Permit CITY OF TIGARD
_!��I��,I�I DEVELOPMENT SERVICES RESTRICTED ENERGY
PERMIT #: ELR98 -0080
DATE ISSUED: 03/18/98
PARCEL: 18135DD -05000
SITE ADDRESS...:11975 SW PACIFIC HWY
SUBDIVISION • ZONING:C —G
BLOCK • LOT • JURISDICTN: TIG
Project Description: 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
RAINBOW PLAY STRUCTURES type amount by date recpt
11975 SW PACIFIC HWY PRMT $ 40.00 DLH 03/18/98 98- 304225
TIGARD OR 97223 5PCT $ 2.00 DLH 03/18/98 98- 304225
Phone #: 503 - 620 -2653
Contractor:
ADT SECURITY ALARM SYSTEMS $ 42.00 TOTAL
703 NE HANCOCK
REQUIRED INSPECTIONS
PORTLAND OR 97212 Ceiling Cover Low Voltage Insp
Phone #: 503 -282 -1549 Wall Cover Elect'l Final
Reg #..: 000599
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 rule adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR 952 -081 -8010 through OAR 952-01 -0080. You may obtain copies of
these rules or direct questions to OUNC at (503)246 -1987. B
Issued by Permittee Signature �Q��
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: 44
LICENSE NO:
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD ESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: .2)
13125 SW HALL BLVD �� 5// 7/9 8 D8' TY - 99 e I —°/ Date Rec'd: -.3/19/94
IS�.
T RD OR 97223 / / PRINT OR P
. V - 503 - 639 -4171 X304 Permit #: EL-/e 9f -00A0
F - 503-684-7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd: ape/9P
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
A) /7
Restricted A LL SY Fee $40.00
�4 -, �i = (FOR ALL SYSTEMS)
JOB Street Address re #
ADDRESS ,' 9'7_5 ,5'aJ • l a Check Type of Work Involved:
Ci /State K one • Audio and Stereo Systems •
e ❑ Burglar Alarm
OWNER M au�n9 Address ❑ Garage Door Opener*
City /State I Zip I Phone # ❑ Heating, Ventilation and Air Conditioning System*
Name ❑ Vacuum Systems'
ADT SECURITY SERVICES, INC. ❑ Other
703 NE HANCOCK
CONTRACTOR Mailing Address PORTLAND, OR 97212
45031284.3265 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /State I Zip Phone # Fee for each system $40.00
copy of all licenses (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Brd Lic. �/ Exp. Date
expired in C.O.T.
# 5 .7 f 4 Check Type of Work Involved:
data base). Electrical Contr. Lic / _ Exp. Date ❑
(v Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date
❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT [l Data Telecommunication Installation
City /State Zip Phone # ❑
Fire Alarm Installation
This permit is issued under OAE 91B-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:
0 Instrumentation
1. Only use electrical licensed persons to do installations where required.
Certain residential and other transactions are exempt from licensing. ED 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
5. Assume responsibility for calling for a final inspection when all of the
corrections are completed. ❑ Other
Permits are non - transferable and non -r= ■ able and expire if work is not
started within 180 days of '- suance o , ork is suspended for 180 days. Number of Systems
The person signing for permit • st be the applicant or a person • No licenses are required. Licenses are required for all other installations
authorized to bind th- . ••plicant.
4F ."-' p _ FEES:
7 v J ENTER FEES $ 4/1-0 '
Si ature
5% SURCHARGE (.05 X TOTAL ABOVE) $
Authority if other than Applicant TOTAL $
is \dsts\resele.doc 7/97 —
`f -
/52-S
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 4- (7 J [ �� A.M. P.M. MST:
Location: / 1 7 5 LO a L-L rC_ (�. BUP:
Tenant: 12A (\ it L PtA- 1 . G' ' ,:i. Bldg MEC:
Contractor: tact 2'1 C( / A Fir Phone: ,&& G-6, jm ,d(_ , PLM:
Owner: 1 T > 6 ' o� (�
1 q" Phone: .)-(/ -- 1_&.s•3 ELC: p p r
ELR: /e — DOJ
•
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ,----CELECTRIC i SITE
Site Post/Beam Post/Beam Post/Beam Cover/Serrice Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling • Rain Drain A/C UG Slab �j�
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump �l;sw Vo a / .eQ 4 / ,
Approved Approved Approved r pprov 44 4 Approved
Appr /Sdwlk Not Approved Not Approved Not Approved of • pproved Not Approved
FINAL FINAL FINAL �" FINAL
1 / . 1 - . — • Al -' D t/c__,
' ,Q ,Q& nG. /)c4211(0)- 14pOrmq J` /D11
ain e___/ £ 10r — ye.._ N to i1 4 s 1.) vid 6�
Y r____. — 9 a '_, 4P ej 7 / f4 Y1 /-- Aoss -1 /e f^i v
1 ) Y
0 Call for reinspectio Reinspection fee of $ required before next inspection 0 Unable to inspect
C�
Inspector: Date: — O — q exO Page of
1 •