Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
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_ COMMUNITY DEVELOPMENT Permit#: ELR2014-00148
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2 39 Date Issued: 06/30/2014
0 K A- ! Parcel: 25101 DC00200
Jurisdiction: Tigard
Site address: 13535 SW 72ND AVE 100
Project: Fullhart Insurance Agency Inc 202807939 Subdivision: 72ND BUSINESS CENTER Lot: 13
Project Description: Low voltage burglar alarm for Fullhart Insurance Agency Inc 81468442. Reprinted permit to show change of
address to Suite 105 from Sutie 100.
Contractor: ADT LLC Owner: PNWP LLC#2
2815 SW 153RD DR BY PACIFIC NW PROP LTD PTNSP
BEAVERTON, OR 97006 PO BOX 2206
BEAVERTON,OR 97075
PHONE: 503-469-7241 PHONE:
FAX: 503-469-7110
FEES
Description Date Amount
Specifics: Restricted Energy Permit 06/30/2014 $75.00
12%State Surcharge-Electrical 06/30/2014 $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)
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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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a co• • -s or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
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Issued By: _ Signature:
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.