Permit •
CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
M A , DEVELOPMENT SERVICES PERMIT #: ELR2000 -00175
" III 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 07/31/2000
SITE ADDRESS: 12447 SW 69TH AVE PARCEL: 2S101AA- 091000
SUBDIVISION: TIGARD CORPORATE CENTER ZONING: MUE
BLOCK: LOT: OOC JURISDICTION: TIG
Project Description: Access Control /CCTV
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: X BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
TIGARD CORPORATE CENTER LP C3 // COMMUNICATION CNNCT CNTR
15400 SW MILLIKAN WAY 10950 SW 5TH
BEAVERTON, OR 97006 SUITE 110
BEAVERTON, OR 97005
Phone: Phone: 503 - 643 -1922
Reg #: LIC 0117658
ELE 24 -373E
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT JMT 07/31/200C $60.00 004104 Elect'l Final
5PCT JMT 07/31/200C $4.80 004104
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 I Permittee Signature J A 71.4A AALL.P
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:
;3125 SW HALL BLVD Date Rec' /7 /llZ)
TIGARD OR 97223 PRINT OR TYPE
V - 503 -639 -4171 X304 Permit #: f A_ ?OOO - o o (7s'
F - 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
P e A A co55AA/Cc /4,x U/ S Restricted Energy Fee $60.00
(FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS 17-2-, y 7 5 --) 69 Check Type of Work Involved:
City /State Zip Phone # ❑ Audio and Stereo Systems
bp i `,zQ y 7aZ3
Name Burglar Alarm
OWNER Mailing Address ❑ Garage Door Opener*
City /State Zip Phone # ❑ Heating, Ventilation and Air Conditioning System*
Name c3 cam pi v !► icA -r 0'^ j ❑ Vacuum Systems*
e gneGno K s otter - /}L_rzurs , / pJ e ❑ Other
CONTRACTOR Mailing Address SUI/e
/09 5 o 56, S T 8 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a y /State Zip Phone # Fee for each system $60.00
copy of all licenses a.rer"n ore 97005 (y3 /q2 (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Br Lic. # Exp. Da e
'
expired in C.O.T. / 174$ 101,to/ Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp Die
`7 �1 — 3 73 - CLq / O i ao ❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # Ex ate
y7 `'a 2 p� D/ ❑ 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:
in 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;
2. Call for inspections when installation under this permit are ready for
❑ Landscape Irrigation Control'
inspection 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 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. M Other /4C6(5. CO/A r re /C rr/
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. Number of Systems
The person signing for this permit must be the applicant or a person • No licenses are required. Licenses are required for all other installations
authorized to bind the applicant.
FEES: /
l / ei�-e- ENTER FEES $ (p U'
Signature
8% SURCHARGE (.08X TOTAL ABOVE) $ 1 b 0
Authority if other than Applicant TOTAL $ CD I li a
is \dsts \forms\resele.doc 3/98
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: '619-4175 • Business Line: 639 -4171
BUP
Date Requested olD AM PM BLD
Location / 2_V y f Suite MEC
.Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR ! -
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT -
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Drywall �` J
Drywall Nailing > [ �j
Firewall /
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
eiVallt% FAIL
Service
Rough In
UG /Slab
,6w Voltagg�
Fire Alarm
( Flf p
ART FAIL
SITE
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 Date P cr Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.