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Permit • CITY OF TIGARD fi DEVELOPMENT SERVICES ELECTRICAL PERMIT — RESTRICTED ENERGY PERMIT #: ELR97 -0210 DATE ISSUED: 07/28/97 PARCEL: 2S112DA -01300 SITE ADDRESS... :06640 SW REDWOOD LN SUBDIVISION....:MLP96 -0002 ZONING:I —P BLOCK • LOT • JURISDICTN: TIG Pro.j ect Description : Add data telecommunication installation A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO...: AUDIO R 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 PACTRUST type amount by date recpt 15350 SW SEQUOIA PRMT $ 40.00 GEO 07/28/97 97- 297614 TIGARD OR 97223 5PCT $ 2.00 GEO 07/28/97 97- 297614 Phone #: Contractor: C3 // COMMUNICATION CNNCT CNTR $ 42.00 TOTAL 7360 0' NEIL RD REQUIRED INSPECTIONS KEIZER OR 97303 Ceiling Cover Elect'1 Final Phone #: 503 -393 -8996 Wall Cover Reg ft.. : 011765 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 Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952-00Viw You may obtain copies of these rules or dire que - '% C at (503)246 -1987. / Issued b � � Permittee Signature ./�; 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: � "v2 LICENSE NO: +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 6:00 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'd: TIGARD OR 97223 PRINT OR TYPE V - 503 -639 -4171 X304 Permit #: ELZQf7T— Co?f 0 F - 503 -684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Cali'd: WILL NOT BE ACCEPTED Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL PO .I � / Restricted Energy Fee $40.00 rt/r,_n /2, (FOR ALL SYSTEMS) JOB Street Address Ste # ADDRESS (,Gyp S t,/ , raj Check Type of Work Involved: Say/State / Z4p7 ZZ.3 Phone # ❑ Audio and Stereo Systems ligard% Or NarrWe �� 0 Burglar Alarm 'uSf ❑ Garage Door Opener* OWNER Mailing Address tS to 3 —S'�"C` ''- ❑ Heating, Ventilation and Air Conditioning System* Ci /State Zip Phone # N �q �'', - Or ❑ Vacuum Systems* arhe C 3 ❑ Other CONTRACTOR Mailing Ad ess , , 7360 On e,1 TYPE OF WORK INVOLVED - COMMERCIAL (Prior to issuance a Ci /State p Phone # Fee for each system $40.00 li copy of all licenses ,zef Or 9730.3 02 (SEE OAR 918 - 260 -260) are required if regon Contr. Brd Lic. # Exp. Date expired in C.O.T. %/ 7G 5$ Check Type of Work Involved: data base). Electrical Contr. Lic. # Exp. Date ❑ Audio and Stereo Systems C.O.T. or Metro Lic. # Exp. Date ❑ Boiler Controls Owner's Name ❑ Clock Systems OWNER - Mailing Address APPLICANT Er Data Telecommunication Installation City /State I 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. „// / i� ENTER FEES $ CO' Signature 5% SURCHARGE (.05 X TOTAL ABOVE) $ Authority if other than Applicant TOTAL $ _ i:lresele.doc 12/96 — Page No. 1 CASE HISTORY FOR CASE NO.: ELR97 -0210 PACTRUST 06640 SW REDWOOD LN 05/13/98 Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By - --- --- -- ------ - -- ELRC001 Application Received 07/28/97 / / 07/28/97 07/28/97 DST ELRC003 Permit Created 07/28/97 / / 07/28/97 07/28/97 DST ELRC500 (F) Issue permit / / / / 07/28/97 PASS GEO 07/28/97 DST ELRC700 Ceiling Cover 07/28/97 / / 08/06/97 PASS MJR 08/06/97 MJR ELRC720 Wall Cover 07/28/97 / / 09/10/97 correction CORR MJR 09/10/97 MJR need cover plates ELRC799 Elect'l Final 07/28/97 / / 01/26/98 PASS BRP 01/26/98 J *H ELRC800 Case finaled / / / / 01/26/98 PASS BRP 01/26/98 J *H