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Permit 1 A,, CITY OF TIGARD ;�;,� DEVE SERVICES ELECTRICAL PERMIT — 9 RESTRICTED ENERGY PERMIT #: ELR98 -0250 DATE ISSUED: 09/09/98 PARCEL: 2S1O2CB -02300 SITE ADDRESS...:132O0 SW PACIFIC HWY SUBDIVISION •FREWINGS ORCHARD TRACTS ZONING:C —G BLOCK • LOT -008 JURISDICTN: TIG Pro.j ect Description : Installation of protective signaling. A. RES I DENT I AL B. COMMERCIAL AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..: BURGLAR ALARM BOILER - LANDSCAPE /IRRI GAT. .: 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 MILLIKAN MEDICAL CENTER type amount by date recpt 13200 SW PACIFIC HWY PRMT $ 40.00 DEB 09/09/98 98- 308976 TIGARD OR 97223 5PCT $ 2.00 DEB 09/09/98 98- 308976 Phone #: Contractor: -- -- HONEYWELL INC $ 42.00 TOTAL 15495 SW SEQUOIA STE 100 REQUIRED INSPECTIONS PORTLAND OR 97224 Ceiling Cover Low Voltage Insp Phone #: 968 -3333 Wall Cover Elect'1 Final Reg #..: 000578 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 1:'+ days. ATTENTION: Oregon law requires you to follow rule adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001- fA10 through OAR 952- 001 -0080. You may obtain copies of these rules irec uestions to OUNC at (503)246 -1987. Issued P ermittee Signature ,j ` / _ //,/ A," 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 -4175 by 7:00 P.M. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APP CA. Rec'd bycpe - 4 a4 13125 SW HALL BLVD $1 tLNc D Date Rec'd: TIGARD OR 97223 (� 'fj'Qp PRINT OR TYPE V - 503 - 639 -4171 X304 v i S P - C' 1998 Permit #: &L/2- qV -a ?SD F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd: WILL NOT BE ACCEPTElS. r1ur:ITY DEVELOMENT Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY /R Restricted Energy Fee $40.00 r / /01 J1 K4,) / erlie,./ Cr. T ct (FOR ALL SYSTEMS) JOB Street Address Ste # ADDRESS 1 nr� o0 SO - r°, Alw y Check Type of Work Involved: __City /State Zip J Phone # ❑ Audio and Stereo Systems a. /trdL e 97 2. 2 3 59P 7 , Na e / O ❑ Burglar Alarm LS G Q S a-,6 o V G • ❑ Garage Door Opener* OWNER Mailing Address City /State I Zip I Phone # ❑ Heating, Ventilation and Air Conditioning System* Name ❑ Vacuum Systems* . HO n CC/ 6 rrii ❑ Other CONTRACTOR Mailing Addrs 1 5 51 75 S 4J —Tegi 0/CL: y .1- /oz) TYPE OF WORK INVOLVED - COMMERCIAL ONLY (Prior to issuance a i t /State Z Phone #J Fee for each system $40.00 copy of all licenses /or flan. (?E q7.2 .2 'Y 476 P 37nz (SEE OAR 918- 260 -260) are required if Oregon Contr. $rd Lic. # Exp. Date expired in C.O.T. () 5 7 ga,y 1/ 27 f 7 Check Type of Work Involved: data base). Electrical Contr. Lic. # Exp. ate ac, -„10 7 e! L E i0/1 /9 n Audio and Stereo Systems C.O.T. or Metro Lic. # Exp. bate G 074i i / g 9 ❑ Boiler Controls Owner's Name ee ❑ 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. n 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 - 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 or a person • No licenses are required. Licenses are required for all other installations authorized to bind the applicant. Y FEES: 11, -uf„A. i/ � � ENTER FEES $ • O O Sig tur 5% SURCHARGE (.05 X TOTAL ABOVE) $ u ,)-- 0 0 Authority if other than Applicant TOTAL $ j © 0 is \dsts\resele.doc 7/97 — Page No. 1 CASE HISTORY FOR CASE NO.: ELR98 -0250 MULLIKAN MEDICAL CENTER 13200 SW PACIFIC HWY 03/04/99 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By - --- - -- -- ------ - -- ELRC001 Application Received / / / / 09/09/98 MAIL DEB 09/09/98 DRA ELRC003 Permit Created / / / / 09/09/98 DONE DEB 09/09/98 DRA ELRC500 (F) Issue permit / / / / 09/09/98 DONE DEB 09/09/98 DRA ELRC700 Ceiling Cover / / / / 10/05/98 Per Ben, verbal approval to cover, PASS BRP 10/06/98 J *H • inspected but not noted on inspection report from 092598. ELRC700 Ceiling Cover / / / / 10/07/98 NOTE: ALL PERMITS WITH CEILING COVER: FAIL BRP 10/15/98 J *H ELR98 -0279, DATA SYSTEM; ELC98 -0375, SERVICE /FEEDERS BY SHAW WEST; ELC98 -0432, SERVICE /FEEDERS BY SHAW WEST; ELR98 -0250, SECURITY SYSTEM NO COVER APPROVAL FOR ANY OF THE CEILINGS UNTIL ALL SYSTEMS ARE INSTALLED AND COMPLETED. BUILDER WILL CALL INSPECTION REQUESTS WHEN AREAS ARE COMPLETE.' ONE FAIL -ALL FAIL FOR ANY COVER APPROVAL. MY VERBAL OKAY IS RETRACTED - DUE TO MY ERROR. ELRC700 Ceiling Cover / / / / 01/12/99 wiring above 2nd flr. ceiling PASS BRP 01/12/99 CD ELRC720 Wall Cover / / / / / / 09/09/98 DRA ELRC725 Low Voltage Inspection / / / / 12/15/98 ok PASS BRP 12/15/98 J *H ELRC725 Low Voltage Inspection / / / / 12/14/98 Honeywell low voltage pass - roughin - PASS BRP 12/15/98 J *H upper floor. ELRC799 Elect'l Final / / / / 01/26/99 PASS CD 01/26/99 CD ELRC800 Case finaled / / / / 01/26/99 PASS CD 01/26/99 VLN