Permit (203) CITY OF TI GARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR2000 -00021
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4174) DATE ISSUED: 1/24/00
SITE ADDRESS: 16200 SW PACIFIC HWY Z PARCEL: 2S1156A -00100
SUBDIVISION: ZONING: C -G
BLOCK: LOT: 4 TIG
Project Description: Installation of CCTV for loss prevention.
f
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:
INSTRUMENTATION: OTHER: CCTV .
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
IBJ SCHRODER BANK + TRUST CO DATA CABLING + ENGINEERING INC
BY ALBERTSONS INC #565 3930 SW 30TH
ATTN: CORPORATE ACCTG DEPT GRESHAM, OR 97080
BOISE, ID 83726
Phone: Phone: 674 -8532
Reg #: LIC 00090908
ELE 3049JLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT DEB 1/24/00 $60.00 00- 321344 Elect'l Final
5PCT DEB 1/24/00 $4.80 00- 321344
Total $64.80
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 : • to •w rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 a 1 -0010 throu• , OAR 951' -0080. You may obtain copies of these rules or direct question to OUNC at (503)
24. -1987. /
Is ued by _.i ; _ , /� ./ � � / Permittee Signature , /i. _AL/
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:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
01/20/00 THU 12:18 FAX 503 598 1980 CITY OF TIGARD lj002
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION . Rec'd by: ��
13125 SW HALL BLVD
TIGARD OR 97223 Date Reed: /- y-00
PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #: eOGtO- Goa/
F - 503 -598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
At-- '>3Oit Restricted Energy Fee $60.00
• (FOR ALL SYSTEMS) •
JOB Street Address
ADDRESS (t°2 S ‘• ( P/\< t.1`1 - `te # 7-• Check Type of Work Involved: RECEIVED
Clty/State Zip Phone # El Audio and Stereo Systems
1Tll .014, 6 T - 1
_ Name � /��,' �' L p
i'60 Cie _ , i /1 t b g Q Zw4 y i�37 El Burglar Alarm JA 2 4 2000
��g,�d Garage Door Opener COMMUNITY DEVELOPMENT
OWNER 1 G.TikNS �%,(, k b1a A
qty /�tsl� ! phone # ❑ Heating, Ventilation and Air Conditioning System'
t it J
Name ❑ Vacuum Systems
DAer Cfc73LArkfi 4 E:1 R.crL ❑ Other
•
CONTRACTOR Mailing Address
lLe303 hcE Cwt - t , BL,,I . b. TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /State Zip Phone # ( ) Fee for each system $60.00
copy of all licenses Rne L.Pcr•pb•,og, ! e t - 1 2-51c--.7-52.3 (SEE OAR 918 - 260 -260)
are required if O(� ,on _Contr. rd Lis # p ate
•
expired in C.O.T. L �(O g kO l Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp Date
21,7 a-4 c--1--E- l o f t ( ao ❑ Audio and Stereo Systems
C.O.T. or Metro Lic: # ' Exp. Date
❑ Boller Controls
Owner's Name •
OWNER - Mailing Address
El Clock Systems
APPLICANT ❑ Data Telecommunication Installation
City /State f I 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:
2. Call for Inspections when installation under this permlt.are ready for ❑ Landscape Irrigation Control*
inspection at 603 - 639 -4176; ❑
Medical
•
3. Purchase separate permits for all Installations that are not ready for an
inspection when the Inspector is out to inspect under this permit; ❑ Nurse Calls
4. Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting•
inspector are done, and;
I] Protective Signaling
5. Assume responsibility for calling for a final inspection when all of the
corrections are completed. " Other (_O S' > /Pjk`S) 171pT( (C;TV
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
•
The person s•• fling for thl • malt must • -- .: t or a person • No licenses are required. Licenses are required for all other installations
e•
authoriz •Indt�ay cant. /
4 , a 1 i FEES: •
g atu = N�ER FEES $ lac). CV
air e� 80
SURCHARGE OW X TOTAL ABOVE) $ ,
Authority if other than Applicant TOTAL $ (04.80
i:ldstsVormsvesele.doc 3189
2
04/17/2000 Activities for Case #: ELR2000 -00021 •
9:13:54 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 •To Done By Disp. Level By Updated Notes
. ELRC001 Application Received 01/24/2000 DEB DONE No Hold DEB 01/24/2000
ELRC003 Permit Created 01/24/2000 DEB DONE No Hold DEB 01/24/2000
ELRC725 Low Voltage Inspection No Hold DEB 01/24/2000
ELRC799 Elect'I Final 01/24/2000 01/24/2000 03/03 /2000 CD PASS No Hold AKJ 03/05/2000
ELRC500 (F) Issue permit 01/24/2000 DEB DONE No Hold DEB 01/24/2000
ELRC799 Elect'l Final 03/05/2000 AKJ DONE No Hold AKJ 03/05/2000
ELRC800 Case finaled 03/05/2000 AKJ DONE No Hold AKJ 03/05/2000
•
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested . 3/ � J � 00 AM PM BLD
Location 1(0,00 .PCV, ( s MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner 4 - -__ E 0 200- 02221
Retaining Wall ELR qqq 0D2
Footing Access:
/
Foundation ° loos f✓lo s/00 i I FP
Ftg Drain I
SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam '
Ext Sheath /Shear
Int Sheath /Shear 0A.:74(/ n
Framing CLi41 C4-6 /, - 7 - FA/e,rote x.4• .arc /A/ L)
Insulation
Drywall Nailing %l N.. c aly.,✓� ( i w L o u �, Sy S
F / /
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
/4/ ! fir V
Misc: /v
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELStCTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
S PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date _ 73 3 Inspector Ext
Final
PASS PART FAIL D N T REMOVE this inspection record from the job site.