Permit ELECTRICAL PERMIT
C OF TIGARD RESTRICTED ENERGY
r � i� DEVELOPMENT SERVICES PERMIT #: ELR2000 -00071
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/6/00
SITE ADDRESS: 11410 SW 68TH PKWY PARCEL: 1S136DA -00101
SUBDIVISION: PERS SITE C RI& ii /j ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
In stallation of data telecommunication system.
Description: y stem.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM &PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATAITELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
OREGON, STATE OF PUBLIC CHRISTENSON ELECTRIC INC
EMPLOYEES' RETIREMENT FUND 111 SW COLUMBIA
11410 SW 68TH PKWY STE 480
TIGARD, OR 97223 PORTLAND, OR 97201
Phone: Phone: 241 -4812
Reg #: LAC 000458
SUP 3289S
PLM 2468S
ELE 26 -34C
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT DEB 4/6/00 $60.00 0001221 Elect'I Final
5PCT DEB 4/6/00 $4.80 0001221
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 -001-0 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct ques'ons to OUNC at (503)
246 -198 . � (
Issued . , �-!-C&AAk Permittee Signature,,yVV, , L /2 SIC0 et
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
fY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
13125 SW HALL BLVD Date Rec'd: 4e - („ ( 0
TIGARI7 OR 97223 PRINT OR TYPE
V - 403-639 -4171 X304 Permit # 0207/
F - 503 - 598 INCOMPLETE OR ILLEGIBLE APPLICATIONS CustCall'd:
JOB:50 - 02409 WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
PERS Restricted Energy Fee.........._._.. _„....,„........„, $60.00
(FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS 11410 SW 68TH PARKWAY Check Type of Work Involved: RECEIVED
T it GARD OR 81 — Phi # ❑ Audio and Stereo Systems
Name .i / UU ❑ Burglar Alarm
APR 6 2000
OWNER Mailing Address ❑ Garage Door Opener* COMMUNITY DEVELOPMENT
City /State I Zip Phone # ❑ Heating, Ventilation and Air Condfloning System*
QUESTIONS? Name ❑ Vacuum Systems*
CONTACT: CHRISTENSON ELECTRIC, INC.,
CARL STENSRUD ❑ Other
CONTRACTOR Mailing Address
111 SW COLUMBIA, SUITE 480 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City/State I - Zip Phone # Fee for each system... .......... ..... .................._ -. $60.00
copy of all licenses PORTLAND OR .H 7 201 241 - 4812 (SEE OAR 918- 260.260)
are required if Oregon Contr. Brd Uc. # gate
expired in C.O.T. 45 id Check Type Of Work Involved:
data base). Eiectnq C Contr. Ue. # 1 � ❑
26 -34 Audio and Stereo Systems
Q Metro Uc. # 1E.
❑ Baler Controls
Owner's Name
OWNER - Mailing Address El Clock Systems
APPLICANT Data Telecommunication Installation
City /State I Tap I Phone* ❑
Fire Alarm Installation
•
This permit la 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; i--t
2. Call for inspections when Installation under this mit ns per are ready for t i Landscape Irrigation Control*
Inspection at 805839 -4175; ❑ Medical
3. Purchase separate pemiits for all installations that are not ready for an
inspection when the inspector is out to inspect under this perml ❑ Nurse Calls
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 nonrefundable 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 permi u the applicant or a person • No licenses are required. Licenses are requhed for all other installations
authorized to b the app lican
FEES:
Si nature 4/4/00
FEES $ 60.
4/4/00
a t )SURCHARGE (XX TOTAL ABOVE) $ 4.80
Authority if other than Applicant TOTAL $ 64.80 /
tldstslformsVesele.doc 3/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
'Date Requested ZW O G AM PM BLD
Location //L /() 5i w� i .t y Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR o 7/
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler ; s
Fire Alarm
Susp'd Ceiling
Roof
F
Final
PASS PART FAIL C■°----
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam -
Rough In
Gas Line
Smoke Dampers
Final
S PA FAIL
( TRlC ( E 6 1. 0 . r E
A
Rough In
UG /Slab
Low Voltage
Fire •
F •, _.
PART FAIL
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 Date ,5 Inspector Ext
Other
Final
PASS PART FAIL 0 NOT REMOVE this inspection record from the job