Permit .
_ ,
CITY OF TIGARD ELECTRICAL CTED ENERGY
G -
�
RESTRICTED ENERGY
,� DEVELOPMENT SERVICE.S PERMIT #: ELR1999 -00273
�- 13125 SW Hall Blvd., Tiggard, OR 97223 ry 6 9-4171 DATE ISSUED: 11/19/99
SITE ADDRESS: 09735 SW SHADY LN 203 1 NA PARCEL: 1 S135BD -00300
•
SUBDIVISION: I L ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: Installation of 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: Contractor:
HAZEL INTERNATIONAL, INC AND HONEYWELL INC
HIGASHIYAMA HIGHLANDS CO, LTD 15495 SW SEQUOIA
BY NORRIS + STEVENS REALTORS STE 100
PORTLAND, OR 97204 PORTLAND, OR 97224
Phone: • Phone: 968 -3300
Reg #: SUP 941 -JLE
LIC 00057824
ELE 26207CLE
•
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT DEB 11/19/99 $60.00 99- 319916 Elect'I Final
5PCT DEB 11/19/99 $4.80 99- 319916
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 -00 S • ough OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -19;
Issued • 11 , I i _ ' I Permittee Signature IL / 1 t
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
r
/ RECEI
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£0'd NOV 1 8199 9 096T 86S LOS 67:91 - -- – 10 -1f)f /
COMMUNII ENERGY ELECTRICAL APPLICATION Recd b' ' .i M
CITY OF TIGARD Date Redd: / /-/R -5
13125 SW HALL BLVD PRINT OR TYPE
Permit #: LG�/1�'1�7'dOv`Z7 3
TIGARD OR 97223
V - 503 - 639 -4171 X304 Cust.Call'd:
F - 503 -598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENT EO NLLY
Restricted Energy Fee
Q yl 1v" i / _ / .i •__ o . `i e. V3 (FOR ALL SYSTEMS)
JOB
S Address Ste # Check Type of Work Involved:
ADDRESS S. S s , - ' •' Sa
12441111 Zip Phone # p Audio and Stereo Systems
. O 972 69 --51A
❑ Burglar Alarm 0 Garage Door Opener
OWNER ❑ Heating, Ventilation and Air Conditioning System*
Zip Phone #
0 Vacuum Systems'
Name 0 O' HONEYWELL Other
CONTRACTOR 1 5n Address - #100 TYPE OF WORK INVOL - COMMERCI ON" 1 SW s60.00
• r • , Phone # Fee for each system
(Prior of issuances CitylStete 968-3303
(SEE OAR 918 - 260.260)
copy of all licenses POrtl. • • ► �
are required If Oregon Contr. Brd Lic. # 1 Ex.. Date Check Type of Work Involved:
data base)' •
expired in C.O.T. 0 : �
Electrical Contr. Lim A Exp. Date ❑ Audio and Stereo Systems
10 _ O a
2 6 - 2 0_7 .
C.O.T. or Metro Lic. # Exp s ate
s • 1.1 ❑ Boiler Controls
Owner's Name ❑ Clock Systems
OWNER - ❑ Data Telecommunication Installation
APPLICANT ® Phone #
City/State 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
permit and to do the following: ❑ Instrumentation
1. Only use electrical licensed persons to do installations where required. Intercom and Paging Systems
All others Certain residential and other eed I ce s ng; exempt from licensing. ❑
These have asterisks(7. ❑ Landscape Irrigation Control"
2. Call for inspections when Installation under this permit.are ready for ID Medical
inspection at 503-639-4175;
3. nsrpectionswhen the Inspector Is out to under this permit an El Nurse Calls
Outdoor Landscape Lighting•
4. Assume responsibility for assuring that all corrections required by the � protective Signaling
Inspector are done, and;
5. Assume responsibility for calling for a final inspection when all of the Other
corrections are completed.
Permits are non - transferable and rion- refundable and expire If work is not Number of Systems
started within 180 days of issuance or if work is suspended for 180 days. are required all other Installations
The person signing for this permit must be the applicant or a person
• Ne licenses are required. Licenses
authorized to bind the applicant.
' EEO: g 60.00
S (j/��. $ � FEES
Signature v y $ 0
l9f?o SURCHARGE (A5 X TOTAL ABOVE) $
TOTAL a —,0 7
■ Authority if other than Applicant
,A,4,0,Arnmwresele.doe 9198
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 0 2-- / AM PM BLD
Location / 7 3 (S S! 4 GI l - r•-- Suite 2ti 3 MEC
Contact Person Ph PLM
Contractor 744, - Ai . 1 Ph SWR
BUILDING Tenant/Owner t • �� ELC
Retaining Wall ELR 1,9r— 4- a Z 7 3
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Fi //
n a l
Fi OAP
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
Service
Rough In
UG /Slab
'Fire Alarm
Fi
/= 'ART FAIL
Backfill /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 Date 2 2--VO Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.