Permit Support Document CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
.111
COMMUNITY DEVELOPMENT Permit*: ELR2018-00163
13125 SW Hall Blvd.,Tigard OR 97223 503.718.243• 3;T jR
9 �4 Date Issued: 09/21/2018 Parcel: 2S112DA01400
, ) Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 350
Project: LSI WFG Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Install access control cable for(1)new card reader door/relocate existing access control cabling from three
existing doors to(3)new card reader doors/install and re-install devices. 1/29/19:REPRINT to chang a address.
Contractor: COCHRAN INC Owner: PACIFIC REALTY ASSOCIATES
7550 SW TECH CENTER DR#220 ATTN: N PIVEN
TIGARD, OR 97223 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-234-6564 PHONE:
FAX: 503-238-2098
FEES
Description Date Amount
Specifics: Restricted Energy Permit 09/21/2018 $75.00
12%State Surcharge-Electrical 09/21/2018 $9.00
Type of Use: COM Misc Administration Fee 01/29/2019 $45.00
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: 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 OAR 952-001-0090. You ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ��I<iG� %v2i Permittee Signature: ,ce"L � /� &a751 Ah
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:
12909 SW 68TH PKWY 350, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical Limited Energy ELR2018-00163
Inspection Type: Inspector:
198 Low voltage final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor