Permit •
A. CITY OF T I G A R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
M DEVELOPMENT SERVICES PERMIT #: ELR2000 -00163
J I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 07/05/2000
SITE ADDRESS: 13939 SW PACIFIC HY * ** PARCEL: 2S103DD -01000
W
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: Checkpoint Inventory Control at front door
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: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: INVEN.CTRL X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
BC REAL ESTATE INVESTMENT GATES ELECTRONICS + SECURITY
BC NORTHWEST LP #707 PETER N GATES
6818 SW CAPITOL HWY
PORTLAND, OR 97219
Phone: Phone: 246 -9951
Reg #: LIC 0076878
SUP 922JLE
ELE 34 -316CL
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT JMT 07/05/200C $60.00 0003459
5PCT JMT 07/05/2000 $4.80 0003459
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 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or di - t questio to • UNC at (503)
246 -1987.
Issued by ' Permittee Signature4r— / 4 j 0
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
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
13125 SW HALL BLVD Date Rec' i y)t-t-
/ 7- - O a
TIGARD OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #: f,,'DDO-oO /b3
F - 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of v p nt r � / TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Q �Z /[ ' Restricted Energy Fee $60.00
JOB Street Address S #
/39. 9 f� ��.�L� H/ (FOR ALL SYSTEMS)
ADDRESS , Check Type of Work Involved:
Late i p P # ❑ Audio and Stereo Systems
Nie e o y �j,; ❑ Burglar Alarm
X eer As 74-& -�' ❑ Garage Door Opener*
OWNER ►v / s
9 4 / 14 7‘.., ` Phone # Heating, Ventilation and Air Conditioning System*
Name
�� p j ❑ Vacuum Systems*
CG i bi - 1 ❑ Other
CONTRACTOR Mailing Address
4(e(r5P t4i7 M TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a to Fee for each system $60.00
, copy of all licenses ✓ /K7 e 751 (SEE OAR 918- 260 -260)
are required if 072 C n Brd Lic. # Ex D e
expired in C.O.T. �� � �r 1 Check Type of Work Involved:
data base). Ele is ntr. L' Lic. # E t
C.O.T. or Metro
3� #3 /�1� n Audio and Stereo Systems
Exp. Date
❑ Boiler Controls
Owner's Name
n Clock Systems
OWNER - Mailing Address
APPLICANT ❑ 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 n 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. n 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; n Medical
3. Purchase separate permits for all installations that are not ready for an n 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. gl Othe ,,. ' ..i �, „��� , .„.„0,r..../4/411'
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 fort; is permit mus be the applicant or a person * No licenses are required. Licenses are required for all other installations
authorized to bind th .. 'cant.
FEES:
�,."
..
Sign. " re ENTER FEES $ f �_
8% SURCHARGE (.08X TOTAL ABOVE) $
Authority if other than Applicant TOTAL $ Oi
is \dsts \forms \resele.doc 3/98
07/11/2000 Activities for Case #: ELR2000 -00163
2:13:28 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRA003 APPlication received 07/05/2000 JMT DONE No Hold DST 07/05/2000
ELRA010 Permit created 07/05/2000 JMT DONE No Hold DST 07/05/2000
ELRA725 Low Voltage Inspection No Hold DST 07/05/2000
ELRA500 (F) Issue permit 07/05/2000 JMT DONE No Hold DST 07/05/2000
ELRC799 Elect l Final 07/06/2000 CD PASS No Hold CD 07/06/2000
ELRC800 Case Finaled 07/11/2000 HAP DONE No Hold HAP 07/11/2000
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