Permit , , CITY OF TIGARD
1
�„,..„ � DEVELOPMENT SERVICES ELECTRICAL PERMIT —
. -' , � 1J.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 RESTRICTED ENERGY
PERMIT #: ELR98 -0192
DATE ISSUED: 07/24/98
PARCEL: 15133AD -06900
SITE ADDRESS...:1O865 SW SUMMER LAKE DR
SUBDIVISION •AMART SUMMERLAKE ZONING:R -7
BLOCK • LOT •113 JURISDICTN: TIG
Pro.j ect De scr i pt i on : Installation of burglar alarm system. Job No. 2028 -HB
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM •X BOILER LANDSCAPE /IRRIGAT..:
GARAGE OPENER • CLOCK • MEDICAL
HVAC • DATA /TELE COMM..: NURSE CALLS •
VACUUM SYSTEM • FIRE ALARM OUTDOOR LANDSC LITE:
OTHER: .. HVAC • PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER..: ::
TOTAL # OF SYSTEMS: 0
Owner: FEES
EVELYN HANSEN type amount by date recpt
10865 SW SUMMER LAKE DR PRMT $ 40.00 DEB 07/24/98 98- 307653
TIGARD OR 97223 5PCT $ 2.00 DEB 07/24/98 98- 307653
Phone #:
Contractor:
ALLTEC SECURITY $ 42.00 TOTAL
PO BOX 55310 REQUIRED INSPECTIONS
PORTLAND OR 97238 -5310 Ceiling Cover Low Voltage Insp
Phone #: 331 -2620 Wall Cover Elect'1 Final
Reg #..: 001188
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 180 days. ATTENTION: Oregon law requires you to follow rule adopted by the
Oregon UV ' ification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952- 001 -0080. You may obtain copies of
these r es or direc uestions OUNC at (503)246 -1987.
Issue by Permittee Signature 4/I _ /' • ,.' /.
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
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
ao..-� -x/13
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 RECEIVED PERMIT # EL (2– F9---_ e / - 9
- ' /
Phone (503) 639-4171110 2 199 ISSUED
..... I � __
_C
� °r e i t ` 1 FAX (503) 684 -7297 – 3 .si..,, `, ' ?. _, TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 63te;1? .15 „iiry cEvciePt :.ElSSUED BY C3 sa.124c,--Aki
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION • 4. TYPE OF WORK
/oR&5” S IiU e� P Drr ve
Addr s RESIDENTIAL — Restricted Energy Fee $40.00
a vd (9/e Q7 23 (FOR ALL SYSTEMS)
City ij / State v / Zip � h Check Type of Work Involved:
PERMITS ARE NON - TRANSFERABLE AND NON - REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems
IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
180 DAYS. I Burglar Alarm
❑ Garage Door Opener*
2. CONTRACTOR APPLICATION ❑ Heating, Ventilation and Air Conditioning System'
' Contractor Alltec Security Type ❑ Vacuum Systems*
❑ Other
Address PO Box 55310 - Portland, OR 97238 -5310
Date --7-,9--9r COMMERCIAL — Fee for each system $40.00
(SEE OAR 918- 260 -260)
Property Owner ,ant 1 Check Type of Work Involved:
Contractor's Board Reg. No. 118839
❑ Audio and Stereo Systems
❑ Boiler Controls
Phone # 331 -2620 ❑ Clock Systems
❑ Data Telecommunication Installations
3. OWNER APPLICATION ❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No ❑ Instrumentation
❑ Intercom and Paging Systems
Address ❑ Landscape Irrigation Control'
- _ City – .. - — ____ - State Zip – . -..._
❑ Medical
❑ Nurse Calls '
This permit is issued under OAR 918. 320.370. This applicant agrees to make only ❑ Outdoor Landscape Lighting'
restricted energy installations (100 volt amps or less) under this permit and to do the
following: ❑ Protective Signaling
1. Only use electrical licensed persons to do installations where required. (Certain ❑ Other
residential and other transactions are exempt from licensing. These have
asterisks('). All others need licensing).
2. Call for an inspection when all of the installations under this permit are ready
for inspection at 503- 639 -41 ❑ Number of Systems
3. Purchase separate permits for all installations that are not ready for inspection
when the inspector is out to inspect under this permit. • No licenses are required. Licenses are required for all other installations.
4. - Assume responsibility for assuring that all corrections required by the inspector
are done, and
5. Assume responsibility for calling for a final inspection when all of the 5. FEES
corrections are completed.
1 The person signing for this p_ermi • u t • the applicant or a person a. Enter Fees $ $.00
authorized to bind °p*cant
b. 5% Surcharge (.05 x total above) $ o2-,00
Signature TOTAL $ DO
• Authority if other than ,applicant
liNCRGAP.CI-IP
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 171
ci / BUP
Date Requested ` `` equested � ' / 9? AM PM 4.7 BLD
Location /O. ' s 31-4-9 S'004 � Q S,uite MEC
Contact Person SteA- -r✓or' Az-WSu Ph _51/X -3/3Z PLM
Contractor Z �1 SCGU e, ft/ Ph 33 / — X O SWR
BUILDING Tenant/Owner ELC
Retaining Wall
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab Urfil SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation /
Drywall Nailing aft
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof �.C�.. er ' +. � P
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
P AIL
Service
Rough In
UG /Slab
oltage
'FireAl
Fi
PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date /6 ^ 9p Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.