Permit CITY OF T 1 GARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
a A � �; � DEVELOPMENT SERVICES
PERMIT #: ELR2000 -00244
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/23/00
SITE ADDRESS: 13333 SW 68TH PKWY PARCEL: 2S101 DA -00104
SUBDIVISION: FARMERS INSURANCE ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
Project Description: Installation of data telecommunication.
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: Contractor:
F I G HOLDING COMPANY CHRISTENSON ELECTRIC INC
REAL ESTATE ACCTG 111 SW COLUMBIA
4680 WILSHIRE BLVD STE 480
LOS ANGELES, CA 90010 PORTLAND, OR 97201
Phone: Phone: 241 -4812
Reg #: LIC 000458
SUP 3289S
PLM 2468S
ELE 26 -34C
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 10/23/00 $75.00 2720000000 Elect'I Final
5PCT CTR 10/23/00 $6.00 2720000000
Total $81.00
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 you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 throu• h OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by L! � ► i - Permittee Sig nature071//97 ( — dJ /97 Et
OWNER INSTALLATION ONLY
The installation is being made on property 1 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: 1/ /L
6525 SW HALL BLVD Date Rec'd: ia/' 2 /"
TIGARD OR 97223 Incomplete or illegible applications Permit #: z. -v -Gb 2 9/
V - 503 - 639 .4171 X304
• will not be accepted Cust.Call'd:
F - 503 -598 -1960 JOB: 50 - 03194 �,,�� tE,
Name of Development Project TYI�Cfi= WORK INVOLVED - RESIDENTIAL ONLY
FARMERS INSURANCE GROUP litiftrictail inn ee $75.00
JOB Street Address Ste # cra ALL SYSTEMS), ,
1, Vtl ut' 1Wtri'
€10/060 g
ADDRESS 13333 SW 68TH PARKWAY jf'Work Involved:
City /State Zip Phone #
TIGARD OR 97223 ❑ Audio and Stereo Systems
Name
❑ Burglar Alarm
OWNER Mailing Address ❑ Garage Door Opener*
City/State Zip Phone # ❑ Heating, Ventilation and Air Conditioning System*
QUESTIONS? Name ❑ Vacuum Systems`
CONTACT: CHRISTENSON ELECTRIC, INC.
CONTRACTVR Mailing Addre ❑ Other
111 SW COLUMBIA,SUITE 480
(Prior to issuance a City /State Zip Phone # TYPE OF WORK INVOLVED - COMMERCIAL ONLY
copy of all licenses PORTLAND OR 97201 241 -4812
are required if Oregon Contr. Brd Lic. # Exp. Date Fee for each system $75.00
expired in C.O.T.. 458 5/1/03 (SEE OAR 918 - 260 -260)
database). Electrical Contr. Lic. # Exp. Date
26 - 34C 10/1/01 Check Type of Work Involved:
C.O.T. or Metro Lic. # Exp. Date
5246 12/31/0C ❑ Audio and Stereo Systems
Owner's Name
❑ Boiler Controls
OWNER - Mailing Address
APPLICANT ❑ Clock Systems
City /State Zip Phone #
Z Data Telecommunication 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 Fire Alarm Installation
permit and to do the following: ❑
HVAC
1. Only use electrical licensed persons to do installations where required.
Certain residential and other transactions are exempt from licensing. ❑ Instrumentation •
These have asterisks('). All others need licensing;
❑ Intercom and Paging Systems
2. Call for inspections when installation under this permit are ready for
inspection at 503 -639 -4175; ❑ Landscape Irrigation Control*
3. Purchase separate permits for all installations that are not ready for an ❑ Medical
inspection when the inspector is out to inspect under this permit;
4. Assume responsibility for assuring that all corrections required by the ❑ Nurse Calls
inspector are done, and; ❑
Outdoor Landscape Lighting*
5. Assume responsibility for calling for a final inspection when all of the
corrections are completed. ❑ Protective Signaling
Permits are non - transferable and non - refundable and expire if work is not ❑ Other
started within 180 days of issuance or if work is suspended for 180 days.
Number of Systems
The person signing for this permit s e the applicant or a person
authorized to b* he applicant. • No licenses are required. Licenses are required for all other installations
I FEES:
• ENTER FEES $ 75.00
Signature
10/11/00
8% SURCHARGE (.08 X TOTAL ABOVE) $ 6.
TOTAL $ 81.00
Authority if other than Applicant
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