -260)
are required if Or on Contr Brd Li # Ex Dale
expired in C.O.T. 7 � � i Check Type of Work Involved:
data base). Elects I C o L i at
. � _ /Q ate ❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # E p . D e
❑ Boiler Controls
O) erlAar�.
,// /A �L// El Clock Systems
OWNER - Mailing Address
APPLICANT ❑ 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 ❑ 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. ❑ Intercom and Paging Systems
These have asterisks( *). All others need licensing;
❑ Landscape Irrigation Control*
2. Call for inspections when installation under this permit are ready for
inspection at 503 - 639 -4175; ❑ 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;
Protective Signaling BK.et" L/ - 1E. ilt-fref
5. Assume responsibility for calling for a • in • - on when all of the /�� 5 � / �
corrections are completed. ® Other Cr 1
Permits are non - transferabl- -nd non -; u ndable an• -xpire if work is not
started within 180 days of • suance if work is • spended for 180 days. a Number of Systems
The person signin • for is • - it . ust • the applicant or a person • No licenses are required. Licenses are required for all other installations
authorized to •' :' he .p• cant.
f ACIAL - E1 &3 FEES: /�J�
Sr17tUr 1 I U ENTER FEES $ hZ e
S URCHARGE (.05 X TOTAL ABOVE) $ 9.
(� l
Authority if other than Applicant TOTAL $ lob / 616
i:\dsts \forms\resele.doc 3/98
4/24/00 Activities for Case #: ELR1999 -00287
5:23:19 PM
• Assigned Hold Updated
Activity Description • Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRC001 Application Received 12/3/99 BON DONE No Hold BON 12/3/99 •
ELRC003 Permit Created 12/3/99 BON DONE No Hold BON 12/3/99 •
ELRC725 Low Voltage Inspection No Hold BON 3/2/00
ELRC730 Elect'I Service 12/3/99 12/3/99 No Hold BON 12/3/99 •
ELRC799 Elect'I Final 12/3/99 12/3/99 1/5/00 BRP PASS No Hold AKJ 1/5/00
ELRC500 (F) Issue permit 12/3/99 BON DONE No Hold BON 12/3/99
ELRC800 Case finaled 1/5/00 • AKJ DONE No Hold AKJ 1/5/00
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested l S r AM PM BLD
Location 1) (Zip ') a ( � Suite MEC
Contact Person s Ph (,3q —2 O I PLM
Contractor 6 ` P n h LI cd q - ( SWR
BUILDING Tenant/Owner 7150A 6 'Y>' ott) L % -6513G ry�
Retaining Wall
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 O eY4 /
FirewalI —2 _ 3
Fire Sprinkler �J C 9 ��`
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Slab !� n 9Q �� �� 4 s
Under Slab J�
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS P FAIL
E TRIG
Service
• Rough In
Low oltage
_ m .
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: 4 [ ] Unable to inspect - no access
ADA / Approach /Sidewalk
•
Other D a t e
- 06 27 Inspector A / //1�1 Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site