Permit CITYOFTIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT —
:14.L. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 RESTRICTED ENERGY
PERMIT #: ELR98 -0086
DATE ISSUED: 03/30/98
PARCEL: 1S136DA -00100
SITE ADDRESS...:11308 SW 68TH PKWY
SUBDIVISION • ZONING:MUE
BLOCK • LOT • JURISDICTN: TIG
Project Description : CCTV and door access
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM • BOILER • LANDSCAPE/ IRRI GAT. .:
GARAGE OPENER • CLOCK • MEDICAL •
HVAC • DATA /TELE COMM..: NURSE CALLS •
VACUUM SYSTEM • FIRE ALARM • OUTDOOR LANDSC LITE:
OTHER: .• HVAC • PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER.. :CCTV /DOOR ::
TOTAL # OF SYSTEMS: 0
Owner: FEES
PROVIDENCE type amount by date recpt
11308 SW 68TH PKWY PRMT $ 80.00 DLH 03/30/98 98- 304484
TIGARD OR 97223 5PCT $ 4.00 DLH 03/30/98 98- 304484
Phone #: 234 -9900
Contract or:
OWNER $ 84.00 TOTAL
REQUIRED INSPECTIONS
Ceiling Cover Low Voltage Insp
Phone #: Wall Cover Elect'1 Final
Reg #..: 999999
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 188 days. ATTENTION: Oregon law requires you to follow rule adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR 9521.0910 through OAR 952 -991 -0080. You may obtain copies of
these rules or direct questions to OUNC at (503)246 -1987.
/Y9 /L E
Issued by
'pi-C., Permittee Signature O1✓ /94 64
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for
sale, lease, or rent.
OWNER'S SIGNATURE: I.!✓ Owe /C'/-7 /t A" DATE: •=3/3/9P
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: /V /9 DATE: �f�DOJ�,
LICENSE NO: /
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
I' 03/13/98 FRI 14:26 FAX 503 598 1960 CITY OF TIGARD RJ002
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
_ 13125 SW HALL BLVD Date Re d ECEIVED
TIGARt OR 97223 PRINT OR TYPE Permit: � R9 �'-G�D ��o
V - 503 - 639-4171 X304
F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Ca {
WILL NOT BE ACCEPTED ti
Name of Development Project TYPE OF WORK INVOLVED - R►o ol+ i:NT
-r' 4-14-g-0 D1 -1-A.. c• f v ..,2 Restricted Energy Fee - - ----- 640.00
p goy, 0 E4u c E. NE. A 5 YS' (FOR ALL SYSTEMS) JOB Street Address Ste d
Check
ADDRESS 113 Of! 5 k) �qp 6a-12,-) . nvolve&
WM -'1 7 VK (ll 23 Phone # ❑ Audio and Stereo Systems
Name ❑ Burglar Alarm
• f�(I I/I DwC-f NF (TH i c IF-41 ❑ Garage Door Opener*
OWNER M� ttngAddress
I'0 g O X r ”q 7 ❑ Heating. Ventilation and Air Conditioning System'
c y 6 fl- - N P off i 7 z 011 < G 21 ❑ Vacuum Systems*
Name
❑ Other
CONTRACTOR Mailing Address TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City/State I Zip Phoned (SEE OA
e 014 h syst0 ..._� ...__.....�... 640.00
copy of all licenses
are required if Oregon Contr. Brd tic. if Ex Date Check Type of Work Involved: expired In C.O.T.
data base). Electrical Contr. Uo. 8 ' Exp. Date ❑ Audio and Stereo Systems
C.O.T. or Metro Lic. 8 Exp. Date ❑ler Controls
Osineris Name ❑ Clock Systems
J G,g -I n�F� '
OWNER - Mailing Address rJ _/• ❑
APPLICANT C1 2-05 5 W (3R2iv 5 '`� Data Telecommunication installation
' cyds n o A-- 5piz4p6`l ❑ 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 ❑ liVAC
permit and to do the following: i--i Instrumentation
1. Only use electrical licensed persons to do installations where required. ❑ Intercom and Paging Systems
Certain residential and other transactions are exempt from licensing.
These have asterisks('). MI others need licensing; ❑
Landscape Irrigation Contror
2. Gail for inspections when installation under this permit are ready for
inspedion 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 moped under this permit;
4. Assume responsibility for assuring that al corrections required by the ID Outdoor landscape
inspector are done, and; . ❑ Protective Signaling
5. Assume responsibility for calling for a final inspection when all of the Other 6C /I V i Part- GE-5 S
corrections are completed.
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. 2.---- Number of Systems
The person signing for this permit must be the applicant or a person • No menses are required Menses are required for all other installations
auttroitred to bind the apprcant.
X1(4 �� mss 0
1 ��[ ENTER � 6
gnature
Y (� SURCHARGE (.06 X TOTAL ABOVE) $
{v� ,�
Author oth t 646 than Applicant TOTAL 3
klastslreeele.doc 7
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I
3/6/00 Activities for Case #: ELR98 -00086
7:51:49 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRC001 Application Received 3/26/98 DEB RECD DLH 3/30/98
ELRC003 Permit Created 3/30/98 DLH DONE DLH 3/30/98
ELRC700 Ceiling Cover 4/3/98 BRP PASS DGW 4/8/98 roughin approved
ELRC720 Wall Cover 4/3/98 BRP PASS DGW 4/8/98 roughin approved
ELRC725 Low Voltage Inspection 4/3/98 BRP PASS B *P 4/6/98 •
ELRC799 Elect'I Final 5/14/98 BRP PASS J *H 5/18/98 CCTV /door
ELRC400 (F) Ready to issue 3/30/98 DLH PASS DLH 3/30/98
ELRC500 (F) Issue permit 3/30/98 DLH DONE DLH 3/30/98
ELRC800 Case finaled 5/18/98 BRP PASS J *H 5/18/98
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