16290 SW 72ND AVENUE ADDRESS:
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Pour Inspection Line: 639-4175 Business Line: 639-4171 — --
BUP _
Date Requested 3' ((u `l`;' _ AM PM BLD
Location j(QZ!tiU -Z 1 Ktd _ Suite B _ MEC
Contact Person s-�/�- (1�1 . F '� Ph PLM
Contractor_ _ Ph SWR
BUILDING TenaoOvvner Gj(� -�( �11-''Lcx�- ELC
Retaining Walt ELR
Footing Access:
Foundation FPS
Fig Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler ��' C'L�✓` S _
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final �` \
PASS PART FAIL I
PLUMBING
Post&Beam
Under Slab
Top Out -
Water Servic3
Sanitary Sewer —
Rain Drains
Final
PASS_ PART FAIL
MECHANICAL
Post& Beam ---
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL.
C- Servi�,.e
a Rough In
un
ow Voltam - -
arm
S PART FAII- - --- ---- --- -
c
-' Backfill/Grading — -
Sanitary Sewer
Storm Drain ! j Reinspection fee of S required before next inspe,.aon. Pay at City Hall, 13125 SW hall Blvd
Catch Basin
Fire Supply Line ( J Please call for reinspection RE: J j Unable to inspect-no access
ADA
Approach/Sidewalk Date �L�
Other Inspector Ext
Fir 31 _—
PAS8_ PART FAIL DO NOT REMOVE this Inspection record from the job site.
CITY CSF TIGA►RD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 RESTRICTED ENERGY
PERMIT #: ELR99-0038
DATE ISSUED: 03/02/99
PARCEL: 2SI13AA-00400
SITE ADDRESS. . . : 16290 SW 72ND AVE #B--02
SUBDIVISION. . . . :ROSEWOOD ACRE TRACTS ZONING: 1-1-
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :C JURISDIITN: TIG
Pr-oJect Descr-ipt ion: Install protective signaling.
A. RESIDENTIAL---------- B COMMERCIAL---
AUDIO & STEREO. . . : AUDIO & STEREO. . : INTERCOM & PAGING. . :
BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. . :
GARAGE OPENER. . . . . CLOCK. . . . . . . . . . . . MEDICAL... . . . . . . . . . . . :
HVAC. . . . . . . . . . . . . : I)PTA/TELE COMM. . : NURSE CALLS. . . . . . . . :
VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR LANDSC LITE:
OTHER: MVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . : X
INSTRUMENTATION. : OTHER. . :
TOTAL # OF SYSTEMS: I
Owner: FEES
GLOBE FURNITURE RENTAL – WHSE type amol-Int by date reept
16290 SW 72ND AVE PRMT $ 4.0. 00 GEO 03102199 99-313377
TIGARD OR 97224 5PCT $ 2. 00 GEO 03/02/99 99-313377
Phone #: 684-2800
Contr-actot-: ---------------------------------------------------------------------------
HONEYWELL INC $ 42. 00 TOTAL
15495 SW SEQUOIA
STE 100 ------ REQUIRED INSPECTIONS
PORTL (IND OR 97224 Low Voltage Insp
Phone #: 968-3333 Elect' l Final
Reg #. . - 000578
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 work will be done in accordance with approved plans. This permit will e!pire if work is not started within 180
days of issuance, or if work is suspended for more than 180 days, ATTEENTION: Oregon law requires you to follow rule adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR 9510-001-0010 through DAR 952-001-0080. You mAy obtain copies of
these rules or direct questions D 7/7at (503)24E-1987. %.
Tsql.ted by ^— Permittee Si gnat .......
1�kl'l
-----------------------------OWNER INSTALLATION ONLY-------------------------------
F– The
NLY-------------------------------
The installation is being made an property I own which is not intended for
sale, lease, or rent.
OWNER' S SIGNATURE: DATE:
-----------.--.----------.---CONTRACTOR INSTALLATION
SIGNATURE OF SUPIR. ELECIN:
DATE:
LICENSE NO:
++++++++•t+++++.1-+++ ' ...........F4•.........4..................4........................
Call 639-4175 by 7:00 P. M. for, an inspection needed the next business day
...............4-+++++++4.................................1-+4.......... ............
RECEIVE['
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by.
131?; SW HALL BLV[�" ;, )(. Date Recd:
TIGARD OR 97223 �YIAk �'') " PRINT OR TYPE
V- 503-639-1171 X301, UNIfY DFVELUP(YE Permit#: ��hoc/�-'6Q�
F - 503.684-7297 INCOMPLETE 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
(FOR ALL SYSTEMS)
JOB Street Address Ste
ACheck Type of Work Involved:
ADDRESS
e2 -2�
ity/State Zip Phone# Audio and Stereo Systems
t iOk
Name Burglar Alarm
C'
30 n e L I L, C'"4'r"'✓ , ❑ Garage Door Opener'
OWNER Mailing Address
City/State Zrp Phone# Heating,Ventilation and Air Conditicning System'
Name ❑ Vacuum Systems'
� ❑ Other—�
CONTRACTOR Marling Addr ss
r' q 1 f�. J �f C o TYPE OF WORK INVOLVED -COMMERCIAL ONLY
(Prior to issuance a C�lSt to Phnr, # Fee for each system.............................................. $40.00
copy of all licenses tel (SEE OAR 918-260-260)
are required it Oregon Contr. BYd Lia# Exp. Date
expired in C-O.T. J Check Type of Work Involved:
data base) Electrical Contr.Lic # gxp. ate
/ - if L L _ 1!?z/
7,2 ❑ Audio and Stereo Systems
C.Q.T.or Metro L`ic # Exp ate
� ❑ Boiler Controls
Owner's Narne
Clock Systems
OWNER - Mailing Address
APPLICANT [] Data Telecommunication Installation
City/State Zip Phone# ❑ Fire Alarm Installation
This permit is issued under CAE 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;
2. Cell for Inspections when installation under this permit are ready for Landscape Irrigation Control'
Inspection at 503.639.4175; ❑ 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;
R 4 Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting'
N inspector are done,and;
Protective Signaling
5. Assume responsibility for calling for a final inspection when all of the
J corrections ere completed. E] Other
Permits are nontransferable and non-refundable and expire if work Is not
LL started within 180 days of issuance or if work is suspended for 180 days. Number of Systems
J
The person signing for this permit must be the applicant or a person ' No licenses are required L,censPs are required for P1'other Installations
authori ed to bind the applicant.
FfE4:
Signature ENTER FEES ; 110, 00
5%SURCHARGE(.05 X TOTAL ABOVE) $ �� • G' C)
Authority if other than Applicant TOTAL $ y..Z U O
I Wsts\resele doc 7/97 – --