Permit , � CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
IN COMMUNITY DEVELOPMENT Permit #: ELR2010 00088
T j G'ARL) 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 05/18/2010
o'r. Parcel: 2S112DA00700
Jurisdiction: Tigard
Site address: 15333 SW SEQUOIA PKWY, STE# 100
Subdivision: PACIFIC CORP CENTER Lot: 0
Project: Coca Cola
Project Description: Installing access control system
FEES
Owner:
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Restricted Energy Permit 05/18/2010 $67.84
PORTLAND, OR 97224 12% State Surcharge - Electrical 05/18/2010 $8.14
PHONE: 503- 624 -6300
Contractor:
SECURITY SIGNAL DEVICES INC
1740 N LEMON ST
ANAHEIM, CA 92801
PHONE: 800- 888 -0444
FAX: 714- 449 -9595
Type of Use: COM
Class of Work: ALT
Total Number of Systems:
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: N
HVAC: N Instrumentation: N Total $75.98
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N Required Items and Reports (Conditions)
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: Y
Other Desc:
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 wit 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 -0100. You may obt - ' - - copy of the les or direct questions to OUNC by calling 503.246.6699 1.800.33
Issued By <<-...--L:! _ / _ '%% Permittee Signature:
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.
CaII 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
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Mab 18 2010 11:33AM p.2
Etectricatpert Apoication - city of Tigard
Page 2 _ Su'" sh buformatiop
LOOTED a c pER�+�a►+ i . • s: • •
Row J ++ wORK ONLY;
Fee for altsesideod41 eyste AS p d._ ., .. $6.8.4
Meek Type of Iltruils Iavolved;
,uaio:and Stereo sys: .I
0 Dow ()Pence
Q v msue
COMMERCIAL V t Y
Fee totem& comMercial $67.84
;system. ,.,..,...� •-
(SEE OAR 918-5
rOhtick Type ai`Woi7S
❑ Audio and Steteu :Systeins
❑ Bonier conu4s
ood S
O Data Telecoirunication installation
❑ Fite Alartniinstallanon
0tIVAC
Q rnatramentation
[ � I n t e r c o a n d ng Systems
[a. Landscape Irrigation G?ntttnl*
[]' Mew
�} Nurse Calls
[] Outdoor: Landscape Lighting*
• Protective Signaling
• Ober kn /Acgra C;canD
Total number of commercial systems: ---
*sl io licemses a:re respired. Licensee toe required
for a►11 other iastalations