Permit •
^
f t OF TIGARD RESTRICTED ENERGY
i�,,� DEVELOPMENT SERVICES ELECTRICAL PERMIT -
PERMIT #: ELR2000 -00193
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/21/00
SITE ADDRESS: 12244 SW SCHOLLS FERRY RD PARCEL: 1S134BC -00300
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: Burglar alarm.
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: BURGLAR AL X
TOTAL # OF SYSTEMS:
Owner: Contractor:
BPP RETAIL LLC PROTECTION ONE ALARM MONITORIN
BY BURNHAM PACIFIC PROPERTIES 15500 SW 72ND AVE
ATTN: JOHN WATERS PORTLAND, OR 97224
SAN DIEGO, CA 92101
Phone: Phone: 624 -0244
Reg #: ELE 34- 428CCLE
LIC 116325
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 8/21/00 $60.00 2720000000
5PCT CTR 8/21/00 $4.80 2720000000
Total $64.80 EXPIRED
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 direct uesti• ns to OUNC at (503)
246 -1987.
Issued by Permittee Signature D„,,
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: Lf7
13125 SW HALL BLVD Date Rec'd: �/2//0Z7
TIGARD OR 97223 PRINT OR TYPE
/ r>r 6'
V - 503 - 639 -4171 X304 Permit #: EL/1.2000 00/93
F - 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd: I
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
/, Restricted Energy Fee $60.00
U, 511133 (FOR ALL SYSTEMS)
JOB Street Address ,k Ste #
Check Type of Work Involved:
ADDRESS /a 4-4 05 e j. A dA/ ,-
CiUSta Zip 7 Phone # ❑ Audio and Stereo Systems
/no /a „doe q7. ;3 s03 6y$.NT:3
Name ❑ Burglar Alarm
a54 -+2._. ❑ Garage Door Opener*
OWNER Mailing Address
City /State Zip Phone # ❑ Heating, Ventilation and Air Conditioning System'
Name
❑ Vacuum Systems'
/ ro c=7ldp Oh -e- ❑ Other
CONTRACTOR Mailing Address
13 — p 0 ,5 10 7/ ' ' TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a at / ;.11 Phone # Fee for each system $60.00
copy of all licenses fir', /ar 4,e 2'/ 'p /,'W- O,Zgjt (SEE OAR 918 -260 -260)
are required if Oregon Contr. Bre Lic. # D to
expired in C.O.T. f/63 Ex paz Check Type of Work Involved:
data base). Electrical Con r . Lic. # Exp. D to
29'147, L /OP ❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. ate
n 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: F kr � 1 7" pl
❑ Instrumentation ' ; f
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. LZ Other aui L /9,Q A.teR,1
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:
' ENTER FEES $ 6,9 • 0-o
Si! - -ture
8 %. SURCHARGE (.08X TOTAL ABOVE) $ y • PO
Authority if other than Applicant TOTAL $ ‘ q. (Po
is \dsts \forms \resele.doc 3/98