12040 SW LINCOLN AVENUE-1 N
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CIT" OF TIGARD BUILDING INSPECTION DIVISI N
24-Hour Inspection Linc: 639-4175 Business Phone: 639-4171
Date Requested. —�� _ A.M. _ — P.M. MST:
Location: ��(' -� � BUP:
Tenant: ,( Suite: Bldg: NEC:
AContractor: C�L`iLc� D�7�-- _._ Phone: _t;,-, r � PLM:
Owner. �`1 ,,1 /1 p t� , Phone: ELC:
ELR
j�SIT:
WILDING BLDG(con't) PLUMBING MECHANICAL ELECTkICAL SITE
Site Post/Beam Post/Ileam Post/Bcam Cover/Service Sewer/Storm
Footing Roof UndFl/Slab Rough-In Ceiling Water Line
Slab Frami,ig Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer tlood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire SI,klr/AIm CrawVFound Dr Ifeat Pumpow—Vo11->
Approved Approved Approved Approve d Approved
Appr/Sdwlk Not Approved Not Al4,roved Not Approved Not Approved Not Approved
FINAL FINAL FINAL CF RX-61 FINAL
t
'J Call for reinspection C1 Reinspection(be of S _required before next inspection 0 Unable to inspect
� ne
Inspector:_ _ � Date:_ V ` — Page----of—
� CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT -
13125 SW Nall Bled,. Tigard,OR 97223 (503)6'9.4171
RESTRICTED ENERGY
PFRMIT #: E'L.R98-0006
DATE ISSUED: 01 /1-198
PARCEL : 2SI02AB-00903
ITE ADDRESS. . , : 1--'040 SW L.T IVi:,UL..N AVt:_
SUOnIVISTON. . . . :KIMBERLY ADDITION ZONING:R-7
IILOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :003 Jl_IRISDICTN: TIG
F"'r-o J ect Descr-i pt i on : Installing a residential burglar alar,
----------------------------------------------------------
A. RESIDENTIAL---------- B.
AUDIO & STEREO. . . : AUDIO R. STEREO. . : INTERCOM & PAGING. . :
BURGLAR ALARM. . . . : X BOIL.ER. . . . . . . . . LANDSCAPE/IRRIGAT. . :
GARAGF OPENER . CLOCK. . . . . . . . . . . : MEDICAI... . . . . . .
HVAC. . . . . . DATF1/YEL_E C:OMM. . • NURSE CALLS. . . . . . . .
VACUUM SYSTEM. . . . : FIRE RE ALARM. . . . . . : OUTDOOR L.ANDSC LITE;
0THr__R: . . HVAC. . . . . . . . . . . . . PROTECTIVE SIGNAL. . :
INSTRUMENTATION. : OTHER. . : . .
TOTAL # OF SYSTEMS: 0
Uwrer: ---------------------.-----_-- ---------_---------._---_ FEES
CHRIS FRAZEE type amoi.lnt by date recpt `
12040 SW LINCOLN PVF PRMT $ 40. 00 S 01 /1:/98 96-302431 1
TIGARD OR 97223 5PCT $ 2. 00 B 01 /12/98 98-3024.:'1
Ph o n- #: 639-608`.:,
Contra- l:or,:
AC'T SFCUPITY ALARMS $ 42. 00 TOTAL
703 NE HANCOCK
--- --- REQUIRED INSPECTIONS ---- - -
FIORTI_.AND OR 97212 Ceiling rover- Low Voltage Insp
Phone #: 284-3065 Wall Co'<er Elect' l Final
Req #. . : 000599
This permit is Issued subject to the regulations contained in the Tigard Mirocipal Evie, state of Ore. Specialty Codes and all other
applicable laws. All work trill be done in accordance with ar�ruveti r!, TIuS permit will exr if Mork is not started with,n 180
days of issuance, or if work is suspended for more then 13o days. ATTEWTON: Oregon law requires you to follow rule adopted by the
,Iregon lltil;ty Notifia,tion Center. Those rules are set firth in OAR 95:-001-Ne18 through OAR 952-061-0880. You may obtain copies of
thfce r r d' t q1JVt1RnJ to DUNG at (503)246-1987. —`-
-
I s s�.1 e h b y._....._.... _. ...___I _ �— F'e r m i t t p P S i q n a t 1_r r e 0�A &N
�t
_ __ _ V
if
_----------------------------OWNER !NSTAL_LATTON
The in5`allation is being made on proper-ty 1 own which is not intended fvr-
sale, lease, or, rent.
OWNER' S SIGNATURE: DATE::
_--.----------------.------CONTRACTOR. INSTALLATION ONLY -__.._._..._.__---_-.--.----_---------.._--
T GNATL IRE OF SUPR. E1-FC' N: ! LATE:
I._.I CENSE NO:
++++++++++++-�-+-►-+++++++++++++++++++++ .4-++-►•+++++++++++++-f•+++++-++++++-++++++++•+++4.++
Call. 639-4175 by 7:00 P. M. for an inspection needed the ne)<t bl..t-iiness day
+++++•.+++++4-+++++-++++++i+++++++++-I-+++++++++++++-F-1-++++++++++-f•++++++++++++++++++...
CITY OF I'IGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by: J G �
13125 SW HALL BLVD Date Recd: , -12- _
TIGARD OR 97223 PRINT OR TYPE
V- 503-639-4171 X304 Permit
F - 503-684-7297 INCOMPLETE OR I1-1 EGIBLE APPLICATIONS Cust.Gall'd:_ _
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVILVED -RESIDENTIAL ONLY
/� Restricted Energy Fee........................................ $40.00
(FOR ALL SYSTEMS)
JOB Street Address Ste#
C Check Type of Work Involved.
ADDRESS 2/Q SW,
4Ci /St Z ip Phone Audio and Stereo Systems
za
N 71 Burglar Alarm
�-� ❑ '
OWNER Mailing Address Garage Door Opener
City/Stela Zip F hone ❑ Heating,Ventilation and Air Conditioning System'
—� ❑ Vacuum Systems'
Name
lei SECLIMTV SYS1EMI&WA Other_
70'HANCOCK - --- —
CONTRACTOR Mailing A Ne01?97M—
M3126i•3265 TYPE OF WOI .K IN'JOLVEiD - COMMERCIAL ONLY
(Prior to Issuance a City/State �7ip Phone# Fee for each system.............................................. $40.00
copy of all licenses (SEE OAR 918-260-260)
are required If Oregon Contt,OBrd Lic.# Exp.Date
expired in C O.T. �19 Check Type of Work Involved:
data base') Electrica Co tr.Lic.0 Exp.Date F-1Audio and Stereo`systems
C,O T or Metro Lic.# Exp. Date
❑ Boiler Ccntrois
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT ❑ Data Telecom.nuoication Installation
City/State Zip Phone# ❑
Fire Alarm Inatallatlon
This permit is Issuers 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. ❑
Instrumenteticn
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;
Landscap�a Irrigation Control•
2. Call for inspections when installation under this permit are ready for
inspection at 503-1c 3u-4176; McJical
3. Purchase separate oermils for all Installations that are not ready for.n r❑ ;urse Calls
inspectic i when the inspector is u-.-t t j Inspect under this permit;
4 Ass„me responsibility for assuring that all corrections required by the ❑� Outdoor Landscape Lighting'
Inspector are done,and; ❑
Protective Signaling
5 Assume rcaDonsib ity for coiling for a final inspection when all of thr ❑
corrections are comp;Rted. Other
Permits are non-transferabb,e, ,hon-ref indable and expire if work is not
staned within 180 days is or if� ork Is suspended for 180 days. — Number of Systems
V
The person signing f this +rmit must be the applicant or a person No licenses are required Licenses are requlred for all other Installations
authorized Ind e a cant.
G� Ems:
r,
D 3ZLL ENTER FEES —
natt re
5%SURCHARGE(.05 X TOTAL ABOVE) $
Authority if other than Applicant - TOTAL $_— _
i ldslslresele doc 7/97 - ----`----