Permit _ I
ELECTRICAL PERMIT -
CITY OF TIGARD RESTRICTED ENERGY
At ' 6 4 5 0 I DEVELOPMENT SERVICES PERMIT #: ELR2000 -00010
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/7/00
SITE ADDRESS: 12447 SW 69TH AVE PARCEL: 2S101AA -TTOOC
O i I INA
SUBDIVISION: TIGARD CORPORATE CENTER ZONING: MUE
BLOCK: LOT: OOC aft JURISDICTION: TIG
Project Description: Installation of data telecommunications system. Job No. 119 -9070.
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: UTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
IGARD CORPORATE CENTER HRISTENSON ELECTRIC INC
5400 SW MILLIKAN WAY 11 SW COLUMBIA
EAVERTON, OR 97006 TE 480
ORTLAND, 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 DEB 1/7/00 $60.00 00 -32100 Elect'I Service
5PCT DEB 1/7/00 $4.80 00 -32100
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 • : • , ugh OAR 9 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1' :7.
/ / �; /� / -
Issue. by !! i _ /%ice 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:
Cali 639 -4175 by 7:00 P.M. for an inspection needed the next business day
A fY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Redd b . — Jl'la
13125 SW HALL BLVD Date Recd: - 7-__e_____ o
TIGA •D OR 97223 PRINT OR TYPE
• V -- 303.639 -4171 X304 Permit#: E1, (L -MO/0
F - 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS CustCall'd:
JOB: 119 - 9070 WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
RENAISSANCE HOLDINGS INC Restricted Energy Fee._...,,,.-,-, - =60.00
(FOR ALL SYSTEMS)
JOB Street Address Ste # RECEIVED
ADDRESS 12447 SW 69TH Check Type af Wort Involved:
TIG/A 1 97223 Phone* ❑ Audio and Stereo Systems JAN 0 7 2000
� Burglar Alarm
Name ❑
6 A 2D eo/1.Po2*ri' 6r12. COMMUNITY DEVELOPMENT
OWNER Mailing Address , ,n J ❑ Garage Door Opener
y D L k � � ,/,, 1 � 7 Heating, Ventilation and Air Conditioning System*
i n e/ o I -- 1 f.77C Phone #
Name ❑ Vacuum Systems*
QUESTIONS ? ?? CHRISTENSON ELECTRIC, INC... CARL STENSRUD ❑ Other
CONTRACTOR Mailing Address
111 SW COLUMBIA, SUITE 480 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /State Zip Phone • Fee tor each system......_.. ...„._ ..... _— ................ $60.00
copy of ap l(censes PORTLAND OR .197201 241 - 4811 (SEE OAR 918- 260.260)
are required if Oregog�ontr. Brd lac. #
expired in C.O.T. 44 i8s Check Type of work involved:
data base). Electrig Soh t[. Uc. * Pdt7 ❑ Audio and Stereo Systems
C.O.T. ,r e (o Lie # En pee 7 / 11U ❑ Boiler Controls
Owner's Name
OWNER - Mailing Address ❑ Clock Systems
APPLICANT X0❑X Data Telecommunication Installation
City /State 1 I Phone it ❑
Fee 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; r-�
2. Can for inspections when installation under this permit am ready for ► I Landscape irrigation CantroP
Inspection at 603- 639.4175; ❑ Medical
3. Purchase separate permits for all installations that are not ready for an
inspection when the inspector is out to inspect under this permit ❑ Nurse Calls
4. Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting*
inspector are done, and;
❑ Protective Signaling
5. Assume responsibility for caning for a final inspection when all of the
corrections are completed. ❑ Other
Permits are non-transferable and nonrefundable 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 thls permi u the applicant or a person • No licenses are required. Ucenses are required for all other installations
authorized to b the applican
FEES:
ENTER FEES $ 60.00
S nature 1/5/00 4.80
at XeSURCHARGE (1X TOTAL ABOVE) $ /
Authority if other than Applicant TOTAL $ 64.80 J
t dstsdomtskesele.doc 3198
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 4g AM PM BLD
Location 1 LP/ - 7 (.1? frig, Suite MEC
Contact Person Mt K' Ph q (D q -' '& S , PLM
Contractor C UZrrs /e.., ' S ,.1 f� ^fe_T Ph SWR
BUILDING Tenant/Owner ELC ,r�nr� 3
Retaining Wall ELR l �I e0 "0Cr) 0
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 a if _ _
Firewall "of ,
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 RS PART FAIL
LECTRI
Service
iu I�
UG /Slab
Low Voltage
Fire Alarm
Fi
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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA 3 Approach /Sidewalk Date 3 J 0" az . Inspector _ Ext
Other
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
/ BUP
Date Requested S/ ZS 00 AM PM BLD
Location 1 "I'l (Q / ,/ �� C Suite MEC
Contact Person e, Ph g — '7 60SO PLM
Contractor ( ' `� / K �r�
ern/ Ph SWR
BUILDING Tenant/Owner ELC ,�r� �,�n
Retaining Wall ELR 2-000 �.0 COD 10
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam • ) Z 1l_ -R �,. K
Ext Sheath /Shear J UJV
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire Sprinkler / F%zr7'
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 S`PART FAIL
ELECTRICAL
Service
dough
UG /Slab
Low Voltage
Fire Alarm
PASS ART 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 rei spection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OFTIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
,�i BUP
Date Requested s I, j00 AM PM BLD
Location / Z �� ) (0111A ()-Q, Suite MEC
/
Contact Person / F�� Ph q60 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR 2 COO) 0
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 Pe/ 0 / 4/47
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
PASS PART FAIL
IL.,ECTRICAt)
Service
gh In
a
Low Voltage
Fire Alarm
Fi
S 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 f r reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date c 7. Inspector ,l Ext
Other
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
f---3 BUP
Date Requested AM PM BLD
Location / 211 5 w 69 b5 Suite MEC
Contact Person Ph g4.9 9 9G S' PLM
Contractor Ph SWR
BUILDING ant/Owner _ _ _,� _ _LC
Retaining Wall EL* , 2 -ett Oe 9/ D
Footing Access: F .
Foundation D /
Ftg Drain ` � /� ELF - U 7'1_7 4 ,
Crawl Drain Inspection Notes: �� 7/o-f3 q N
Slab IT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof a .�
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
PASS PART FAIL
ELECTRIC
Service
Rough In
UG /Slab
Crow Voltage,
F' - =. rm
.arm
PAS' 'ART 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 Date Inspector Eft
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.