Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
�y DEVELOPMENT SERVICES PERMIT #: ELR2000 -00101
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 05/05/2000
SITE ADDRESS: 10865 SW WALNUT ST PARCEL: 2S103AA -00101
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
Project Description: Modification of HVAC system in existing commercial building.
•
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: X PROTECTIVE SIGNAL:
INSTRUMENTATION: , OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
SCHOOL DISTRICT NO 23 J REITMEIER MECHANICAL INC
13137 SW PACIFIC HWY 7051 SW SANDBURG #400
TIGARD, OR 97223
Phone: Phone: 603 -0205 ORIGINAL
Reg #: ELE 244LHR
LIC 63242
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT KJP 05/05/200C $60.00 0001954 Elect'I Final
5PCT KJP 05/05/200C $4.80 0001954
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 - 001 -0010 throu R 952 - 001 -0080. You may obtain copies of these rules or direct que . ons to OUNC at (503)
246 -1987. T
Issued by ��l.w� Permittee Signature y .fi "
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
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Reed
ete Reed:
13125 SW HALL BLVD PRINT OR TYPE
TIGARD OR 97223 Permit # IQ Zdoo - (7 O! of
V - 503 -639 -4171 X304
F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS CustCatlyd:
WILL NOT BE ACCEPTED
' Name of Development Prefect TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee 040.00
/601W /27/ S t/ (FOR ALL SYSTEMS)
JOB Street Address $te 0 Check Type of Work Involved: /(� b5 ,j2) k)
7 / /State 1/6 I Zip 3 Phone C ❑ Audio and Stereo Systems
❑ Burglar Alarm
--
:1 . r : _ . ❑ Garage Door Opener
OWNER Mang Address
0
Phone * 0 Heating, Ventilation and Alt Conditioning System'
City /Slate I Zip Phone 0 Vacuum Systems'
Name / / J
✓J IL i-i /� /74- ekt /I /< <1Inl, ❑ Other
CONTRACTOR Add J ). ,i,401] TYPE OF WORK INVOLVED - COMMERCIAL ONLY
` Phone C Fee for each system
(Prior to issuance a C' > ? SEE OAR ate•260 -280)
copy of all licenses , y it 7 3 6 •G . ( 6 �• ti D
are required If Oregon Contr. Brd Lk. C Exp. Date , �/ Check Type of Work Involved: in C.O.T. r)(d abs y
3 2 -�f� D ^
data base). Electrical Contr. ❑ Audio and Stereo Systems
2 I LL to _ a C.O.T. or M Exp. Date a / Date
2 y N Ll+I�- _V _ ( -a. -y [] Boiler Controls
Owner's Name ❑ Clock Systems
OWNER - Marling Address ❑ Data Telecommunication Installation APPLICANT
City /State l Zip I Phone s ❑ Fire Alarm Installation
This permit is Issued under OAE installations 91B-320-370. This
(100 volt amps or applicant agrees under this SAC — C
make only restricted energy
permit and to do the following: ❑ Instrumentation
1. Only use electrical licensed persons to do installations licensing. Certain residential and other transactions are exempt g• ❑ Intercom and Paging Systems
These have asterisks('). All others need licensing: a
Landscape Irrigation Control'
2. Call for inspections when installation under this permit are ready for
inspection at 803436 -4175: 0 Medical
3. Purchase separate permits for all installations that are not reedy for an ❑ Nurse Cans
inspection when the inspector is out to inspect under this permit:
4. Assume responsibility for assuring that all corrections required by the
0 Outdoor Landscape Lighting'
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 ransferable 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
• No licenses are required. Licenses are required for ell other installetians
authorized to bind the applicant.
E.
1 ' ENTER FEES t (d • :1 l
4n re 0 SURCHARGE (.05 X TOTAL ABOVE) $
TOTAL 5
Authority if other than Applicant
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP
Date Requested C/ cf/00 AM PM BLD
Location (0 ( t.(05 1ADct - S+ Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner POIA DI OA ELC
Retaining Wall ELR 7fl) )" 00l 0
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: as y �� f
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
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
PASS PART FAIL
EI gCTRI ►L`AL •
Service
Rough In
UG/ .•
ow Volta se
Fire arm
Fi
ASS PART FAIL
` SIT
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next ins. on. P- "at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for einspection RE: ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Ext
Other Date r Ins 1
Final
PASS PART FAIL D • NOT REMOVE this inspection record from the job site