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Permit CITYOFTIGARD. DEVEL OPMENT SERVICES ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 ELECTRICAL PERMIT — RESTRICTED ENERGY PERMIT #: ELR99 -0037 b,stp DATE ISSUED: 03/02/99 k PARCEL: 2S112DA -00300 SITE ADDRESS...:15230 SW SEQUOIA PKWY #190 . SUBDIVISION • ZONING:I—P BLOCK LOT JURISDICTN:'TIG Project Description: Install protective signaling. . 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..:X INSTRUMENTATION.: OTHER..: . ° TOTAL # OF SYSTEMS: 1 Owner: FEES PACTRUST type amount by date recpt 1 SEQUOIA PKWY, SUITE 300 PRMT $ 40:00 GEO 03/02/99 99- 313375 TIGARD OR 97224 BLNK $ 0.00 GEO 03/02/99 99- 313375 Phone #: 624 -6300 • Contractor: HONEYWELL INC $ 40.00 TOTAL .15495 SW SEQUOIA • STE 100 REQUIRED INSPECTIONS PORTLAND OR 97224 Low Voltage Insp Phone #: 968-3333 Elect'1 Final Reg #..: 000578 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- 001 -0080. You may obtain copies of these rules or direct uesti. .o I10- at (503)246 -1987. . o Issued by Permittee Signature 0 4l • 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 : K.// DATE:, ' 02 rl LICENSEHNO: +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call. 639 -4175 by 7:00 P. M. for ' an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ - - RECEWED CITY OF laGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: 131 5'SW HALL BLVMAR 0 2 1999 Date Rec'd: TIGARD OR 97223 PRINT OR TYPE V 503-639-4171 wimuNITY DEVELOPMENT Permit #: kG-e 9 -- F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd: WILL NOT BE ACCEPTED Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Restricted Energy Fee $40.00 G Jo h,.. F&.rn/ /are, "R - f ta-L - /Ce i,L (FOR ALL SYSTEMS) JOB Street Address Ste # Check Type of Work Involved: ADDRESS /.'Sa30 SW lrp aolo a, #/40 City /State Zip one # 0 Audio and Stereo Systems '�r�f/a.,vt 9 7:2 5/ Name / ❑ Burglar Alarm I.JQm LLS (1 An t/e, I I Garage Door Opener* OWNER Mailing Address City /State I Zip I Phone # El Heating, Ventilation and Air Conditioning System* Name ❑ Vacuum Systems* / /off J G1f ❑ Other CONTRACTOR Mailing Add ss /-5y S sti) S iinioa7 j 0O TYPE OF WORK INVOLVED - COMMERCIAL ONLY (Prior to issuance a - Oita /Stateip Phone # Fee for each system $40.00 copy of all licenses for/land. O 9 7 v 46g -_ " (SEE OAR 918 -260 -260) are required if Oregon Contr. Bfd Lic. # ! Exp. Date expired in C.O.T. ( 9 ,y /1"1" Check Type of Work Involved: data base). Electrical Contr. Lic. # xp. ate h -- 07 c_L C / ❑ Audio and Stereo Systems C.O.T. or Metro Lic. # xp. Date (o (fin? y j j / ❑ Boiler Controls Owner's Name ` ❑ Clock Systems OWNER - Mailing Address APPLICANT ❑ Data Telecommunication Installation City /State Zip Phone # ❑ Fire Alarm Installation This permit is issued under OAE 918 - 320 -370. This applicant agrees to make only restricted energy installations (100 volt amps or less) under this ❑ HVAC permit and to do the following: ❑ Instrumentation 1. Only use electrical licensed persons to do installations where required. - Certain residential and other transactions are exempt from licensing. ❑ Intercom and Paging Systems These have asterisks( *). All others need licensing; ❑ Landscape Irrigation Control' 2. Call for inspections when installation under this permit are ready for inspection at 503 - 639 - 4175; ❑ Medical 3. Purchase separate permits for all installations that are not ready for an ❑ Nurse Calls inspection when the inspector is out to inspect under this permit; 4. Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting* inspector are done, and; xii Protective Signaling 5. Assume responsibility for calling for a final inspection when all of the corrections are completed. Ti Other Permits are non - transferable and non - refundable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. I Number of Systems The person signing for this permit must be the applicant or a person * No licenses are required. Licenses are required for all other installations autho • ed to bind th$cant.- ppli FEES: gnature ENTER FEES $ f 0.0D • 5% SURCHARGE (.05 X TOTAL ABOVE) $ .7 . © 0 Authority if other than Applicant TOTAL $ �� • o a is \dsts \resele.doc 7/97 — C" F • " ` 5/17160 Activitie for :Ca # EL - 0 0 03 7 • . . , .. Assigned :Hold Updated .;Activity Description . . • Date 1; Date'2 : Date•3 -''To . .Done ; By :c_;Disp: t , _ ' Level _;;:By: =; Updated. Notes : -• ELRC001 Application Received - - _T , - 3/2/99 ' GEO :MAIL - -GEO' - 7 3/2/99 - v ELRC003 - -Permit Created ' " _'I _ - 3/2/99 `. GEO • DONE _ GEO : 3/2/99 ELRC725' Low Voltage Inspec • ^ ELRC799 tion - _ + - ,GEO 3/2/99` • ., Elect'I Final • '" - _ SST, . 2/4/00.,' - 2/4100- inspection request to ' .. • • '1 _ Hap , .. : ELRC Issue permit - - 3/2/99, __ , ..GEO' PASS,, ' GEO `3/2/99 ' ' 4 ELRA510 • (F) Repent permit 4/5/99 DLIi DONE No Hold, , -DLH : 4/5/99 , - _ `ELR,gg,}5 Request Inspection research i ,_3/24/00 _ _ JMT -_ -DONE , No Hold, •�JMT•_ .,'3/24/00 • ,, ELRA580 Expired by'limitation° ° • ,3/28/00 - - - .- _HAP =`: " - - DONE `• . No Hold _- AKJ • ' ~ ^.;3728/ • - - - . - - • • Page 1 of 1 -