Permit CITY O F T I G A R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
��I� DEVE It 639 -4171 DATE PERMIT # 00 -00180 : 8% 020
SITE ADDRESS: 06975 SW SANDBURG ST PARCEL: 2S101 DD -00101
SUBDIVISION: ZONING: C -P
BLOCK: LOT: JURISDICTION: 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:
Owner: Contractor:
WESTON HOLDING CO LLC PHILLIPS ELECTRONICS
2154 NE BROADWAY (DBA FOR MASTER ALARM L.L.C.)
PORTLAND, OR 97232 1110 NW FLANDERS
PORTLAND, OR 97209
Phone: Phone: 222 -5083
Reg #: LIC 00125364
SUP 329JLE
ELE 26213CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT DLH 8/2/00 • $60.00 HAND
5PCT DLH 8/2/00 $4.80 HAND
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 OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987. � /
Issued by V - Permittee Signature /y�/LE/� OA/ f!-/°/'L /e.1- i70n/
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 APPLICATION Rec'd by:
131;5 SW,}•IALL BLVD RECEIVED Date Rec'd:
TIGARD OR 97223 PRINT OR TYPE
V - 503 -639 -4171 X304 Permit #: 1.7/e 2000 — / d
F - 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPt kik123 4O0g Cust.Call'd:
WILL NOT BE ACC ED
Name of Development Project T E k'e/ I iDIIILVED - RESIDENTIAL ONLY
Restricted Energy Fee $60.00
(COIff/1 N (FOR ALL SYSTEMS)
JOB Sf reetAddres s s,. ✓, _ d„.... Ste" , .�: : .i ~z,_. ,�.- . `_
ADDRESS -'C heck `"ype of Work Involved
'
'" /State - .-2._ _. , e • =
— ----
•- - -=- -a--- , q - udio and- S2efeo Systems
e ❑ Burglar Alarm
• Cht � i" ❑ Garage Door Opener'
OWNER
T �s 770
ity/State Zi hone # [:=1 Heating, Ventilation and Air Conditioning System*
Name M El Vacuum Systems'
t S efe. c2 ❑ Other
CONTRACTOR M N"rCO f j J
/C TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a y/S 6 i Phone # Fee for each system $60.00
copy of all licenses /�/ (SEE OAR 918- 260 -260)
are required if Oregon Contr. Brd Lic. # Exp. Date
expired in C.O.T. / Z„S,3G y/ Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp. Date
2
C-2- f Z — (71- C. ❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date
❑ Boiler Controls
Owner's Name
❑ 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
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.
FEES:
Signature
ENTER FEES $ 6
SI
s 8' .e) 4-,
OK SURCHARGE (.85 X TOTAL ABOVE) $
Authority if other than Applicant TOTAL $ P P
i:\dsts\forms\resele.doc 3/98
C ITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
q(2-47 BUP
Date Requested AM PM BLD
Location brlr S S4rtl Z' 4/24 Suite MEC
Contact Person 1 . /�_ mo / PLM
Contractor �1 / //i , S ? (.r i''ou - Ph 72— $D8 3 SWR
BUILDING Tenant/Owner C ELC
Retaining Wall '7)j 60 ad
Footing Access:
Foundation FPS
Ftg Drain , SGN
Crawl Drain Inspection Notes: // � /
Slab T 4-<• I`!(/C � 'l �i n/, SIT
Post & Beam 1
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing o __
Fire wall Q /�
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
Smoke Dampers
Final
PASS PART FAIL
Sery L
Rough In `��
UG /Slab (/d A Q�
Low Voltage 0v �i'
Fire Alarm /
Fin
' •, • RT FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk
Other Date v Inspector ,rte Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.