Permit CITY OF TIGARD
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DEVELOPMENT SERVICES ELECTRICAL PERMIT — Hall Blvd., Tigard, RESTRICTED ENERGY
PERMIT #: ELR97 -0136
DATE ISSUED: 05/09/97
PARCEL: 1S135BD- 01200
SITE ADDRESS...:O98O4 SW SHADY LN
SUBDIVISION ZONING:C—G
BLOCK LOT . JURISDICTN: TIG
Project Descri pt ion : REPLACE PROTECTIVE SIGNAL - ENTIRE BUILDING
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
NENTEL type amount by date recpt
9804 SW SHADY LN PRMT $ 40.00 JMH 05/09/97 97 -294367
TIGARD OR 97223 SPOT $ 2.00 JMH 05/09/97 97 -29436
7
Phone #:
Contractor:
QUADRANT SECURITY $ 42.00 TOTAL
(GARY NEDELISKY)
P 0 BOX 86508 REQUIRED INSPECTIONS - - - --
PORTLAND OR 97286 Ceiling Cover Elect'1 Service
Phone #: 234 -5558 Wall Cover Ele t'l Final
Reg #..: 096806
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This permit is issued subject to the regulations contained in the .�k • L �� �' ( 2
Tigard Municipal Code, State of Ore. Specialty Codes and all other 'erm i t e e Signature
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applicable laws. All work will be done in accordance with /�
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approved plans. This permit will expire if work is not started q M a( � /`, f_ within 18® days of issuance, or if work is suspended for more �' �
than 188 days. I '-ied By
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 for inspection — 639 -4175
05/08/97 13:48 0503 684 7297 CITY OF TIGARD II002 /002
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CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by: / v
13125 SW HALL BLVD Date Rec'd:_5/
TIGARD OR 97223 PRINT OR TYPE permit #: �L�� 7
V - 503 - 639 -4171 X304
F - 503- 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL
Restricted Energy Fee $40.00
N ontol _ (FOR ALL SYSTEMS)
JOB Street Address Ste M Check Type of Work Involved:
ADDRESS q$Qy s �1 2 -C�11 6
1 a C) ziPa l x P117755-6— ❑ Audio and Stereo Systems
Na ❑ Burglar Alarm
❑ Garage Door Opener
OWNER ' Mailing Address
City/State I Zip I Phone*
1=1 Healing, Ventilation and Air Conditioning System'
Name I ❑ Vacuum Systems'
( L4dd tan+ Scc,uri'y 0 Oar
CONTRACTOR d P6 in 1 02( W65aA dress TYPE OF WORK INVOLVED - COMMERCIAL
(Prior to issuance aty/S - • Zi • • . Phone 0 Fee for each system $40.00
copy of all licenses A a A I • r , • —555: (SEE OAR 918- 260 -280)
are required If Oregon Contr.: • Lic_ * D e Check Type of Work Involved:
expired in C.O.T. 14SD� , 5 / 3 7
data base). Electrical Contr. Uc. 0 Exp. t
Q a2�p - 5Lv5CL1: O% 97 ❑ Audio and Stereo Systems
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1(/8 7�! 7 C.O.T. or Metro Lic. O Li1P� E j/ ❑
Boiler Controls
Owner's Name ❑
Clock Systems
OWNER - Mailing Address
APPLICANT ❑ Data Telecommunication Installation
City 1 Zip I Phone 0 ❑ Fire Alarm Installation
This permit is issued under OAE 918 -320 -370. This applicant agrees to HVAC
make only restricted energy installations (100 volt amps or less) under this El
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;
El Landscape Irrigation Control'
2. Call for inspections when Installation under this pemilt are ready for
inspection at 503 - 6394175; ❑ Medical
3. Purchase separate permits for all installations that ere 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 ❑ utdoor 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 Ileeree6 are required- Licenses we requited for ail other installations
authorized to bind the applicanL
ENTER FEES $ V\-.(42-12)------
Sign Z -
5% SURCHARGE (.05 X TOTAL ABOVE) S L� 7
TOTAL 5 l
Authority if other than Applicant
i:vesele.doc 17/99
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CITY OF TIGARD BUILDING INSPECTION DIVISION -
24- Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 6/ID--/q7 A.M. LV .--- P.M. MST:
Location: 9Q S V 3 BUP:
Tenant: e On t P B I-- DC/— UJJ OCCt k PI ED Suite: Bldg: MEC:
Contractor: � ` UA wjJ� / P..3 N Spy Phone: 3 Li ^ 05 C I�I !J C-e � PLM:
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Owner: Giv, t Phone: ELC:
L9CBD)c SO - '-)" ELR:Cf /36
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service 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 : I
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump sw Vol again
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not A ed Not Approved
FINAL FINAL FINAL ( FINAL
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O Call for reinspection O Reinspection fee of required before next inspection 0 Unable to inspect
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Inspector: � � � ,, ,,._ - ■� ' - Date: � -- / - � � 7 Page of (
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7/26/99 Activities for Case #: ELR97 -00136
2:35:02 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRC001 Application Received 5/9/97 5/9/97 J *H 5/9/97
ELRC003 Permit Created 5/9/97 5/9/97 J'H 5/9/97
ELRC700 Ceiling Cover 5/9/97 J'H 5/9/97
ELRC720 Wall Cover 5/9/97 . J'H 5/9/97
ELRC731 Elect'I Service 5/9/97 J'H 5/9/97
ELRC799 Elect'I Final 5/9/97 5/12/97 JMH PASS GES 5/12/97 Needs permit for data line.
Alarm final approved.
ELRC500 (F) Issue permit 5/9/97 JMH PASS J'H 5/9/97
ELRC800 Case finaled 5/12/97 MJR PASS GES 5/12/97 ALARM FINAL ONLY
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