Permit ` CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
r DEVELOPMENT SERVICES PERMIT #: ELR2000 -00007
-- r 13125 SW Hall Blvd., Tigard, OR 97223 (50 .39 -4171 DATE ISSUED: 1/6/00
• 41 SITE ADDRESS: 16280 SW UPPER BOONES FERRYR PARCEL: 2S113AB -01201 •
SUBDIVISION: FANNO CREEK ACRE, TRACTS ( /, V ZONING: I -L
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:
PACIFIC REALTY ASSOCIATES HONEYWELL INC
15350 SW SEQUOIA PKWY #300 -WMI 15495 SW SEQUOIA
PORTLAND, OR 97224 STE 100
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 1/6/00 $60.00 00- 320973 Elect'l Final
5PCT DEB 1/6/00 $4.80 00- 320973
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 -00 010 ough OAR 9.52 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246- 987. _
1 &
if - , - /,, / 1L[.. 9 / � Permittee Si nature �ti„ • / Iu Y �L��_I _ /L� .._ . /� Issu d b
' 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
,
£0'd
0961 06S LOS 6b : 6 -10 -Inc
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION . PRINT OR TYPE Date ReC'd: / i
13125 SW HALL BLVD
TIGARD OR 97223 permit #: G�L,e���r»� - t:Y�57
V - 503 - 639 -4 X304 Cust.Call'd:
F - 503 - 598 - 1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS
WILL NOT BE ACCEPTED
TYPE OF WORK INV OLVED - RESIDENTI ONLY
Name of Development Project $60.00
Restricted Energy Fee
F • S t (FOR LL SYSTEMS) stommi
JOB Check Type of Work Involved:
ADDRESS • iiiiiiiiimirimihr
Audio and Stereo Systems
•
�� ' O. Burglar Alarm
rififfillin 111 ❑ Garage Door Opener*
OWNER Mailing Address
/ • 5 .. • 7 lad ❑ Heating, Ventilation and Air Conditioning System'
ly /State Phone #
Z Z �ipp
nc�. ∎ Y '7 a 2 ❑ Vacuum Systems'
Name ❑
HONEYWELL other
CONTRACTOR Meilin Address #100 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
1 SW - •r - •• `� • Fee for each system $60.00
Phone
(Prior to issuance a CltylStete � � 968 -3300 (SEE OAR 918 - 260 -260)
copy of all licenses Portland • + •
are required if Oregon Contr. Brd Lic. # �.• Date
expired 1 27 Check Type of Work Involved:
dat C.O.T. 0
data base). Electrical Contr. 6 - 2 0 0 _ 10 Exp. Date
# - CO ❑ Audio and Stereo Systems
26 -
C.O.T. or Metro Lic Exp. # 11 El Boiler Controls
Owner's Name El Clock Systems
OWNER - Mailing Address Zip S. 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.
Certain residential and other transactions are exempt from licensing. ❑ • Intercom and Paging Systems
These have asterisks(7. All others need licensing; ❑ Landscape irrigation Control*
2. Call for inspections when Installation under this permit.are ready for ❑ Medical at 503 - 639.4175;
3 ns the inspector Is out installations that are
under thistpermit;for an El Nurse Calls
Outdoor Landscape Lighting*
4. Assume responsibility for assuring that all corrections required by the
Inspector are done, and; ❑ Protective Signaling
5. Assume responsibility for calling for a final inspection when all of the Other
corrections are completed.
Permits are non - transferable and non- refundable and expire if work is not , _Number of Systems
started within 180 days of issuance or if work is suspended for 180 days.
The person signing for this permit must be the applicant or a person
• Na licenses are required. Licenses are required for all other installations
authorized to bind the apphcunt•
FEES:
ma T ER F EES $ 60.00
Signat 8
SURCHAHA
RGE (.05 X TOTAL ABOVE) $ — 9_9(_._2—__
TOTAL $ ��
Authority if other than Applicant
. ,rae.rnnncvesele.doc 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 - Business Line: 639 -4171
UP
Date Requested y12, (70 AM PM BLD
Location 1(0 2 //
O f Suites .L . MEC .
Contact Person P��`t t f �1 L1 XL(' Ph ! (Pq J 3 3 33 P
Contractor Ph SWR
BUILDING Tenant/Owner =_�1.� ELC 1 ck 1 ° � ( 0g4
Retaining Wall
Footing Access:
Foundation
Ftg Drain
Crawl Drain Inspection Notes:
Slab _ SIT -
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear ei. 1 ct , /W ( 4
Framing G �I"l`�I VlJ
Insulation ,/� C �1 ,q� ,
Drywall Nailing E Lk(Z 2,o v p U U U 1. ` U �� c.J` w"� S. M
Firewall
°'�'
Fire Sprinkler
Fire Alarm
Susp'd Ceiling •
Roof
Misc:
Final /i- // p n c �� - 1 a P ASS PART FAIL L I_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
ECESTRICAt'Th
Service
Rough In
UG /Slab
Low Voltage
Fire larm •
PAS PART 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 Dat j — /
2. Ins Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•