Permit CITY OF TIGARD
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DEVELOPMENT SERVICES -
'�I�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639°4171 RESTRICTED PERMIT
RESTRI TED CTED ENERGY
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PERMIT #: ELR97 -0021
DATE ISSUED: 01/17/97
PARCEL: 28104CD -10000
SITE ADDRESS...: 13652 SW TRACY PL
SUBDIVISION....: HILLSHIRE ESTATES NO. 2 ZONING :R -7 PD
BLOCK........... LOT °099
Project Description: instl burglar alarm
job # 814-11941-01
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
WINWOOD CONSTRUCTION INC type amount by date recpt
6933 SW TIERRA DEL MAR PRMT $ 40.00 TAT 01/17/97 97- 289117
5PCT $ 2.00 TAT 01/17/97 97- 289117
BEAVERTON OR 97007
Phone #:
Contractor:
ADT SECURITY ALARMS $ 42.00 TOTAL
703 NE HANCOCK
REQUIRED INSPECTIONS
PORTLAND OR 97212 Ceiling Cover Elect'1 Service
Phone #: 503 - 284 -3265 Wall Cover Elect' 1 Final
Reg #..: 59944 //ff
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm' t S i gnat i e
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 182 days of issuance, or if work is suspended for more AAt4 ./„_ „.,./ . .
than 180 days. Is 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
2nsf //JQ197'
0. Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
..
13125 SW Hall Blvd. L� VV (�
97 ` 2 4
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Tigard, OR 97223 PERMIT # ii v � ;\ Phone (503) 639 -4171
, -.11 I TDD No5 684 DATE ISSUED / V 7
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY I
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
/365cV sic) i Pe _ Restricted Address RESIDENTIAL —
Energy
972 a 3 (FOR ALL YSTEMS
fi'7a r�
City State Zip 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. 7f Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
Contractor Type D ❑ Vacuum Systems*
e1 maim SYSTEMS, III ❑ Other
Address 793 NE HANCOCK
PORTLAND, OR 91 Ia
Date 1 f f 9 /'j 7 " 3)2844265 COMMERCIAL — Fee for each system $40.00
(SEE OAR 918 - 260 -260)
Property Owner niQ HO Let /' ��^^ J d-�K 11 € Check Type of Work Involved
Contractor's Board Reg. No. .- 9 ❑ Audio and Stereo Systems
L ❑ Boiler Controls
Phone # i'L /7 / )1941* & / ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
3-a 46/9 ❑ HVAC
Print Owner's Name Phone No
❑ Instrumentation
Address ❑ Intercom and Paging Systems
❑ Landscape Irrigation Controls
City State Zip ❑ Medical
This permit is issued under OAR 918 - 320 -370. This applicant agrees to make only ❑ Nurse Calls
restricted energy installations (100 volt amps or less) under this permit and to do the ❑ Outdoor Landscape Lighting*
following:
1. Only use electrical licensed persons to do installations where required. (Certain ❑ Protective Signaling
residential and other transactions are exempt from licensing. These have ❑ Other
asterisks(•). All others need licensing).
2. Call for an inspection when all of the installations under this permit are ready
for inspection at 503-639-4175. ❑ 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.
The person signing for this permit must be the applicant or a person a. Enter Fees $ 116
authori d to bind the app
�: nt.
I r '� b. 5% Surcharge (.05 x total above) $ a
•TAL $ io ..-
Authority if other than applicant
ENERGAP.CHP
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639- 4175 Business Line: 639 -4171
Date Requested / < / 7 l / 0 AM PM _ BLD
Location / (06 1 � � jO Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner _ aaD
Retaining Wall ,
Footing Access: /
Foundation
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath/Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing �� � �r:� / : _.di
Firewall
Fire Sprinkler - 'J dA AL - 40 � . 1._ :: �.i__ /
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final .i
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
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Al - rm
FO. FAIL
BackfilUGrading
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 p
Other D Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.