Permit CITY OF TIGARD
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DEVELOPMENT SERVICES ELECTRICAL PERMIT — Hall Blvd., Tigard, OR 97223 (503) 639-4171 RESTRICTED ENERGY
PERMIT #: ELR97 -0055
DATE ISSUED: 02/24/97
PARCEL: 25103AA -00101
SITE PDDRESS.o_: 10865 SW WALNUT ST
SUBDIVISION....: ZONING: R -4. 5
BLOCK........... LOT.............:
Project Description: inst 1 C.C. T. V.
job `• 102719
A. RESIDENTIAL B. COMMERCIAL --
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM..,.: BOILER..........: LANDSCAPE /IRRIGAT..:
S ^RAGE OPENER..... CLOCK..,......... MEDICAL............:
HVAC ............. DATA /TELE COMM..: NURSE CALLS.......,
VACUUM SYSTEM. .. r : FIRE ALARM......: OUTDOOR LANDSC LITE:
OTHER: :: HVAC,..o..000000: PROTECTIVE SIGNAL..
INSTRUMENTATION®: OTHER.. : C. C. T. V :: X
TOTAL # OF SYSTEMS: 1
Owner - - - - - -- -- - - - - -- - -- — FEF_S
TIGARD SCHOOL DISTRICT type amount by date recpt
13137 SW PACIFIC HWY PRMT $ 40.00 TAT 02/24/97 97-290758
SPCT $ 2.00 TAT 02/24/97 97- 290758
TIGARD OR 97223
Phone #: 620 -1620
Contractor:
AAA ALARM CO OF OREGON , 42.00 TOTAL
7865 SW CIRRUS DR
REQUIRED INSPECTIONS ---
BEAVERTON OR 97008 Ceiling Cover E_lect'1 Service
Phone # : 646 -2700 Wall Cover Elect'1 Final
Reg , #..: 000938 n/ �,� /�
This permit is issued subject to the regulations contained in the —.� / / (_(.t
Tigard Municipal Code, State of Cre. Specialty C3aes and all other Permit Si gnat I.
applicable laws. All work will he done in accordance with
aaproved plans. This perlit Gill expire if work is not started
r :it4in in days of issuance, or if c :ork is susper^'sd for nre A—daL , I At Jg '
than 112 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
13125 SW Hall Blvd. 1,R97-51:6-5
Tigard, OR 97223 PERMIT # C�
AVOl# Phone (503) 639 -4171 7
■ I FAX (503) 684 -7297 DATE ISSUED l /�
�- TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
I o? f, S S vv \K)al u+ S-4
Address D 2 RESIDENTIAL — Restricted Energy Fee $40.00
T L� P C 1 - 1D-3 3 (FOR ALL SYSTEMS)
City v 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. ❑ Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener*
pp ❑ Heating, Ventilation and Air Conditioning System*
Contractor APIA Ala rm Co. Type Et.Q C4 tCal ❑ Vacuum Systems*
' 78 65 5 W Ct rws Dr Pva� ❑ Other
Address
02c1700 (o
Date ah g ) w'T COMMERCIAL — Fee for each system $40.00
_ M (SEE OAR 918 - 260 - 260)
Property OwiQ'r Iv %10d I e SC Check Type of Work Involved;
Contractor's Board Reg. No. 938(1Q- ❑ Audio and Stereo Systems
_ � O D ❑ Boiler Controls
Phone # b O' ❑ 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 Sign , /
residential and other transactions are exempt from licensing These have Other `G� v/
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 $ 9-0. 00
authorized to bind the plicant.
r b. 5% Surcharge (.05 x total above) $ .0 O
Signature TOTAL $ •
Authority if other than applicant
ENERGAP.CHP
3 -31 Pts. coiJ74Cj 1
0ci 3 4
� / .P d CITY OF TIGARD BUILDING INSPECTION DIVISION
/ / 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: / 4 I � -q 0 A.M. P.M. MST:
Location: 108 (p 5 c c �ii(J W 0 BUP:
Tenant: /) WZr5 S uite: Bldg: MEC:
Contractor: G( ) Phone: _ (l 91 /�� PLM:
T
Owner: Phone: ELC:
. % . • / /V % / 1. /�/ " / 10 —ii / r q7-0055
ELR:
�i / 0./ / _ _ / /11 �J / ` ! /lam ��J_ te SIT:
/
BUILDING ; LD ((con't) . PLUMBING MECHANICAL SITE
• Site Post/Beam Post/Beam Post/Beam Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump w VolCD
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL } FINAL
CID -.5 £/Vr t i 1 1A e , /J 4 ss
O Call for reinspection Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: "-� 1/ — O - ? b
D ate: � ..3 xt sp' Page of
3 -11
O82
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
•
Date Requested: 3-1.1-q, A.M. P.M. MST:
Location: /08'65 d c (/[J BUP:
Tenant: ^ ` c SC��i;(0`e_, Suite: Bldg: MEC:
Contractor: AAA Aleut-n/1 Phone: 6c,16- PLM:
Owner: Phone: C ELC:
Cheri-e, � `�J�
f_XiLta-O7 a/1 11 S �� eriC� : C g ELR: 77-O055
/ SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECT SITE
Site Post/Beam Post/Beam Post/Beam' Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab e � j Shear /Sheath Fire Spk1r /Alm Crawl/Found Dr Heat Pump '�ow Vo1� /,�
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved .ldot Approve) Not Approved
FINAL FINAL FINAL FINAL FINAL
)444 C4Z-.A. ,,AAi-t.:6, A-61—€.4P-frer.c,ec._
l irL.# 1
t /L .d.,1 - s _- . i 4 ' _ �• ,11 .4 _ , .I. / _ �L �J
a /
0 Call for reinspection Reinspection fee of $ required before next inspection nable to inspect
Inspector: Date: 3/7/94p Page of