Permit Support Document (19) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2017 00267
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/18/2017
Parcel: 2S113AB00500
Jurisdiction: Tigard
Site address: 16083 SW UPPER BOONES FERRY RD 200
Project: PDX-15166 Liberty Mutual Tigard Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37
Project Description: Low voltage security system addition-access control in suite 200. 12/21/2017: REPRINT permit to correct site
address.
Contractor: ARONSON SECURITY GROUP Owner: PACIFIC REALTY ASSOCIATES LP
8089 SW CIRRUS DR ATTN: N PIVEN
BEAVERTON, OR 97008 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-639-9988 PHONE:
FAX: 503-684-4357
FEES
Description Date Amount
Specifics: Restricted Energy Permit 12/18/2017 $75.00
12%State Surcharge-Electrical 12/18/2017 $9.00
Type of Use: COM Misc Administration Fee 12/21/2017 $45.00
Class of Work: ADD
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: 0 Other: 1 Total $129.00
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. 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 0 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987/ or 1.800.332.2344.
Issued By: z�i Permittee Signature: L�44-/i1B(&"--
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.
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16083 SW UPPER BOONES FERRY RD 200,
TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Electrical Limited Energy ELR2017-00267
Inspection Type: Inspector:
198 Low voltage final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor