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Permit ! • CITY OF TIGARD ELECTRICAL ERG RESTRICTED CTED ENERGY 'war!* DEVELOPMENT SERVICES PERMIT #: ELR2000 -00044 r�' I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 03/10/2000 SITE ADDRESS: 12442 SW SCHOLLS FERRY RD 2NDFL PARCEL: 1S134BC-00401 SUBDIVISION: ZONING: C -N BLOCK: LOT: JURISDICTION: TIG Project Description: Low voltage system for modification of fire alarm on 2nd floor. 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: X OUTDOOR LANDSC LITE: OTHER: : HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: SISTERS OF PROVIDENCE IN OR METRO SAFETY AND FIRE INC BY STEVE FOSTER 7055 NE GLISAN PO BOX 13993 PORTLAND, OR 97213 PORTLAND, OR 97213 Phone: Phone: 231 -2999 Reg #: LIC 63651 ELE 803RET FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT DEB 02/28/200C $60.00 00- 321878 Elect'l Final 5PCT DEB 02/28/200C $4.80 00- 321878 Total $64.80 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 question . c• OUNC at (503) 246 -1987. Issued by Perm ittee Signature f3... �Vl g , / L _ 1 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 / v DATE: LICENSE NO: Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day CITY CIOF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by. 13125 SW HALL BLVD Date Rec'd: ar- e' TIGARD OR 97223 PRINT OR TYPE V - 503 - 639 -4171 X304 Permit #: FL/49,96 0 F - 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd: - 7 -Z WILL NOT BE ACCEPTED Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Restricted Energy Fee $60.00 P- a7;Dp. E . . v s C`r Ad I C- (FOR ALL SYSTEMS) JOB Street Address ^ (� Ste # ADDRESS j.�yyZ . Sw AAA s rem l;dl. a 4-, Check Type of Work Involved: City /State Zii 7 z � 3 Phone # ❑ Audio and Stereo Systems Narhe ❑ Burglar Alarm C #4 Dtc_-- ❑ OWNER Mailing Address Garage Door Opener' City /State Zip Phone # ❑ Heating, Ventilation and Air Conditioning System' Name T ❑ Vacuum Systems' ! itr o SA�17 4- 'F, KZ , 1-N C • El Other CONTRACTOR Mailing Address • 7C�SS NZ Col 3 TYPE OF WORK INVOLVED - COMMERCIAL ONLY (Prior to issuance a citY/S to Zip Phone # Fee for each system $60.00 copy of all licenses f g.+1 .i,) 9 7.13 a31-ZS59 (SEE OAR 918- 260 -260) are required if Oregon Contr. Brd Lic. # Exp. Date expired in C.O.T. 6„3C ( / -2c,-z(c ), Check Type of Work Involved: data base). Electrical Contr. Lic. # Exp. Date %03 R a_- /0- /-Zcxg- ❑ 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 - 6394175; ❑ 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 D corrections are completed. Other Eifel- (Arta -t;w, M g le On.) 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 app' .nt. FEES: 1 , a0 /! A . / ENTER FEES D ' Signature v �jo .o F 1U o SURCHARGE (.05 X TOTAL ABOVE) $ Authority if other than Applicant TOTAL $ ') . gU is \dsts \formsiesele.doc 3/98 CITY OF TIGARD BUILDING' INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 • Business Line: 6394171 P Date Requested .� Zp c9`z� AM PM / , BLD Location C / et-7'y Suite - ' MEC Contact Person Ph av - 24' PLM Contractor Ph SWR BUILDING Tenant/Owner ith _ 7-7 ELC Retaining Wall � 7-■ ©z9 COO 4 Footing Access: Foundation , ` FPS Ftg Drain /a Crawl Drain Inspection Notes: SGN Slab %' (0 7 SIT Post & Beam Ext Sheath /Shear .� .r - re__ Int She9thlShear Framing 1 Insulation / Drywall Nailing Firewall Fire Sprinkler Fire Alarm _ 1 Susp'd Ceiling oil/L/ Roof Misc: Final P ASS PART FAIL a l 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 RIC Rough In UG /Slab Low Voltage Fire Alarm Final • PART FAIL : ackfill /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 Dat Other 3 /&7in Inspector / Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 3 J cb AM PM BLD Location 12 9 J I C ell A Suite MEC Contact Person t e - — - 2 e' - zl 1 PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR a - c. --() Footing Access: Foundation FPS Ftg Drain SGN Slab Crawl Drain Inspection Notes: n SIT Post & Beam Ext Sheath /Shear • Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler 'Wd4As CAJo. Fire Alarm Xe ' �� Susp'd Ceiling �- � �' ) Zd ° c Roof / 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 ELECTRIC) Service Rough In UG /Slab Low Voltage Fire Alarm in ASS PART SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin e Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to ins pct - no access ADA f Approach /Sidewalk Other Date Inspector ` _ - Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. •