Permit CITYOFTIGARD
^ ^/ n � I � h � � DEVELOPMENT SERVICES ELECTRICAL PERMIT -
RESTRICTED ENERGY
PERMIT #: ELR98 -0131
DATE ISSUED: 05/07/98
PARCEL: 19136DA -00100
SITE ADDRESS...:11308 SW 68TH PKWY
SUBDIVISION • ZONING:MUE
BLOCK • LOT • JURISDICTN: TIG
Project Description: Providence RN tenant
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM BOILER • LANDSCAPE /IRRIGAT..:
GARAGE OPENER • CLOCK • MEDICAL
HVAC • DATA /TELE COMM..:X NURSE CALLS
VACUUM SYSTEM • FIRE ALARM • OUTDOOR LANDSC LITE:
OTHER: :: HVAC • PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER..: ..
TOTAL # OF SYSTEMS: 1
Owner: FEES
PROVIDENCE type amount by date recpt
11308 SW 68TH PRMT $ 40.00 JSD 05/07/98 98- 305565
TIGARD OR 97223 5PCT $ 2.00 JSD 05/07/98 98- 305565
Phone #:
Contractor:
OREGON ELECTRIC CONST /GROUP $ 42.00 TOTAL
1010 SE 11TH AVE
REQUIRED INSPECTIONS
PORTLAND OR 97214 Ceiling Cover Low Voltage Insp
Phone #: 234 -9900 Wall Cover Elect'l Final
Reg #..: 203
This permit 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 more than 180 days. ATTENTION: Oregon law requires you to follow rule ado.ted by the
Oregon Utility Notification Center. Tho rules are - forth in OAR 952- 001 -0010 through OAR 952 - 0011880. You . ..tain copies of
„,,,-
i111r10": rules or dire t question to OUNC 1503)246
r ,
Issued /� Permittee Signatur= 4 � /adr
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
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + ++ + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
131253
OR A97 B 3 �t ECEIVED J #60070 PRINT OR TYPE Date Recd: VS('S
V - 503 - 639 -4171 X3f Permit #: E 0 ( 7
F - 503 - 684 -7297 l',: Y 0 7 1998 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
CONafree b
1 D r dbg { �+itt i'P$oject TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee $40.00
Providence RN (FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS 11308 SW 68th Check Type of Work Involved:
City /State Zip Phone # ❑ Audio and Stereo Systems
Tigard, OR
Name ❑ Burglar Alarm
Providence ❑ Garage Door Opener*
OWNER Mailing Address
11308 SW 68th ❑ Heating, Ventilation and Air Conditioning System*
City /State Zip Phone #
Tigard, OR ❑
Name Vacuum Systems'
Oregon Electric Group ❑ Other
CONTRACTOR Mailing Address
1010 SE llth Ave. TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /State Zip Phone # Fee for each system $40.00
copy of all licenses Port land, OR 97214 234 (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Brd Lic. # Exp. Date
expired in C.O.T. 26 - 95C Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp. Date
203 ❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date
199.5 ❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT ® Data Telecommunication Installation
City /State Zip 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;
El Landscape Irrigation Control*
2. Call for inspections when installation under this permit are ready for
inspection at 503 - 639 -4175; 0 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; ❑
Protective Signaling
5. Assume responsibility for calling for a final inspection when all of the
corrections are completed. ❑ Other
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. 1 Number of Systems
The person signing fo is permit must be the applicant or a person • No licenses are required. Licenses are required for all other installations
authorized to bind t plican .
���� i.f FEES:
Signature ENTER FEES $ 40.0()
5% SURCHARGE (.05 X TOTAL ABOVE) $ 2.00
Signing Sup.
Authority if other than Applicant TOTAL $ 42.00
i:'.dstsvesele.doc 7/97 0 I G• 0/6
3/6/00 Activities for Case #: ELR98 -00131
7:52:12 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRC001 Application Received 5/7/98 JSD USPS CTR 5/7/98
ELRC003 Permit Created 5/7/98 JSD PASS CTR 5/7/98
ELRC700 Ceiling Cover 5/15/98 BRP PASS J *H 5/18/98
ELRC725 Low Voltage Inspection 5/15/98 BRP PASS J *H 5/18/98
ELRC799 Elect'I Final 5/15/98 BRP PASS J *H 5/18/98 Data /tel ceiling pass. To be
connected to power poles for
future cubicle additions.
ELRC500 (F) Issue permit 5/7/98 JSD PASS CTR 5/7/98 Mailed to contractor
ELRC800 Case finaled 5/18/98 BRP PASS J *H 5/18/98
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