Permit ...
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. .. CITY OF TIGARD OR1GINA
y 1a DEVELOPMENT SERVICES PERMIT #: ELR1999 -00126
13125 SW Hall Blvd., Tigard, O R 97223 (503) 639 -4171 DATE ISSUED: 5/19/99
SITE ADDRESS: 14100 SW 72ND AVE PARCEL: 2S112AA -01000
SUBDIVISION: PP1992 -007 ZONING: I -H
BLOCK: LOT: 001 IS)
4( ;t JURISDICTION: TIG
Project Description: Data Telecommunication installation.
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:
WILLIAMS CONTROLS INC CHRISTENSON ELECTRIC INC
14100 SW 72ND AVE 111 SW COLUMBIA
- TIGARD, OR 97223 STE 480
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 Elect'I Final
PRMT GEO 5/19/99 $40.00 99- 315513 L ot) 1/DL7 - 4q - f /,()9PP6 r
5PCT GEO 5/19/99 $2.00 99- 315513
Total $42.00
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 through OAR 952 -.01 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987. i e
Issued by fit Permittee Signature i 7/
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: 41 DATE: ` -/ ! - 99
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
I
RECEIVED
Y"
CIT TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
i r3 1 25 SW HALL BLVD Date Rec'd:
TIGARD OR 97223 MAY 191999 PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #: re £ /189 O /'
F - 503 - 684 -7297 CO IfJIUNITY DEVELOP uuMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
JOB:50 -01071 WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee $40.00
WILLIAMS CONTROLS INC. (FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS 14100 SW 72ND AVE Check Type of Work Involved:
City /State Zip Phone # ❑ Audio and Stereo Systems
PORTLAND 97224 _ 684 -8600
Name ❑ Burglar Alarm
WILLIAMS CONTROLS INC.
OWNER Mailing Address ❑ Garage Door Opener`
SAME AS ABOVE ❑ Heating, Ventilation and Air Conditioning System*
City /State Zip Phone #
Name ❑ Vacuum Systems`
CHRISTENSON ELECTRIC, INC. ❑ Other
CONTRACTOR Mailing Address
111 SW COLUMBIA, SUITE 480 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a CCity/State Zpio 24on # Fee for each system $40.00
copy of all licenses PORTLAND, O (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Brd Lic. # Ex Date
expired in C.O.T. 458 5 / 1 / 03 Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp. Date
26 - 14C 10/99 ❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date
5246 12/99 ❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT )111 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:
❑ 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. Call for inspections when installation under this permit are ready for
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. ❑ Other
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:
\�' to -� .: _"
11.� ENTER FEES $ 40.
S t 5/17/99
5% SURCHARGE (.05 X TOTAL ABOVE) $ 2.
Authority if other than Applicant TOTAL $ 42.00 _/
i:\dsts\resele.doc 7/97 —
. 6/20/00 Activities for Case #: ELR1999 -00126
1:26:55 PM
e
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes 0
ELRC001 Application Received 5/19/99 GEO MAIL No Hold GEO 5/19/99
ELRC003 Permit Created 5/19/99 GEO DONE No Hold GEO 5/19/99
ELRC725 Low Voltage Inspection No Hold GEO 5/19/99
ELRC799 Elect'I Final 5/19/99 5/19/99 No Hold GEO 5/19/99
ELRC500 (F) Issue permit 5/19/99 GEO PASS No Hold GEO 5/19/99
ELRA920 Miscellaneous action 2/11/00 JMT DONE No Hold JMT 2/11/00 research inspection request
ELRC580 Expired by limitation 3/28/00 HAP DONE No Hold AKJ 3/28/00
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