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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BLIP
Date Requested G� ��-t'" r� AM PM _� BL.0 _
Location
Suite 1 MEC
Contact Person ✓�'1��✓ Ph Z�� j'61 Z y 1 PLM
Contractor Ph - SWR
BUILDING Tenant/OwnerELC ,�/�
Retaining Wall - ELR 7 001CO
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: --
Slab _ _ _--- - ----- SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing --- --- ---- - -
Insulation j
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 Pf RT FAIL
MECHANICAL
Post& Beam
Rough In
Gas Line
Smoke Dampers
Final - -- - - - - -- --
PASS PART FAIL
CLEZtRICAL
Service
Rough in ��
o_ UG/Slab -_ -- _ --
L, :r Voltage
Ln Fire Alarm
in
11m, PART FAIL __ .r ----_.--- - - ----- —
J 1E
Backfill/Grading
co Sanitary Sewer
Storm Drain [ )Reinspection fee of$ required before next Inspectlor. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ )Please call for reinspection RE: [ )Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk
Other Date �� Inspector Ext
--
Final
PASS PART FAIL DO MOT REMOVtE this inspection record from the job site.
ELECTRICAL PERMIT-
CITY OF TICARD
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR1999-00100
13125 SW Hall BI Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/27/99
PARCEL: 1 S125DA-07700
SITE ADDRESS: 09245 SW FJTH AVE
SUBDIVISION: KINGS VIEW ZONING: R-4 5
BLOCK: LOT: 076 .fURIS DICTION: TIG
Proiect Description: Installation of protecti, e signaling.
A.RESIDENTIAL B.COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: X BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL#OF SYSTEMS: _
Owner: A Contractor:
BOB + DENI TOMASOVIC PHILLIPS ELECTRONICS
9245 SW 69TH (DBA FOR MASTER ALARM L.L.0 )
TIGARD, OR 97223 1110 NW FLANDERS
PORTLAND. OR 97209
Phone: 293-6241 Phone: 222-5083
Reg #: LIC 00125364
SUP 329JLE
ELE 26-213CLE
FEES Required Inspections
Type By Date Amount Receipt Elect'! Final "w ✓oc rA.' ��/'f
PRMT URA 4/27/99 $40.00 99-314872
5PCT DRA 4/27/99 $2.00 99-314872
Total $42.00
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
952-001-00-fD through OAR 952-001-0080 You may obtain copies of these rules or direct ques'os to OUNC at (503)
246 987_
n. Issu d by Permittee Signature 1.
ci 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:
c�
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N — _ _ DATE:
LICENSE NO:
Gall 639-4175 by 7:00 P.M. for an inspection needed the next business day
stir
CITY OF TIGARD RECD"JE'iRESTWCTED ENERGY ELECTRICAL APPLICATION Rec'tl by:
13125 SW HALL BLS/D Date Rec'd:
TIGARD OR 97223 APIR -4, 7 10' PRINT OR TYPE
V-503-639-41''1 X304 Permit#:-f11R.1499'0149
F-503•-684-72 37 C,MM0%V1j 0EVLLONM NCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED-RESIDENTIAL ONLY
Restricted Energy Fee........................................ $40.00
Derr Sr_ (FOR ALL SYSTEMS)
JOB treat Address Ste#
ADDRESS �{Z •- Sr,,, +.�„ Check Type of Work Involved:
City/State Zip Phone# ❑ Audio and Stereo Systems
I , "r 17-1723 7`f3•-62l
Narrid Burglar Alarm
I* -�S°v I C,- C,'' S e- ❑ Garage Door Opener-
OWNER Mailing Address
City/State Zip Phone# ❑ Heating,Ventilation and Air Conditioning System"
Name ❑ Vacuum Systems-
In, ❑ Other _
CONTRACTOR Mail)Ig 13 << f TYPE OF WORK INVOLVED -COMMERCIAL ONLY
(Prior to issuance a Cit /State 7i Phone# Fee for eac'r system.............................................. $40.00
copy of all licenses �7? 7-22 -S,1r3 (SEE OAR 918-260.260)
are required if Oregon Contr. Brd Lic # Ex ate
expired in C.O.T. I Z 3 `! ..` Check Type of'VVork Involved:
data base). Electrical Contr.Lic.# Exp are ❑
211,-213, C G j. O f Audio and stereo Systems
C.O.T or Metro Lic # xp ate
0- ❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
F-1APPLICANT Data Telecommunication Installation
City/State Zip Phone# C-I
.J Fire Alarm Installation
This permit is Ise ed under OAE 918-320-370.This applicant agrees to ❑
make only restric, 1 energy installations(100 volt amps or less)uncer this HVAC
permit and to do the following ❑
Instrumentation
1. Only use electrical licensed persons to do installations where required t�I
Certain residential and other transactions are exempt from licensing. t l 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 503-839-4175; ❑ Medical
3. Purchase separate permits for all installations that are not ready for an ❑ Nurse Calls
inspection when the inspector is out to Insprct under this permit;
4. Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting*
n inspector are done,and;
fes- 5. Assume responsibility yr ceiling for a final Inspection when all of the ❑
cn corrections are completed. Other
L
~ Permits are non-transferable and non-refundable and expire If work is not
—+ started within 180 days of Issuance or if work Is suspended for 180 days. Number of Systems
m
The person signing for this permit must be the apoliermt or a person No licenses are required Licenses are required for all other Installations
LO
U.) authorized to bind the applicant.
J
FEES:
ENTER FEES
Signature
5%SURCHARGE(.05 X TOTAL ABOVE) 5 0(�
Authority if other than Applicant TOTAL
I klstsvesele doc 7/97