Permit (199) CITY OF TIGARD
% � i �;�� DEVELOPMENT SERVICES ELECTRICAL PERMIT — Hall . 13125 Blvd., Tigard, ) 639-4171 RESTRICTED ENERGY
PERMIT #: ELR97 -0235
DATE ISSUED: 08/14/97
PARCEL: 2S115BA -00101
SITE ADDRESS...:162O0 SW PACIFIC HWY #Z -3
SUBDIVISION • ZONING:C —G
BLOCK • LOT • JURISDICTN: TIG
Project Description: Add protective signaling and other (closed curuit TV).
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..:CCTV ::X
TOTAL # OF SYSTEMS: 2
Owner: FEES
CONTINENTAL BANK type amount by date recpt
16200 SW PACIFIC HWY PRMT $ 80.00 GEO 08/14/97 97- 298285
STE Z -3 5PCT $ 4.00 GEO 08/14/97 97- 298285
TIGARD OR 97224
Phone #:
Contractor:
LE FEBURE CORP $ 84.00 TOTAL
12658 INTERBAN S
REQUIRED INSPECTIONS
SEATTLE WA 98168 Ceiling Cover Elect'1 Final
Phone #: 206- 248 -3161 Wall Cover
Reg #..: 000706
This persit 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 expire if work is not started within 180
days of issuance, or if work is suspended for sore than 180 days. ATTENTION: Oregon law requires you to follow rule adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001-0010 through OAR 952- 001 -0880. You say obtain copies of
these rules or direct. ue /f ay (5031246 -1987.
Issued by _ 4 , , "�� > Permittee Signatures ,, — � i� -7.7
i /
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:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' N : DATE: / 9
LICENSE NO:
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + ++ + + + + + + + + + + +++
Call 639 -4175 by 6:00 P.M. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
1
CITY OFTIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
13125 SW HALL BLVD Date Rec'd:
TIGARD OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #: , l — Qa 3s
F - 503 -684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL
Restricted Energy Fee $40.00
4 .1.4 vi / (s (FOR ALL SYSTEMS)
JOB Street i�J. i.', reef Address /� Ste # Check Type of Work Involved:
ADDRESS 602 Fs Gi-A'L , z-" .3
/State Zip y Phone # ❑ Audio and Stereo Systems
//.4///.4/ , /72Zf
Name ar Burglar Alarm
c
O
yl L ❑
OWNER Mailing Address Garage Door Opener'
City /State Zip I Phone # El Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems'
Name
2£/;;C3k E .7_ pV , ❑ Other
CONTRACTOR Mailing Address
1,065 , -- Xti2gA.✓ S TYPE OF WORK INVOLVED - COMMERCIAL
'
(Prior to issuance a C /Stat Zi Phone # ( a) Fee for each system $40.00
copy of all licenses / Jq, W/ /4 ' - 01)11' 3/( / (SEE OAR 918 - 260 -260)
are required if Oregon Cot*. Brd c. / E D to
expired in C.O.T. ( (e 3 5- �jrf Check Type of Work Involved:
data base). Electrical Contr. Lic. # £x D ate
❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date
❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT ❑ Data Telecommunication Installation
City /State Zip I Phone # ❑
Fire Alarm Installation
This 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 - 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;
4. Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting*
inspector are done, and; 12 Protective Signaling
5. Assume responsibility for calling for a final inspection when all of the �%, r
corrections are completed. Other 1/
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. p2 Number of Systems
The person signing for this permit must be the applicant or a person • No licenses are required. Licenses are required for all other installations
authorized to bind the applicant.
ig W1
Signature ENTER FEES $ 3c7
5% SURCHARGE (.05 X TOTAL ABOVE) $ e t , /�
Authority if other than Applicant TOTAL $ 5 f
i:kesele.doc 12/96 _
7
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 8 - a" !? A.M. P.M. MST:
Location: _ la li _� ,A L ial ' ■ . I . ' BUP:
Tenant: CONT7N au 7 ∎, A Jv )(_ Suite: 2 Bldg: Z. MEC:
Contractor: / Phone: �73- 09'C)5 PLM:
�: Phone: ELC: -- 10 3
/ / ,k EL .-mviir ---- 0 ,_
�i�.2., 1
BUILDING - IJi f:�.`r,'t) PLUMBING MECHANICAL MBA Q III :I [M! 0 SITE
Site ' o r : eam Post/Beam Post/Beam Cover - 'ce Sewer/Sto ` I i
Footing Roof UndFl/Slab Rough -In v tGT1iio Water Line
Slab Framing Top Out Gas Line UG Sprinkler
Foundation • Insulation Sewer Hood/Duct • ::. meet Vault
Bsmt Damp Drywall Storm Furnace Temp Service MSC.
Masonry Ceiling Rain Drain A/C UG Sla
Shear /Sheath Fire Spklr /Alm ' Crawl/Found Dr Heat Pump Low olt
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved ved Not Approved
FINAL FINAL FINAL FINAL FINAL
r ;`
C e T - - - - - - e_ 9 _
- - " f -- - I --9 c -ff - -- '-c_ . 1 14 .st (
.Z1�-( c(7 f V.=:e+:=0 75 c'eL-e f, 41 -/ tr e>P
r ., .
........._
O Call for reinspection O Reinspection fee of required before next inspection 0 Unable to inspect
Inspector: I hispec ,L 416, Date: ^2:2_ "-- Page 1 of /