Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
, DEVELOPMENT SERVICES PERMIT #: ELR2000 -00173
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 DATE ISSUED: 7/28/00
SITE ADDRESS: 12123 SW 69TH AVE PARCEL: 2S101AA- 02900A
SUBDIVISION: TIGARD CORPORATE CENTER ZONING: MUE
BLOCK: LOT: OOA JURISDICTION: TIG
Project Description: Data communications installation for Building "A"
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:
Owner: Contractor:
TIGARD CORPORATE CENTER LP CHRISTENSON ELECTRIC INC
15400 SW MILLIKAN 111 SW COLUMBIA
BEAVERTON, OR 97006 STE 480
PORTLAND, OR 97201
Phone: 646 -2202 Phone: 241 -4812
Reg #: LIC 000458
SUP 3289S
PLM 2468S
ELE 26-34C
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
5PCT GWL 7/28/00 $4.80 0004046 Elect'l Final
PRMT GWL 7/28/00 $60.00 0004046
Total $64.80
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 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by J 6 / � Permittee Signature
i
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
.r IY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Reed by: M k '
13125 SW HALL BLVD �` Date Recd: 1 - LJ - Up
GA(�D OR 97223 PRINT OR TYPE 1
V - 503-639.4171 X304 Permit*. ( L 1 2, 000 - 00 z 32_
F - 503 - 598 - 1960 INCOMPLETE OR ILLEGIBLE APP CATIONS CustCall'd:
JOB: 119 - 9400 WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIACSBNLY
RENAISSANCE HOLDINGS, INC. Restricted Energy LL QL G" o
Fee._.......- ._... --,..., d (,�`®® , $50.pp
(FOR A SYSTEMS)
JOB Street Address Ste 9 % V Q # ADDRESS 12123 SW 69TH AVE Check Type of Work Involved: c�
T i�tyy/�gg O
t eiRD OR I P2 2 3 Phone 1 ❑ Audio and Stereo Systems • 0 ���
Name ❑ Burglar Alarm 0*
k
OWNER Mailing Address ❑ Garage Door Opener*
City /State
'Zip I Phone 8 ❑ Heating, Ventilation and Air Conditioning System*
QUESTIONS? Name ❑ Vacuum Systems*
CARL STENSRUD CHRISTENSON ELECTRIC, INC. ❑ Other
CONTRACTOR Mailing Address
111 SW COLUMBIA, SUITE 480 _ TYPE OF WORK INVOLVED - COMMERCIAL ONLY_ _
(Prior to issuance a City /State Zip Phoned Fee for each system..._..... ....._ ..... ...._..........._... $60.00
copy of all licenses PORTLAND OR -197201 241 - 4812. (SEE OAR 918- 260.260)
are required if Oregon Contr. Brd Lie. 1 ae
expired in C.O.T. 26-34C i0 / Q 1 / 00 Check Type of Work Involved:
data base). ectrtcal Contr. Lic. 1 Ex�
0458 5/ ?3 ❑ Audio and Stereo Systems
O.. or Metro Lic. #
X4+
fl)/51,00 ❑ Boiler Controls
Owners Name
OWNER - Mailing Address ❑ Clock Systems
APPLICANT ] Data Telecommunication Installation
City /State 'Zip I Phone 1 ❑
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;
❑ Landscape Irrigation Control'
2. C for inspections when installation under this permit are ready for
CA
inspection at 603. 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 inspect under this permit ❑
4. Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting'
Inspector are done, and;
❑ Protective Slgnagng
5. Assume responsibility for calling for a final inspection when all of the
corrections are completed. ❑ Other
Permds 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. Number of Systems
The person signing for this perm u the applicant or a person • No licenses are required. Licenses are required for all other installations
authorized to b the app icant
//
FEES:
Si nature ENTER FEES S 60.
7 4.80
8 SURCHARGE (AVX TOTAL ABOVE) 5
Authority if other than Applicant ( TOTAL $ 64.80 l
1: ldstsformslresele.doc 3198
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested ( jj b 9 AM PM BLD
Location (Z-11- 3 5ev Cyr 4040 Suite MEC
Contact Person Ph 2s/7 0 PLM
Contractor Givr-,37 / Ph SWR
BUILDING Tenant/Owner ELC 2
Retaining Wall ELR ��— V »
/
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: { 'X ,,
Slab .0 7 QV 4 1.b -Gu1 SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing '
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
f :6-4-e---et--.)
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
P FAIL
Service
Rough In
UG /Slab
w Lsl
ire Alarm
if�
PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: ] Unable to inspect - no access
ADA
Approach /Sidewalk D ate ��
Other 1� r.�7J Inspector - Ext
Final •,
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION ' MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
p BUP
p
Date Requested d p or AM • % M BLD
Location 410— 3 <S `t • Suite .RL „ � MEC
Contact Person y Ph PLM
Contractor / A, if - ,A,., Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELRZ6+9• — 'O /.3
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall I - S
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
P FAIL
ELECTRICAL
Rough In
U Slab
Low olta •
ire Alan
age PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: ] Unable to inspect - no access
ADA /J
Approach /Sidewalk Date 9 0t Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.