10260 SW NIMBUS AVENUE BLDG M STE 12 ZIW 3AV SIIOWIN MS 09ZOT
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10260 SW NIMBUS AVE M12
CITY OFF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT -
13125 SW Nall Blvd.,Tigard,OR 97223 (503)839. 171 RESTRICTED ENERGY
PERMIT #: EL R9 7-01182
DATE ISSUED: 06/:30/97
PARCEL: IS134AA-01800
SITE ADDRESS. . . : 1O26O SW NIMBUS AVE #M-12
SUBDIVISION. . . . : 1 KNOLL BUSINESS CENTER TIGARD ZONING: I-P
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :2 JURISDICT.N: TIG
Project Dr.scar i pt i on a add protective signaling
----------------------------------------------------------------------------------
A. RESIDENTIAL--------- B. COMMERCIAL-------------------------------------------
AUDIO & STEREO. . . : AUDIO & STEREO. . a INTERCOM & PAGING. . a
BURGLAR ALARM. . . . : BOILER. . . . . . . . . : L_ANDSCAPE/IRRIGAT. . :
GARAGEOPENER. . . . . CLOCK. . . . . . . . . . . : MEDICAL. . . . . . . . . . . . :
HVAC. . . . . . . . . . . . . : DATA/TELE COMM. . . NURSE CALLS. . . . . . . .
VACUUM SYSTEM. . . . e FIRE ALARM. . . . . . : OUTDOOR LANDSC LITE:
OTHER: a : HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . : X
INSTRUMENTATION. : OTHER. . : : :
TOTAL. # OF SYSTEMS: 1
Owner: -------------------------- -------------------------- FEES --------- ----- --
FORUM PROPERTIES type amount by date recpt
PRMT $ 40. 00 GEO 06/30/97 97-296625
SPCT $ 22. 00 GEO 06/30/97 97--2966E5
Phone #: 684-0510
Contractor: --------------------.__-----------
----------------------------------------.
AAA ALARM CO OF OREGON B 42. 00 TOTAL
7865 SW CIRRUS DR
-- --- REQUIRED INSPECTIONS -------
BEAVERTON OR 97008 Ceiling Cover Elect' l Final
Phone #: 646-22700 Wall Cover
Reg #. . : 000938 _
This permit is issued subject to the regulations contained in the Tigard punicipal Code, State of Ore. Specialty Codes and all other
applicable laws. All Mork will be done in accordance with approved plans. This permit will expire if Mork is not started within 199
days of issuance, or if work is suspended for more than 199 days. ATTENTIft lY*gan law requires you to follow rule adopted by the
Oregon 1liility Notification Ceoter. Those rules are set forth in OAR %2- 91 7019 through OAR 95PAPI- 999. You may obtain copies of
these rules or direct uestI to at (593)246-1997.
7
4 Issued by Permittee Signature_
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------------------------------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------------------.----.-----
S I GNATURE OF S+UPR. ELEC' N a �O
�3.> DATE: -- 7
L I CENSE NO: 7
++++++.....++++++++++++++++-a+++++.+++++++++4++++++++++++++++++++++++++++++++++++
Call 639-4175 by 6:00 P. M. for, an inspection needed the next business day
++++++++++++++++++++++++.I....++++++++++¢++++++++++++++++.+++++++++++++♦++++++++.
v
} Community Development RESTRICTED�ENNER�GY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard,OR 97223 PERMIT# _
Phone(503)639-4171
FAX(503)684-7297 DATE ISSUED___
TDD No. (503)684-2772
(CITY OF TIGARD Inspection (503)639-4175 ISSULD BY
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INS1AL ATION 4. TYPE OF WORK
1o�b Uimbri 4M12-
Addcess RESIDENTIAL—Restricted Energy Fee. . . . . . . . . �4Q,QQ
T1 Qg rte— Or- '11-2.7-3 (FOR ALL SYSTEMS)
City State Zip Check Typeof Work InyL4yed:
PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND EXPIRE IF WORK Audio and Stereo Systems'
IS NOT STARTFD WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
Ino DAYS ❑ Burglar Alarm
2. CONTRACTOR APPLICATION C1 Garage Door Opener*
//��
AA /^ ❑ Heating,Ventilation and Air Conditioning System"
Contractor AAA- A 101_!x1_ Type_ n ��p El Vacuum Systems*
Address 1� 9 5-W. C r r U s pri K ❑ Other
Date V U K, 191 l q q� COMMERCIAL— Fee for each system . . . . . . . S40.QQ
--_ — Q (SFE OAR 918-260-260)
Property Owner_ ICAC, ]pQ� - �iy�yf Work InvyJyt&
(f J
Contractor's Board Reg. No. —f b-f ❑ Audio and Stereo Systems"
El Boiler Controls
Phone # 503)_�r r} _ ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No
❑ Instrumentation
Address — ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control'
City State Zip ❑ Medical
This permit Is issued under OAR 918.320.370.This applicant agrees to make only ❑ Nurse Calls
restricted energy installatons(100 Yoh amps or less)under this permit and to do the ❑ Outdoor Landscape Lighting*
following: M/y
1. Only use electrical licensed persons to do installations where required.(Certain AI Protective Signaling
residential and other transactions are exempt from licensing.These have ❑ Other
a asterisks(•).All others need licensing). — — — -- -----
a 2. Call for an inspection when all of the installations under this permit are ready
I— for inspection at 503-639-4175.
U ❑ Number of Systems
3. Purchase separate permits for all installationsthis
that are not ready for Inspection
when
--- u—
when the inspector is out to Inspect under this permit. •No Ncenses are required. licenses are requited for all tNlter installations
4 Assume responsibility for assuring that all corrections required by the inspector
are done,and
5. Assume responsibility for railing for a final inspection when all of the corrections 5. FEES
W are completed. ''n
The person signing for this permit must he the applicant or a person a. Enter Fees $ `Tu•
authorized to bind the applicant.
IgK#+/1 mw--� b. 5% Surcharge(.05 x total above) $_ a_�n
Signature
oaks CoordinU-Hr TOTAL $ � Ob
IJ
Authority if other than applicant
ENERGAP.CHP
CITY OF TIGARD P"ILDING INSPECTION DIVISION
24-H
o
ur Inspection Line: 639-4175 Business Phone: 639-4171
Date Requested: / - 16 � 7 _ A.M. - P.M.,_ MST:
I.ocation:_ �- �v C) J / _ _ BUP:
Tcnant _
— �*-7 ,� --^ ,{�/� � Suite: —..`Hld4: -'� .Z MEC:
Contractor: �L / 't C.�1'0 fi i'T L[�n�Y]_Phone: O-L-1 �_ PLM: _
(honer: —� ---pf�e �L -� �� ELC: _
BUILDING —_ BIDG -a't) PLUMBING MECHAWICAI, CTRICtA�` SITE
Site Post/Beam Post/Beam Pod/Beam Cove Sewer/Storm
Footing Roof UndFl/Slab Rough-in Ceiling Water Lint
Slab Framing Top Out Gas Line Rough-In Ud Slorinkler
l'oundation Insulation Sewer Hood/Duct Ilecamnoct Vault
l3smt Damp Drywall Storm Furnace Temp Service IMISC.
Masonry Ceiling Rain Dram A/C UG Slab
Shear/Sheath Fire Spklr/AlmM Crawl/Famxi Ir Heat Pump _
Appn-ved Approved Approved Appro Approved
Appr/Sdwlk Not Approves{ Not Approved Not Approved ved Not Approved
FINAL FINAL FINAL FINAL
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Call for reinspeL einspection fee of S— fired orenextinspection 0 Unable to inspect
Inspector: `. _— Date: // �4 page of