Permit CITY OF TI GA ® ELECTRICAL PERMIT -
-/ ` RESTRICTED ENERGY
4 1' 4 011 4 DEVELOPMENT r 639 -4171 DATE SSU 0324/0 0065
= 13125 2000
SITE ADDRESS: 15865 SW 74TH AVE 100 PARCEL: 2S112DC-01400
SUBDIVISION: CREEKVIEW INDUSTRIAL PARK ZONING: I -P
BLOCK: LOT: 004 JURISDICTION: TIG
Project Description: Fire alarm installation.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
CREEKVIEW BUSINESS PARK LAND CURRENT ELECTRIC
JDS, LLC & PACIFIC SANTA FE PO BOX 19652
17700 SW UPPER BOONES FRY 100 PORTLAND, OR 97280
PORTLAND, OR 97224
Phone: Phone: 245 -5997
Reg #: SUP 3689S
LIC 00046994
ELE 26 -471C
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT GEO 03/24/200C $60.00 0000927 Elect'I Final
5PCT GEO 03/24/200C $4.80 0000927
Total $64.80
ORIGINAL
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 thro OAR 95 .11-0080. Y-1• ay obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by . i f ` Permittee Signature /� �,p
OWNER INSTALLATION ONLY U ��
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 /r) DATE: `7" ��//
-0d
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
09/30/99 THU 15:29 FAX 503 598 1960 CITY OF TIGARD tQ 002
•
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by:
_
13125 SW HALL BLVD Date Rec'd: _
TIGARD OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X304
Permit #: leX ood - oeViir
F - 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPUCATIONS Cust.Call'd:
_ ___ WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Gch Rest ricted Energy Fee $60.00 (FOR ALL SYSTEMS)
JOB ir tmet ss Ste #
. ,, 607 1 Check Type of Work Involved:
ADDRESS ❑
Phone # Audio and Stereo Systems
Name ❑ Burglar Alarm
❑ Garage Door Opener'
OWNER Mailing Address •
❑ Heating, Ventilation and Air Conditioning System"
City /State j Zip 1 Phone #
I f ED Vacuum Systems'
ame �j
1 - ❑ Other
CONTRACTOR ve3 G &- TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Phone # Fee for each system $60.00 (SEE OAR 918- 260 -260)
(Prior of issuance a tytta-telj ' 2:,i15-"SW i
copy of alt licenses �`��]]((�(1S5�1(' - I `�
are required if Oregon iC 7J d2/rc• # l Check Type Work Involved:
expired in C.O.T. 6 •/ IE�'fi
data base). Ele&tr cal L • L. # Ell Audio and Stereo Systems
C.O.T. or Metro Lic xp. Date ❑
Boiler Controls
• ,
Owner's Name ❑ Clock Systems
-
OWNER - Mailing Address ❑
Data Telecommunication Installation
APPLICANT
City/State l Zip f Phone # Fire Alarm Installation
This permit is issued under OAE 918 - 320 -370. This applicant agrees to .
El HVAC
make only restricted energy installations (100 volt amps or less) under this
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. ❑ I ntercom and Paging Systems
g n9 y
These have asterisks('). All others need licensing; ❑ Landscape Irrigation Cont[or
2. CaII for inspections when installation under this permit are ready for ❑
inspection at 503 - 6394176; 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 ❑ Omer
corrections are completed.
Permits are non - transferable and non - refundable and expire if work is not Number of Systems
started within 180 days of issuance or if work is suspended for 180 days.
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:
W' e0
WO FEES $
. Signature o Ts0 •
Ve: SURCHARGE (.05 X TOTAL ABOVE) $
� Authority if other than Applicant TOTAL $ i-/-9)(9
i:ldstslfom+skesele.doe 3198