Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR1999 -00266
' -' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/16/1999
SITE ADDRESS: 15575 SW SEQUOIA PKWY 100 PARCEL: 2S112DD -01600
SUBDIVISION: ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Electrical TI - Burglar alarm
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPEIIRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: BURGLAR X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES ADT SECURITY SERVICES, INC
15350 SW SEQUOIA PKWY #300 -WMI 2815 SW 153RD DR
PORTLAND, OR 97224 BEAVERTON, OR 97006
Phone: Phone: 503469 -7100
Reg #: LAC 0059944
ELE 26209CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT BON 11/16/199E $60.00 99- 319787 Elect'I Service
5PCT BON 11/16/199£ $4.80 99- 319787 Elect'I Final
Total $64.80
ORIGINAL
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 questions to OUNC kt (503)
246 -1987.
Issued by I // Permittee Signature - f 4
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:
C ONTRACTOR INSTALLATION ONLY
• SIGNATURE OF SUPR. ELEC'N � l , DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
1
1
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL ApRoms Rec'd by:
13125 S\ - 'HALL BLVD p C Date Rec'd:
TIG OR 97223 0 3- 1 I1 ' PRINT OR TYPE NOV 15 1999
y - t"
V - 503 - 639 -4171 X304 v • /1�itis Permit #: FLKlglg -cv '
F - 503 - 598 -1960 INC PLETE OR ILLEGIBLE APB hint LOPMENT Cust.Call'd:
WILL NOT BE ACCEP
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee $60.00
(FOR ALL SYSTEMS)
JOB Street Address Ste # /0 a
ADDRESS /srf r SO 3 eeuo IA Vict y Check Type of Work Involved:
it /Stet Zip Phone # ❑ Audio and Stereo Systems
i U, 51.2 -100a
Nam ❑ Burglar Alarm
OWNER Mailing Address /� -
.xt / Oj�
Garage Door Opener*
/. 6 -7 s'`� al ❑ Heating, Ventilation and Air Conditioning System*
Ctate— Zip Phone #
- 4/. 971.Y/c1. 30-500 0 Vacuum Systems'
Name
ADT SECURITY SERVICES, INC. ❑ Other
CONTRACTOR Mailing Add 261' S.W. 153rd DR LLL ess
ei ERTON, OR 97006 C� ,,,
TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City/State (503) 4C6.7 Phow # Fee for each system $60.00
copy of all licenses (0 �9 (SEE OAR 918 - 260 - 260)
are required if Oregon Contr . Brd ic. # 1 19Y—
xp. D e
expired in C.O.T. SL/' R 7/0/ Check Type of Work Involved:
data base). Electrical Contr. ic. # E ye
p?Q�j ,d , -3j Q ❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # Ex . D e
❑ 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;
❑ Protective Si naling
5. Assume responsibility for calling for a final inspection when all of the
corrections are completed. V Other
Permits are non - transferable and l fund- . e an• -xpire if work is not
started within 180 days of issua a •r if w• is s , •ended for 180 days. / Number of Systems
The person signing for this p= ' it must ••e t - applicant or a person ' No licenses are required. Licenses are required for all other installations
autho ized to bi • • - e appl' - .
FEES:
Si,Pa ` �� ENT R FEES $ k • 06
0 U RCHARGE (.05 X TOTAL ABOVE) $ q• W
Authority if other than Applicant TOTAL $ (a 7. t'
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