Inspections q CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
14 * COMMUNITY DEVELOPMENT Permit#: ELR2013 00301
T[GA R P 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
9 Date Issued: 11/21/2013
Parcel: 1S134AA01800
'• �� Jurisdiction: Tigard
Site address: 10240 SW NIMBUS AVE L11
Project: Proffessional Video&Tape 400112739 Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: 2
Project Description: Low voltage burglar alarm for Professional Video&Tape 400112739-Ste L11. 3/5/14,reprinted to correct suite
address to L11.
Contractor: ADT LLC Owner: HANSON, RONALD D
2815 SW 153RD DR ROBINSON, CONSTANCE A
BEAVERTON, OR 97006 ROBINSON, CHESTER TRUST ET AL
203604 EAST FINLEY RD
KENNEWICK,WA 99331
PHONE: 503-469-7241 PHONE:
FAX: 503-469-7110
FEES
Description Date Amount
Specifics: Restricted Energy Permit 11/21/2013 $75.00
12%State Surcharge-Electrical 11/21/2013 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 0 Fire Alarm: 0
HVAC: 0 Instrumentation: 0
Intercom/Paging: 0 Landscape/Irrigation: 0
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
Security Alarm: 1 Other: 0 Total $84.00
Other Desc: Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTI• . •regon .w requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 , rough OAR 952-0I1-•••0. Y•u may obtain a copy of the rules or direct questions to OUNC by calling 58.. . 987 or 1.800`32.2344.
l .4
Issued : : Permittee Signature. _ ,e—cc
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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Location:
Record Type:
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Inspection Date:
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Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10240 SW NIMBUS AVE L11, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
199 Electrical final
2014-03-14 (null)
ELR2013-00301
PASS - No C of O
Violation Summary:
Inspector Contractor