11795 SW GREENBURG ROAD E
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11795 SW GREENBURG ROAD i
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hous Inspection Line: 639-4175 Business Line: 639-4171 ------ ------
BUP
Date Requested ��- k AM PM W
r---- BLD
Location (_l C _ \ Suite MEC ---_ --
Contact Person_ Ph (�, 3 �— 0� PLM `
Contractor A- ,_(� L � i Phi ���3��� SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing AcceScc.
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes SGN
Slab
Post&Beam _-� - SIT _-_--
Ext Sheath/Shear
Int Sheath/Shear -
Framing
Insulghon
Drywall Nailing
Firewall J _
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final — T --
PASS PART FAIL --
PLUMBING
Post&Beam
Under Slab
Top Out - - -
Water Service
Sanitary Sewer
Rain Drains
Final - -- --
PASS_ PART FAIL
MECHANICAL
Post&& Beam - - - - --
Rc,ugh In
Gas Line --- - - - -- - ---
Smoke Dampers
Final
PASS PART FAIL.
ELECTRICAL -- -
Service
Rough In
UG/Slab
Low Voltage
Fire-Alarm
fi
A PART FAIL
Backfill/Grading
Sanitary Sewer
Storm Drain ( J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ Please cal)for reinspection RE: _— ( J Unable to inspect- no access
ADA
Approach/Sidewalk , /t-e
/ ,OtherDate -�__ _ 9� Inspector .GG�{',,{'J E aFinal _ _
PASS FART FAIL 00 NOT REMOVE this inspection record from the job site.
CITY CUFF TIGARD
DEVELOPMENT SERVICES
ELECTRICAL PERMIT
13125 SW Nall Blvd., Tigard,OR 97223 (503)639.4171 -
RESTRICTEIENERGY
PERMIT #: ELR98-0211
DATE ISSUED: 08/05/98
PARCEL: 1S135DC-00400
SITE ADDRESS. . . : 11795 SW GREENBURG RD
SUBDIVISION. . . . :TIGARDVILLE PARK ZONING:C—P
BLOCK. .. . . . . . . . . : LOT. . . . . . . . . . . . . :OO8 JURISDICTN: TIG
Pro J ect Description : Steven W Black, DDS
A. RESIDENTIAL--_______ B. COMMERCIAL.—_--__---_—._-------------_-.__----_..-----._
AUDIO & STEREO. . . : AUDIO R S'TEREO. . : INTERCOM & PAGING. . :
BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. .
GARAGE OPENER. . . . . CL.00K. . . . . . . . . . . . MEDICAL.. . . . . . . . . . . . .
HVAC. . . . . . . . . . . . . : DATA/TELE COMM. . ; NURSE CALLS. . . . . . . . :
VACUUM SYSTEM. . . . : FIREALARM. . . . . . OUTDOOR LANDSC; LITE-
OTHER:
_ITE:OTHER: : : HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . : X
INSTRUMENTATION. : OTHER. , : : :
TOTAL. # OF SYSTEMS: 1
Owner: _______________._______---_-. FEES
STEVEN W BLACK, DDS type amol-int by date recpt
11795 SW GREENBURG RD PRMT $ 40. 00 JSD 08/05/98 98-308004
TIGARD OR 97223--0000 SPC l $ 2. 00 JSD 08/05/98 98-30800+
Phone #: 639-4201
Contractor: --------------------------------------------------------------.---
AUT SECURITY ALARMS $ 42. 00 TOTAL.
703 NE HANCOCK
------ Ri ')U I RED INSPECTIONS
---- --
PORTLAND OR 97212 Ceiling Co-er Low Voltage Insp
Phone #: 284-3265 Wall Cover Fleet' ] Final
Reg #. . : 000599
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All Mork will be done in accordance with approved plans. This permit will expire if work it not started within 180
days of issuance, ar if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rule auopted by the
Oregt,n Utility Notification Center, 67rules are set forth in OAR 952--001-0010 through OAR 952-001-0080. You may obtair. c its of
these rules or direct questions to At i5631246-1987. ��,�
IsSUed by� Permittee Signat�_�
---)--------OWNER INSTALLATION ONLY-------------
The installati,3n is eing made in property I own which is not intended for,
sale, lease, or rent.
OWNER' S SIGNATURE: _ _._ DATE:
----------------------CCINTRACTOR INSTALLATION
SIGNATURE OF SUPR. ELEC' N: DATE:
++++++++++++++++++++++++++++++++•4•+++++++++++•4-++4.++++++++++++++++4-+++++4•+++++++•4+
Cali 639-4175 by 7:00 P. M. for an inspection needed the next business day
++++++++++++++++•4•+++++++++++++++++++++++++++++•r++++++4•++++++++++++++++++4•+++++++
r
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd hy:<'
13125 SVv HALL BLVD .D 2�1Q 3�S �/ Date Recd:
TIGARD OR 97223 �4` l_.� PRINT OR TYPE
V- 503-639-4171 X304 JL*- - �J �fr Permit#: /`1 0C
F - 503-684-7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd.
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVEr7-RESIDENTIAL ONLY
Restricted Energy Fee....................................... $40.00
(FOR ALL.SYSTEMS)
JOB Street Address Ste!t
_,1„5� SGj �A,cC.�/ � _ Check Type of Work Involved:
/
ADDRESS � �!�
C t /Stat Z p Ph o # / ❑ Audio and Stereo Systems
Name _ -- — ❑ Burglar Alarm
❑ Garage Door Opener'
OWNER Mailir�� �Address
Cd'"";late
Zrp Phone# F-1 Heating,Ventilation and Air Conditioning System*
---- —��--- ❑ Vacuum Systems'
Nam
IDT
SECURITY
'INC.
3 NE HANCOCK ❑ — --
Other—_
CONTRACTOR Mailing �2i4 3265 TYPE OF WORK INVOLVED -COMMERCIAL ONLY
(Prior to issuanct a City/State lip Phone# Fee for oath system.............................................. $40.00
copy of all licenses T (SEE OAR 918-260.260)
are requirad if Ore r Lit # Fx
Vaje—
expired in C.O.T. —� Check Type of Work Involved:
data base). Flet cal Cogir Lic # Exrp ❑
yl (J Audio and Stereo Systems
C.O.T.or etro Lic # Exp ate
❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Marling Address
APPLICANT ❑ Data Telecommunication installation
City/State Zip Phone# ❑
Fire Alarm Installation
I his permit is issued under OAE 918-320-370.This applicant agrees to ❑
make only restricted energy installations(100 volt amps or less)under this HVAC
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('). All others need licensing;
❑ Landscape Irrigation Control*
2 Call for inspections when installation under this permit are ready for
inspection at 503-594175; ❑ Medical
3 Purchase separate permits for all installations that are not ready for an ❑ Nurse Calls
inspection when the inspector is out to inspect under this permit;
4 Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting'
inspector are done,and;
Protective Signaling
5 Assume responsibility for calling for a final inspection when all of the
corrections are completed. ❑ Other
Permits are non-transferable and non-re'undab and expire if ork is riot
started within 180 days of issuance i.work suspended r 180 days Number of Systems
The person signing for this perm wst be th applic or a person No licenses are required Licenses are required for all other installations
authorized to bind the applicai
FEES:
`— -- / ENTER FEES $ MV
Signa re -
5"/e SURCHARGE(.05 X TOTAL ABOVE) $_ 0�, _
Authority if other than Applicant TOTAL
i tdstsvesele doc 7197 -—