Permit CITY OF TIGARD
A l �� l � DEVELOPMENT SERVICES ELECTRICAL PERMIT —
+l_ ' 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 -4171 RESTRICTED ENERGY
PERMIT #: ELR96 -0385
DATE ISSUED: 12/30/96
PARCEL: 25102CA -00924
SITE ADDRESS...: 13220 SW VILLAGE GLENN DR
SUBDIVISION . VILLAGE GLENN ZONING:R -4.5
BLOCK.......... e LOT..... ........ : 24
Project Description: INSTALL BURGLAR ALARM
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO...: AUDIO R STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM -X BOILER - LANDSCAPE /IRRIGAT..:
GARAGE OPENER....: CLOCK............ MEDICAL............:
PVAC .............. DATA /TELE COMM..: NURSE CALLS........0.
VACUUM SYSTEM....: FIRE ALARM. - -. -.: OUTDOOR LANDSC LITE:
OTHER: :: HVAC ............: PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER..: .o
TOTAL # OF SYSTEMS: 0
Owner: FEES - - - - --
JAMES JOHNSON type amount by date recpt
13220 SW VILLAGE GLENN DR PRMT 40.00 TAT 12/30/96 96- 288267
5PCT $ 2.00 TAT 12/30/96 96- 288267
TIGARD OR 97223
Phone #:
Contractor:
BRINKS HOME SECURITY $ 42.00 TOTAL
8059 SW CIRRUS DR
REQUIRED INSPECTIONS
BEAVERTON OR 97008 Ceiling Cover Elect'1 Service
Phone #: V -641 -0574 Wall Cover Elect'1 Final
Reg #ti` ... 44421
This permit is issued subject to the regulations contained in the 421 0 A L !)
Tigard Municipal Cede, State of Ore. Specialty Codes and all other Perm • S i gnat ur
applicable laws. All work will be done in accordance with
approved plans. This pernit will expire if work is not started v � ,� 71141). 1�
within. 180 days of issuance, or if work is suspended for more 4,L
than 180 days. Issued 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
':.:. , Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
PERMIT # (p J
13125 SW Hall Blvd.
Tigard, OR 97223 ,L f 9 -63Y5
/�H+r ; \ Phone (503) 639 -4171
.I I FAX (503) 684 -7297 DATE ISSUED /' o t f,'
_ - TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY 4 i)
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INS • LLAT � 4. TYPE OF WORK
• ddress / RESIDENTIAL — Restricted Energy Fee $40.00
(FOR ALL SYSTEMS)
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 p j
180 DAYS. /�� Burglar Alarm
2. CONTRACTOR APPLICATION i ❑ � Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
RINKS HOME SECURL ALARM
Contrado ype ❑ Vacuum Systems* •
Address 8059 S.W. CIRRUS DRIVE, BEAVERTON 97008 ❑ Other
Date /,q..(g e 74 . - COMMERCIAL — Fee for each system $40.00
C ( SEE OAR 918 260 260)
Property Owner Ch ec k T ype o W ork Involved;
Contractor's Board Reg. No. O4iIii 21 ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone # .(503) 641 -0574 ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No
❑ Instrumentation
Address ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control'
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.. L The person signing for this permit must be the applicant or a person a. Enter Fees $
authorized to bind the applicant. �—
b. 5% Surcharge (.05 x total above) $
Signature
TOTAL $ V
•
r
Authority i other than apNlica v
�I � n C � / ENERGAP.CHP
a
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested — AM A O PM BLD
Location ( 3Z10 U ( 14 6LQ,v) flf Suite MEC
Contact Person 're. wL Ph t 8 -t PLM
Contractor Ph SWR
BUILDING Tenant/Owner C',Ii(Q,vw, ,'701409,t_ C281-1'Z737 ELC �
Retaining Wall ELR q(40
Footing Access:
Foundation FPS
Ftg Drain ��,� SGN
Crawl Drain Inspection Notes: � ��,
Slab's SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler gr �'o r 1 Y! S VP 14/1 —
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab 7414g/— 9 r c"
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
CECECTRtCAL.)
Service
Rough In
UG /Slab
Low Voltage
Fir larm
• SS PART FAIL
SITE
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 Q e
ns p
Approach /Sidewalk 4 .1°
Other D � f — L / Inspector — _/it 1 Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
%i