Permit (92) . ELECTRICAL PERMIT -
CITY TIGARD RESTRICTED ENERGY
41A DEVELOPMENT H B SO R9 2CiES 639 -4171 DATE ISSUED: g /6R19 99 -00188
- 13125 SITE ADDRESS: 16200 SW PACIFIC HY Q -2 PARCEL: 2S115BA -00101
W
SUBDIVISION: PP1994 -028 ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
Project Description: Protective signaling
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: V CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
BIT HOLDINGS LTD PARTNERSHIP HONEYWELL INC
BY FORUM PROPERTIES INC 15495 SW SEQUOIA
FIVE CENTERPOINTE DR STE 100
LAKE OSWEGO, OR 97035 PORTLAND, OR 97224
Phone: Phone: 968 -3300
Reg #: SUP 941 -JLE
LIC 00057824
ELE 26207CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT BON 8/6/99 $60.00 99- 317456 Elect'I Service
Elect'I Final
5PCT BON 8/6/99 $4.20 99- 317456
•
Total $64.20
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 at (503)
246 -1987. `
Issued by ru.A...� I(_ l i L- Permittee Signature C (cLAV1 — Wad
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'N: lQA" DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
RECEIVED
• AUG 0 5 1999 0961 86S LOS 6P:91 6661- 10 -1nr
£0'd
COMMUNITY DEVELOPMFNT
,..?
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION . Date Recd: -
13125 SW HALL BLVD PRINT OR TYPE ,� '�pp 0
TIGARD OR 97223 Permit �N I ` ` ' T�
F - 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS
V - 503 -639 -417 X304 Permit all'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESI aONLY
Y
... // estricted Energy Fee
.TOrc (OR ALL SYSTEMS)
JOB S- I ••�• / ste# y37 f�
, - t Address Check Type of Work Involved:
ADDRESS I6.206 . S 0 , Q
_ /Staff Phone # 0 Audio and Stereo Systems
= � ' ;7
N: • e / 0 Burglar Alarm • v o. s, - i • • p V 0 Garage Door Opener'
OWNER 0 Heating, Ventilation and Air Conditioning System'
City /State Phone #
0 vacuum Systems'
Name a
H ONEYWELL Other
CONTRACTOR 1 5n Address # 100 TYPE OF WORK INVOLVED - CO MMERCIAL ONLY
1 SW __- •r • ' - • �• • •
Fee for each system 560.00
• hone #
(Prior of issuance Port 968 -3300 (SEE OAR 918- 260 -26
copy of all licenses POI`t: - II •
Oregon Contr. Brd Lie. # Ex • . Date
are required C.O.T. Greg 7 00 Check Type of Work Involved:
expired in C.. 0
data base). Electrical Contr. Lie. # E Date Audio and Stereo Systems
• 2 6 - ? 1.1 . - •
C.O.T. or Metro Lie Exp. Date # 1.1 0 Boiler Controls
Owner's Name 0 Clock Systems
OWNER - 0 Data Telecommunication Installation
City /State
APPLICANT h Phone U Q . Fire Alarm Installation
This permit is Issued under OAE 918 - 320 -37 This applicant agrees to HVAC
make only restricted energy Installations (100 volt amps or less) under this
permit and to do the following: • 0 Instrumentation
1. Only use electrical licensed persons to do installations where required. Intercom and Paging Systems
A8 others
Certain residential and other need licensing; Pt from licensing. ❑
These have asterisks(7. 0 Landscape Irrigation Control'
2. Call for inspections when Installation under this permit. are ready for ❑ Medical
inspection at 503639.4175;
3. inspection when t the p Inspector Is out installations that are not
permit;
4. an Nurse Calls
4. Assume responsibility for assuring that all corrections required by the
0 Outdoor Landscape Lighting*
inspector are done, and; ® Protective Signaling
5. Assume responsibility for calling for a final inspection when all of the Other
corrections are completed.
Permits are non - transferable and non- refundable and expire if work is not Number of Systems
started within 180 days of issuance or If work is suspended for 180 days. all deer Installations person signing for this permit must be the applicant or a person • No lloenses are required. Licenses are required
authorized to bind the applicant.
( �� 60.00
`—'� -, S
/' `-�— � �TER FEES
Signature , 4.20
MG SURCHARGE (.05 X TOTAL ABOVE) 5
$ 64.20
Authority if other than Applicant TOTAL
i.w.•.vevrnnkresele.doc 9198