Permit 114 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2020-00138
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 1/4/2021
T I C;r1 R p g Parcel: 1S136CD02200
Jurisdiction: Tigard
Site address: 7850 SW DARTMOUTH ST
Project: Costco Wholesale,fire alarm upgrade Subdivision: PALMER ACRES Lot: 3
Project Description: Fire alarm.
Contractor: ADT LLC Owner: COSTCO WHOLESALE CORPORATION
7989 SW CIRRUS DR PROPERTY TAX DEPT 111
BEAVERTON, OR 97008 999 LAKE DR
ISSAQUAH,WA 98027
PHONE: 503-469-7241 PHONE:
FAX: 503-469-7110
FEES
Description Date Amount
Specifics: Restricted Energy Permit 12/23/2020 $75.00
12%State Surcharge-Electrical 12/23/2020 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 0
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 0 Fire Alarm: 1
HVAC: 0 Instrumentation: 0
Intercom/Paging: 0 Landscape/Irrigation: 0
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
Security Alarm: 0 Other: 0 Total $84.00
Other Desc: Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-001 D through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332 2344.
Issued By: `113v art,rf Wei Permittee Signature: on ("kepiIcciticy-\
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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.