Permit sr�
i
CITYOFTIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
Vr� DEVELOPMENT SERVICES PERMIT #: ELR2000 -00111
l 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/18/00
SITE ADDRESS: 14280 SW 72ND AVE PARCEL: 2S112AA -00400
SUBDIVISION: NELSON BUSINESS CENTER ZONING: I -H
BLOCK: LOT: OOB JURISDICTION: TIG
Project Description: Installation of data telecommunication system. Job No. 50- 02576.
•
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:
SPIEKER PROPERTIES LP CHRISTENSON ELECTRIC INC
4380 SW MACADAM AVE STE 100 111 SW COLUMBIA
PORTLAND, OR 97201 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 Low Voltage Inspection
PRMT DEB 5/18/00 $60.00 0002267 Elect'I Final
5PCT DEB 5/18/00 $4.80 0002267
Total $64.80 `
(N OW
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 I ! = ough OAR 952- 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1' :7. • /
Issue by , , J! � , / Permittee Signature ,,, • � , � �, s_.(./ / _ ,
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
.• (Y OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: M0-...0
13125 SW HALL BLVD Date Rec'd: 5 - /.6 -
TI,ARD' OR 97223 RECEIVED PRINT OR TYPE
V • 503 -639 -4171 X304 Permit#: Ea -,9 O-C2IN
F - 503 - 598-1960 OR ILLEGIBLE APPLICATIONS CustCall'd:
JOB: 50 - 02576 �A� �ILLL NOT BE ACCEPTED
Name of D LOPMENT TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
HUNTAIR Restricted Energy Fee.-. ......- .- .-- .........,.- ..... .. :60.00
(FOR AU. SYSTEMS)
JOB Street Address Ste*
ADDRESS � 1 � 42 � 80 SW 72ND AVE Check Type of Work Involved:
y'
T I G (5,224 Phone # ❑ Audio and Stereo Systems
Name ❑ Burglar Alarm
OWNER Mailing Address ❑ Garage Door Opener`
City /State I Zip Phone It ❑ Heating, Ventilation and Air Conditioning System*
QUESTIONS ? Name ❑ Vacuum Systems*
CONTACT:DERRICK
LEWIS CHRISTENSON ELECTRIC, INC.. • ❑ Other
_ __ CONTRACTOR M 11�SW CO LUMBIA, SUITE 480
Mar AND TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a PORTLAND OR 19 101 L 4 ?"84812 �t Fee for each system..._......_. .... ..... .. ..................... $60.0o
copy of all licenses (SEE OAR 918- 260 -260)
are required if Oregon Contr. Brd Lid 0
expired in C.O.T. 458 5,4M t� Check Type . of Work Involved:
data base). Electtrical Contr. Lid # 1 U0 ❑
Audio and Stereo Systems
C.O. tro Lie. # OC
❑ Boiler Controls
Owner's Name
OWN - Mailing Address ❑ Clock Systems
APPLICANT DEE Data Telecommunication Installation
City /State I Zip Phone* ❑
Fire Alarm Installation
This permit Is issued under OAE 918 - 320370. 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. 0 Intercom and Paging Systems
These have asterislcse). All others need licensing;
2. Cali for inspections when installation under this permit are ready for ❑ Landscape litigation Cantor
inspection at 503.639 -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 permI ❑ Nurse Calls
un
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. 0 Other
Permlts 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 r
authorized to b the applican squired for all other installations
FEES:
j r
60.
Si nature 5/15/00 ENTER FEES $
4.80
9, 1 )(SURCHARGE (A5'X TOTAL ABOVE) $
Authority if other than Applicant TOTAL $ 64.80 /
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