Permit (73) CITY OF TIGARD ELECTRICALPERMIT -
RESTRICTED ENERGY
A DEVELOPMENT SERVICES PERMIT #: ELR1999 -00298
Ali 13125 SW Hall Blvd., Tigard, OR 97223 (50 1 DATE ISSUED: 12/10/99
W
SITE ADDRESS: 16200 SW PACIFIC HY S (J I b I PARCEL: 2S115BA -00101
A
SUBDIVISION: PP1994 -028 ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
Project Description: Installation of data telecommunication system. Job No. 51 -01931
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: _ : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
BIT HOLDINGS LTD PARTNERSHIP CHRISTENSON ELECTRIC INC
BY FORUM PROPERTIES INC 111 SW COLUMBIA
FIVE CENTERPOINTE DR STE 290 STE 480
LAKE OSWEGO, OR 97035 PORTLAND, OR 97201
Phone: Phone: 241 -4812
Reg #: LIC 000458
SUP 3289S
PLM 2468S
ELE 26-34C
•
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT DEB 12/10/99 $60.00 99- 320352 Elect'l Final
5PCT DEB 12/10/99 $4.80 99- 320352
Total $64.80
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 -00 = •h OAR 952 - 001 -0080. You may obtain copies of these rules or direct quesli•ns to OUNC at (503)
246 -198.
Issued by_ j Permittee Signature _ /_// i t „J.// _I
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: DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
-r IY OF TIGARD REffeltPTED ENERGY ELECTRICAL APPLICATION Recd by: (Z.Q- b //Yla -d
13126 SW HALL BLVD
TIGARD OR 97223 • DEC 0 9 1999 PRINT OR TYPE Date Recd: �� -G-95
V - 5031639 -4171 X304 Permit#; t„./z/ 999- 40 917
F.- 503- 598-1 51 - 0 1 9 3 1 COMMUNITY D E OR ILLEGIBLE APPLICATIONS CustCall'd:
WILL NOT BE ACCEPTED'
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
• Restricted Energy Fee. -..._....._._-- ..— :80.00
BLOCKBUSTER VIDEO (FOR ALL SYSTEMS) »....M
JOB Street Address Ste #
ADDRESS 16200 �yy SW PACIFIC HWY S Check Type of Work Involved: -
T GGARD 0224 Phone* ❑ Audio and Stereo Systems
Name ❑ Burglar Alarm
OWNER Mailing Address ❑ Garage Door opener
City /State 14 Phone # ❑ Heating, Ventilation and Air Conditioning System'
QUESTIONS? CONTAMWne ❑ Vacuum Systems*
CAROL 285 -1970 CHRISTENSON ELECTRIC, INC.' ❑ Other
•
CONTRACTOR Mailing Address •
111 SW COLUMBIA, SUITE 480 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /State L 27P Phone # Fee for each
system........... ...._........._................ $60.00
copy of aU licenses PORTLAND OR .F7201 241 - 4812 (SEE OAR 918- 260 -260)
are required H Oregon Contr. Brd tic. # E� pate
expired in C.O.T. 458 S I O 3 Check Type of Work Involved:
data base). Electrical Contr. t . Li. 9 IT ❑
Audio and Stereo Systems
. ' 1 C.O.T
Ex
Qr Lis 9 n, Data
L 66 12 / y y ❑ Boller Controls
Owner's Name
•
OWNER - Mailing Address ❑ Clock Systems
APPLICANT Xlnl Data Telecommunication Installation
City /State I rip I Phone 9 ❑
Fire Alarm Installation
This permit Is Issued under OAE 918-320-370. This applicant agrees to •
make only restricted energy installations (100 volt amps or less) under this ❑ HVAC
permit and to do the following:
❑ Instrumentation
1. Only use electrical licensed persons to do installations where required.
Certain residential and other transactions are exempt from licensing. ❑ Intercom and Paging Systems
These have asterisks(`). All others need licensing;
❑ Landscape Irrigation Control'
2. Can for inspections when installation under this permit are ready for
inspection at 603. 6394175; ❑ Medical
3. Purchase separate permits for all installations that are not ready for an Nurse Calls •
inspection when the Inspector is out to inspect under this permit
❑
4. Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting*
inspector are done, and;
❑ Protective Signaling
5. Assume responsibility for calling for a final inspection when all of the •
corrections are completed. ❑ Other
Permits are non - transferable and non - refundable and expire if work is not
started within 180 days of issuance or if work is suspended for 180 days. Number of Systems .
•
The person signing for this perm u the applicant or a person • No licenses are r
authorized to b the app can
equired Licenses are required for all other installations
• FEES:
S mature • ENTER FEES S 60.00
12/7/99 4.80
•
• at SURCHARGE O8'X TOTAL ABOVE) 5
•
Authority if other than Applicant TOTAL $ 64.80 /
tldstsfwmslresele.doc 3/99
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location /o' .2o1.) �W P.M � Suite 5 MEC
Contact Person �G !� Ph PLM
Contractor / Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR // ,? y,ff
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall JO__ Fire Sprinkler SP �'p r V►2 4 1 1/ C - 15 ,S'y.� e.- YJ�
Fire Alarm `
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab n q / 4 S __S
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In '.. j
Gas Line
Smoke Dampers
Final '.1"j
P T FAIL •
LECTRICAL
, 1.j. \pe
Service
Rough In (. t
UG /Slab \ .
Low Voltage
Fir Alarm
A ),
SS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach/Sidewalk /
Other Date / A- -- -99 Inspector f _ _ 4 /_ _ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.