9714 SW WASHINGTON SQUARE ROAD I
ADDRESS:
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CITY OF TIGARD BUILDING INSPECTIOr ,"VISION MST
24-Hour Inspection Line: 639-4176 Business Line: 639-4171 —
BUP
Date Requested �7 AM PM BLD
Location Suite tL MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING — en a t/Owner
Retaining Wall
Footing
Foundation FPS —
Ftg Drain NOT REQUESTED SGN
Crawl Drain OUND DURING RESEARCH
Slab NO INSPECTION(S) IN FILE SIT
Post&Beam ---
Ext Sheath/Shear
Int Sheath/Shear —
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: -- — -- —
FPA /
PASS PART FAIL �-�C•(�+-�' 1�r �' — .S 'S -
PLUMBING
Post& Beam — -- —
Under Slab
Top Out ------
Water Service
Sanitary Sewer —�
Rain Drains —
Final i
PASS PART FAIL
MECHANICAL
Post& Beam -- --- - - —
Rough In
Gas Line _--
Smoke Dampers
Find -- -- --ASS---PWT FAIL ---
LECTRICAL
Rough In
CILL�GISIab ------- --- ----- --
cr o a
—
> Fin•
ASS PART FAIL
SI
Backfill/Grading
W Sanitary Sewo,
J Storm Drair f t Reinspection fee of$ _ _required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin I I Please call for reinspection RE: _ I I Unable to inspect-no access
Fire Supply Line
ADA �i � XL
Approach/Sidewalk Date ��..__..�_ Inspector eA Ext
Other ----
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
CITY OF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd,, Tigard,OR 97223 (503)639.4171 ELECTRICAL PERMIT —
RESTRICTED ENERGY
PERMIT #: ELR98-0003
DATE ISSUED: 01/07/98
PARCEL: 1S126CO-01107
SITE ADDRESS. . . :09'714 SW WASHINGTON SQUARE RD
SUBDIVISION. . . . : ZONI NG:C--(-'3
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTN: TIG
ProJ ect Description - Installation of a protective signaling system.
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. . . . . . . . . . . . : PROTECTIVE SIGNAL. . : X
INSTRUMENTATION. : OTHER. . : . .
TOTAL # OF SYSTEMS: 1
Owner-: --------------------------------------------------------- FEES -----------------
MELVILL..E CORPORATION type amol-mt by date recpt
ONE THEALL RD PRMT E 40. 00 DRA 01/07/98 98-302334
RYE. NY 10580 SPCT $ 2. 00 DRA 01 /07/98 98-302.334
Phone #: 914-925-4000
ContTactor,: -----------------------------------------------.-------------------------
SECURITYLINK FROM AMERICTECH f 42. 00 TOTAL
5110 NE SANDY BLVD
------ REQUIRED INSPECTIONS ------------
PORTLAND OR 97213 Ceiling Cover Low Voltage Insp
Phone #: ;'88--3430 Wall Cover Eler_t' l Final
Req #. . - 005506
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable lbws. 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 188 days. ATTENTION: Oregon law requires you to follow rule adopted by the
Oregon Utii t.y-Natifiration Center. Those rules are set forth in OAR 952-MI-MIS through OAR 952-01-OW. You may obtain copies of
these rule or direct, questions7)A.
OK at 1503!246-1987.
Isso-:e by 7 = _ Permittee Signature
--------------------------OWNER INSTALLATION ONLY---------------------------- -
The installation is being made on proper-ty I own which is not intended for
Nsale, lease, or- rent.
r
OWNER' S SIGNATURE: DATE:
-------------------------CONTRACTOR INSTALLATION ONLY----------------------------
s
73 SIGNATURE OF SUF'R. ELEC' N: DATE:
LICENSE NO:
++++++++++++++++++++++++++++++++F+++++++++++++++++++++++++++++++++++++++++++++++
Call 639-4175 by 7:00 P. M. for• an inspection needed the next b1-1siness day
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd. L� J g ���
Tigard, OR 97223 PERK-11r # _ CL 's --
Phone (503) 639-4171 — 7--�'7
FAX (503) 684-7297 DATE ISSUED
TDD No. (503) 664-2772 ( I -GL✓YLL. _ JZ
CITY OF TIGARD Inspection (503) 6.39-4175 ISSUED BY � � r
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 7i '>' -�<<) lv f/- 4. TYPE OF WORK
WASNrhgTZ7N � �D - FmTAcTTa� uSA fZZ���
Address RESIDENTIAL—Restricted Energy Fee . . . . . . . . . $40.00
it 6-,4x_0 OK 9727-3 (FOR ALL SYSTEMS)
City State Zip Check Tyne of Work Involved:
PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Svstems
IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
180 DAYS. ❑ Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener`
P1-01 r'c 7-1✓C_ ❑ Heating, Ventilation and Ai.-Conditioning System'
Contractor 544LtA Vily SLI W K___ rype 5 L_r rvG-- ❑ Vacuum Systems`
Address 5//0 N'F• Ala Oy 53L.Jn_ I��k-TL4 jo ❑ Other
Date _ COMMERCIAL—Fee for each system . . . . . . . $40.00
(SEE OAR 918-260-260)
Property Owner _ Check Type of Work Involved:
<fc. A A�--
Contractor's Board Reg. No. -C)(
c� ❑ Audio and Stereo Systems
�?� Z 8 8-3Y3o � J ❑ Boiler Controls
Phone # -S �f�) ❑ Clock Systems
5805 ❑ Data lelecommunication Installations
3. OWNER APPLICATION
❑ 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 918.320-170.This applicant agrees to make only ❑ Nurse Calls
restricted energy installations(100 wit 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 Signaling
residential and other transactions are exempt from licensing.These have ❑ Other
asterisksM.All others need licensing).
2. Call fur an inspection when all of the installations under this permit are ready
a for inspoctinn at 503.639-4175. Number of Systems
h3. Purchase separate permits for all installations that am.not ready for Inspection
N when the inspector h out to inspect under this permit. •No licenses are required. Licenses are required for all other Installations.
T 4. Assume responsibility fnr assuring that all corrections required by the inspector
are done.and
J i. Assume responsibility for calling for a final inspection when all of the S. FEES
s
corrections are completed.
W The person signing for this permit must be the applicant or a person a. Enter Fees $ 0�
--+ authorized to hind the applicant,
el eT�4{'irl b. 5% Surcharge(05 x total above) $__ .?r 0O
Signalure
TOTAL $� o
Authority if other than applicant
ENERGAP.CHP
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666
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