Permit CITY OF T I GA R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
'"'��'y; DEVELOPMENT SERVICES PERMIT #: ELR2000 -00125
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 DATE ISSUED: 05/31/2000
SITE ADDRESS: 14800 SW SEQUOIA PKWY PARCEL: 2S112AD -00900
SUBDIVISION: ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Proiect Description: Installation of Data Communication System in existing commercial building.
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: 1
Owner: Contractor:
HOME DEPOT USA INC OPTEC INC
BY MARSHALL + STEVENS INC FIRSTWORLD COMMUNICATIONS
ATTN: MELISSA SHAPIRO 7324 SW DURHAM RD
PHILADELPHIA, PA 19103 PORTLAND, OR 97224
Phone: Phone: 639 -2871 i
Reg #: ORIGINAL
LC 4 6137
ELE 34266CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT KJP 05/31/200C $60.00 HANDRCPT Elect'I Final
5PCT KJP 05/31/200C $4.80 HANDRCPT
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 -• :s adopted by the Oregon Utility Notification Center. Those ml:- are set fo h in OAR
952 - 001 -0010 t ro • 0 R 952 - 001 -0080. You may obtain copies of these rules or erect questio to 0 • ; j �(503)
246 -1987.
Issued by , Permittee Signature #L1ZA&
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
O fY 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 #Ibt Q.d -000 -Q)l
F - 503 - 598 -1960 IN COMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Develop ent Project TY PE OF WORK INVOLVED - RESIDENTIAL ONLY
e R estricted Energy Fee $60.00
(FOR ALL SYSTEMS)
JOB S r et Address Ste #
' ' • ,ADDRESS 1L0O Zw ftclk Check Type of Work Involved: .
_lily /State alp Phone # ❑ Audio and Stereo Systems
a �5 3 5o b
Na ❑ Burglar Alarm
• •
.ekvsAC_ aS ok6` ❑ Garage Door Opener*
_OWNER Mailing Address
City /State Zip Phone .# ❑ Heating, Ventilation and Air Conditioning System' •
Name I I Vacuum Systems* .
® MC— (F - ° & , El Other ,
CONTRACTOR Mailing Ad ress ((((
3 L� ‘sW us-Lim... . , TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a � /St -t- _ Zip Phone # Fee for each system $60.00 '
v
copy bf all licenses , a 0 i � a .3' Al t/ 1 (SEE OAR 918 - 260 -260) ,
are required if 0 on Contr. 1rd Lic. # E D to
expired in C.O.T. O(, Q 1 Sr30 0,)-. �y;''• Check • Type of Work Involved: .
• data base). Electrical ntr. Lic. # Exp. at , � j ✓ .
3 3y,.a_y4c(E /D pate '3''. n Audio and Stereo Systems
C.O.T. or etro ic. # Exp. Date ❑
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 .. I � I .
- make only restricted energy installations (100 volt amps or less) under this. - I I . 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. l l Intercom and Paging Systems ,
These have asterisks( *). All others need licensing;
2. Call for inspections when installation -under this permit are ready for
El Landscape Irrigation Control*
. inspection at 503- 639 -4175; . - . ❑ Medical '
3. Purchase separate permits for all installations that are not ready -for an I I Nurse,Calls PRRF
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 . ' . - .
startedwithin 180 days of issuance or if work is suspended for 180 days. Number of. Systems , . .
The perso signing for thi permit must be the applicant or a 'person • No licenses are required. _Licenses are required forall.other installations
authorizito bind the ap. . ant.
/ -
� / .. FEES: . .
' u
. � � l l - 1 ' ■ - • � i / A./ ENTER FEES
® • - - - O "
$
8 %SURCHARGE (.08X TOTAL ABOVE) . $ • V Q''"---
Authority ,if other_ than Applicant ' TOTAL $ (0111$
0
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