9600 SW OAK STREET STE 440 0VV 31s 1S HdO hAS 0096
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9600 SW OAK ST STE 440
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CITY CSF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT --
13125SWHolt Blvd.,Tlgera,OR 27223 (50:+)&*4171 RESTRICTED ENERGY
PERMIT #: ELRI37--0174
DATE ISSUEDe 06/20/97
PARCEL: 1 S 1 G3613-00100
SITE ADDRESS. . . :09600 SW OAK ST #440
SUBDIVISION. . . . :ASHBROOK FARM ZONING:C—P
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .5 JURISDICTN: TIG
Project Description: Installing data telecossunicat ions systes
A. RESIDENTIAL----- --- B. COMME RC I A�-----___-___-, ________________--______---_—
AUDIO & STEREO. . . : AUDIO & STEREO. . : INTERCOM & PAGING. . a
BURGLAR ALARM. . . . : BOILER. . . . . . . . . . a LANDSCAPE/IRRIGAT. . s
GARAGE OPENER. . . . : CLOCK. . . . . . . . . . . : MEDICP.!. . . . . . . . . . . . s
HVAC. . . . . . . . . . . . . : DATA/TEL.E COMM— s X NURSE CALLS. . . . . . . . ..
VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . a OUTDOOR LANDSC LITE:
OTHER: : : HVAC. . . . . . . . . . ., . : PROTECTIVE SIGNAL. . a
INSTRUMENTATION. : OTHER. . :
TOTAL NI OF SYSTEMSs 1
Owner: ------------------------------------------------------ ES
___----------___--
STAN KLEWENO type amount by date recpt
520 SW 6TH AVE PRMT t 40. 11+0 B 06/20/97 97-296279
STE 930 5PCT $ 2. 00 B 06/20/97 97--296279
PORTLAND OR 97204
Phone #: 2224-9854
Contractor: ---.------------------.__________-__--___—_.._—_______—_______.________
MOORE COMMUNICATIONS INC $ 42. 00 TOTAL
20811 NW CORNELL RD
;3TE 700 ------ REQUIRED INSPEC', IONS •-------
HILLSBORO OR 97124 Ceiling Cover Elect' 1 Finan
Phone M: 617-9800 Wall Cover
Reg It, . : 000763
This persit is issued subject to the regulations contained in the Tigard Municipal Coda, State of Ore. Specialty Codes and all othor
applicable laws. All Mork will be done in accordance with approved plans. This Mrrsit will expire if work is not started within to@
days of issuance, or if work is suspended for sore than 161 days. ATTENTION: Oregon law requires you to follow rule adopted by the
Oregon Utility !Notification Center. Those rules are set forth in OAR %2-01-010 through OAR 952-111-IIA6. You say obtain copies of
these rules or d t questions to OWIC at 15831246-19A7.
A r...
Issued by d (L---� _ Permittee Signature: _
a
----------------------------OWNER INSTALi.-ATION
�— The installation is being made on property I own which is not intended for
N sale, lease, or rent.
OWNER' S SIGNATURE: � � DATE;
m
_
-------------------------CONTRACTOR INSTALLATION ONLY----________._._______,_______
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SIGNATURE OF SUPR. ELEC' N: DATE:
LICENSE NO:
+++++++++.+++++++++++++++++++++++++++++f+++++++++4++++++++++++++++++++++++++++++
Call 639-4175 by 6:00 P. M. for an inspection needed the next business day
++-+++++++++$-++++++++++++++++. +4+++-r•++++++++++++++++++++++++++++++++++++++++
UTY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION rtec'd by: �J _
13125 SW HALL BLVD Date Recd:
TIGARD OR 97223 PRINT OR TYPE
V-503-6394171 X304 Permit 0:Ft-�°i'7 ' 17 q
F -503-684-7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Cali'd:� _
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WOR;t INVOLVED-RESIDENTIAL _
Restricted EnoM Fee........................................ $40.00
SM (FOR ALL SYSTEMS)
JOB Street Address Sts N
ADDRESS ,(4VI/O
Check Type of Work Involved:
City/Statn Zip 3 Phone 0 E] Audio and Stoma Systems
Name L_J Burglar Alarm
_11L W vi 0 ❑ Garage,Door Opener'
OWNER Mailing Address 11,,/1 �� O
City/Stats pho3 El Heating,Ventilation and Air Conditioning System'
A9 -
o 41y ❑
Na a Vdcuam Systems-
AA J9 e
Fn
❑ Oti.er _
CONTRACTOR Mailing Address
2.0�11 N �/._ e ,Oct TYPE OF WORK INVOLVED-COMMERCIAL
(Prior to Issuance a Phone 0 Fee for each systmn.............................................. 0.00
copy of all licenses /` O// 16-Z 0 (SEE OAR 918-280-280)
are required if Oregon Contr.Bid le.0 Exp.Date
expired In C.O.T. Check Type of Work Involved:
data base). Electrl I Co tS01 Uc.�' C Exp.Date
Audio and Stereo Systems
C.O.T.or Metro Lic.# Exp.Date
❑ Baiter Controls
r homer's Nam
❑ Clock Systems
OWNER- Mailing Address
APPLICANT 2,0 8 /r .Cl,; y � ' � � Data Telecommunication Installation
C / is ZIp Phone N
rp 121, ? �� ❑ Fire Alarm Installation
This permit is Issued ur der 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;nstallations where requiied.
Certain residential and other transactions are exeinpi from licensing. ❑ Intercom and Paging Systems
These hs!e asterisks(*). All others need licensing;
❑ Landscape Irrigation Cc ntrol'
2. Call for Inspections when Installation under this permit are ready for
inspection at 503-639.4178; ❑ Medical
S. Purchase separate permits for all installations that aro not ready for an ❑ Nurse Calls
a inspection when the Inspector is out to Inspect under this permit;
F— ❑ Outdoor Landscape Lighting'
N 4. Assume responsibility for assuring that all corrections required by the
Inspector are done,and; ❑
Protect ive Signaling
5. Assume responsibility for calling for a final inspection when all o!the
m corrections are completed. ❑ Other
WPermits aro nvlrtransferable and non-refundable and expire If work Is not
J started within 180 days of Issuance or If work Is suspended for 180 days. Number of Systems
The person signingf44�'this permit must be the applicant or a person No kit enses ere rquirevt Lkensea aro required for ah other inatalla8ent
authorized to bind thtfl�pplicent. -------
EEE;;;
SigrlatU ENTER FEES
6%SURCHARGE(.05 X TOTAL ABOVE) $_
Authority if other t ren Applicant TOTAL
i:lresele.doc 12M —
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line:639-4175 Busima Ph=:639-4171
Date Requested: .2-� 1 AM. F.M_ r MST:
Location: !7 _ BUP:
Tenant: n► Q.' ja-- (.Lut/[,l e t 13ttib�Q,�id� WC:—
Conhnct�r. >F Ll'l I( 'LL�7!< fL.�1eA y (L•
` Phone: '17- jJ00Q PLM:
/ `'1 7 7 ELC:
Owner: Phone:
l�t�Y W'+til Tri h1 C✓F >ti1 � .: t LELR:
6UILDi— BLDG(con't) PLUMBING MEC IAMCAL RLECMCAL _ SITE
Cite Post/Rcam PosUReam Post/Beam ttteeri'Jerricr- Sewcr/Storm
Footit,g Roof UndF)/Slab Rough-In Ceiling Water Lint
Slab Framing Top Out (ias Line Rough-In UG Sprinkler
Found:.ion Insulation Scwcr Flood/Duct Reuanrtmt Vault
Rsmt Damp Drywall Storm Furnace Terre Service MLSC.
Masonry Ceiling Rain Thain A/C U0 SWb
Shear/Sheath Fire Spklr/Alm Crnwl/Found Dr Heat Pump Volt,
Approved Appmved Arttroved A— Approved
Appr/Sdwik Not Approved Not Approved Not Approved ved Not Approved
FINAL FINAL FINAL FINAL
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C1 Call for rciin`s�pection I 1 Reinspection fce of ___-__^_required before next inaction CI Unable to inspect
Inspector:.'�-�` C— r'1 �?— Dat:.— Page of �