Permit CITY OF TIGARD
_
*,„, DEVELOPMEN SERVICES ELECTRICAL PERMIT —
RESTRICTED ENERGY
PERMIT #: ELR98 -0142
DATE ISSUED: 05 /28/98
PARCEL: 2S103DD -0 1201
SITE ADDRESS...:139O0 SW PACIFIC HWY
SUBDIVISION ZONING:C —G
BLOCK • LOT • JURISDICTN: TIG
Pro.j ect Description : Installation of data telecommunication system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM • BOILER LANDSCAPE/ IRRI GAT. .:
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: FEES
24 HOUR FITNESS type amount by date recpt
13900 SW PACIFIC HWY PRMT $ 40.00 DEB 05 /28/98 98- 306088
TIGARD OR 97223 SPCT $ 2.00 DEB 05/28/98 98- 306088
Phone #:
Contractor:
CHRISTENSON ELECTRIC INC $ 42.00 TOTAL
111 SW COLUMBIA
STE 480 REQUIRED INSPECTIONS
PORTLAND OR 97201 Ceiling Cover Low Voltage Insp
Phone #: 241 -4812 Wall Cover Elect'1 Final
Reg #..: 000458
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 rule adopted by the
Oregon Utilit ' ' ation Center. Those rules are set forth in OAR 952-001-0010 through OAR 952 -001 -0080. You may obtain copies of
these rule or direct q stions OUNC at (503)246 -1987.
Issue • by ■ • e . !J,,, I I,1 Permittee Si gnat ure✓j'n/AlC2
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:
CONTRA OR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' N: /I 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: i `'f
13125 SW HALL BLVD Date Rec'd: - • y;
TIGARD OR 97223 PRINT OR TYPE �
V - 503 - 639 -4171 X304 Permit #: La- 9g -t#/Y.:)--.
F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
JOB: 509 - 6005 WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
24 HOUR FITNESS #565 Restricted Energy Fee $40.00
(FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS 13900 PACIFIC HWY 99W Check Type of Work Involved:
C 9 Phone # ❑ Audio and Stereo Systems
Name ❑ Burglar Alarm RECEIVED
OWNER Mailing Address ❑ Garage Door Opener' !Y 2 v 1998
City /State Zip Phone # ❑ Heating, Ventilation and Air eUU p d�t, SvsteL r. ENT
Name ❑ Vacuum Systems' rr p ll L�1it
CHRISTENSON ELECTRIC, INC. El Other
CONTRACTOR Mailing Address
111 SW COLUMBI SUITE 4 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /State Zip [ Phone # Fee for each system $40.00
copy of all licenses PORTLAND OR 972 1 241 - 4812 (SEE OAR 918- 260 -260)
are required if Oregon Cogtr Brd Lic. # Exp. Date
expired in C.O.T. 44 8 Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp. Date
26 - 34C n Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date
El Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT ® Data Telecommunication Installation
City /State Zip Phone #
El
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
El 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; .
El
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.
.111M_III■ �-- -- FEES:
` , _ 1 40.
i . • i ENTER FEES $
Signature 2.
5% SURCHARGE (.05 X TOTAL ABOVE) $
42.
Authority if other than Applicant TOTAL $
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