Permit CITY OF TIGARD ELECTRICAL CTED ENERGY
4 RESTRICTED ENERGY
��� r;� DEVELOPMENT SERVICES PERMIT #: ELR2000 -00190
Ail 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/15/00
SITE ADDRESS: 06650 SW REDWOOD LN 360 PARCEL: 2S112DA -01400
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 JURISDICTION: TIG
Project Description: Tenant Improvement
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:
Owner: Contractor:
PACIFIC REALTY ASSOCIATES AMERICAN TELECOM INC
15350 SW SEQUOIA PKWY #300 -WMI 2410 SE 11TH AVE
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: Phone: 236 -8991
Reg #: LIC 0077238
ELE 26 -763CL
FEES Required Inspections
Type By Date Amount Receipt Elect'I Final
PRMT RCP 8/15/00 $60.00 HAND
5PCT RCP 8/15/00 $4.80 HAND
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 irect ques •onsto OUNC at (503)
246 -1987 "AA
Issued by ( c P/' 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:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OIrTIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by Y t
13125 SW HALL BLVD Date Recd: V/SiOn
TIGARD OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #: &IvUt / 90
F - 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee $60.00
J 0 ConSul 61.E d Cn i n -QeC5 (FOR ALL SYSTEMS)
JOB Street Address Ste #
II 11 Check Type of Work Involved:
ADDRESS ( a SW Redwcoc LAnt 36
City/State II Zip Phone # ❑ Audio and Stereo Systems
• or•T14(N!t 0 2
Name ❑ Burglar Alarm
OWNER Mailing Address
I n Garage Door Opener*
City /State Zip Phone # I Heating, Ventilation and Air Conditioning System'
n Vacuum Systems*
Name /
•
i rn-e `f &to 4 - e co M ❑ Other
CONTRACTOR Mailing Address
r,?y /p Sf Hill Avc TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a ty /State I Zip Phone #3 Fee for each system $60.00
copy of all licenses \ MC" t k.c.,/• U 97d1 da10 3/071 (SEE OAR 918- 260 -260)
are required if Oregon Contr. Brd Lic. # 97.023 Exp. Date
expired in C.O.T. g Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp. Date
0710- 76 3C Lt n Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date ❑
Boiler Controls
Owner's Name
❑ 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 ❑ HVAC
permit and to do the following: n
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; ❑ 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. n 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:
Si n tlJf @1 a %.d"---4--/ ENTER FEES $ 6,0 t D
8% SURCHARGE (.08X TOTAL ABOVE) $ q, 2'0
Authority if other than Applicant TOTAL $ (p Li, g
is \dsts \forms \resele.doc 3/98