Permit A CITY OF TIGARD
^^ �
DEVELOPMENT SERVICES RESTRICTED ENERGY Hall Blvd., Tigard,
PERMIT #: ELR97 -0368
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�I-) DATE ISSUED: 12/30/97
PARCEL: 2S101DA -00101
SITE ADDRESS... :13190 SW 68TH PKWY
SUBDIVISION :TRIANGLE CORPORATE PARK ZONING:C —P
BLOCK • LOT •003 JURISDICTN: TIG
Project De scr i pt ion : University of Phoenix
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM • BOILER • LANDSCAPE/ IRRI GAT. .:
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: FEES
GERDING /EDLEN DEVELOPMENT type amount by date recpt
4650 SW MACADAM AVE PRMT $ 40.00 JSD 12/26/97 97- 302060
STE 200 5PCT $ 2.00 JSD 12/26/97 97- 302060
PORTLAND OR 97201
Phone #: 299 -6000
Contractor:
LUCENT TECHNOLOGIES $ 42.00 TOTAL
283 KING GEORGE RD ROOM C2A31
REQUIRED INSPECTIONS
WARREN NJ 07059 Ceiling Cover Low Voltage Insp
Phone #: 331 -5700 Wall Cover Elect'1 Final
Reg #.. : 119107
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 1: ". days. ATTENTION: Oregon law requires you to follow rule adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0014810 through OAR 952-001 'o may obtain copies of
these rules or dire;:uestions to OUNC at (583)246 -1987.
Issued by � / / ��✓ Permittee Signature '�1�
l
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: /2- . 97
LICENSE NO:
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + ++ + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
1312 SW OALL BLVD Date Rec'd:
TIGARD OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #: �� ` - 01 (O
F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
(NW, D h 1 \ cs i ') � Restricted Energy Fee $40.00
`- K v (FOR ALL SYSTEMS)
JOB Street Address Q'� n�/ Ste #
ADDRESS 13110 3 JJ cO o f ^w ii 130 Check Type of Work Involved:
fty/S
� isAra a Zip Phone # ❑ Audio and Stereo Systems
j _ q7 2 3 _
Name ❑ Burglar Alarm
OWNER Mailing Address ❑ Garage Door Opener*
City /State Zip I Phone # ❑ Heating, Ventilation and Air Conditioning System*
Name ❑ Vacuum Systems*
� ticeST 76C(r}/qO L-0616 S ❑ Other
CONTRACTOR Mailing Addr
'j SZS N 4M4.A -5 SA9 otL PL. TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a ty/State Zip Phone # Fee for each system $40.00
copy of all licenses rt. &i &41J 0 97)--_ -V (SEE OAR 918 - 260 -260)
are required if -4 Oregon Contr. Brd Lic. # Exp. Date
expired in C.O.T. Check Type of Work Involved:
data base). Electric l Contr. Lic. # Exp. Date
acf ,,,� ❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date
❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT Data Telecommunication Installation
City /State Zip Phone # ❑
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. Call for inspections when installation under this permit are ready for
inspection at 503 - 639 -4175; ❑ 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 permit must be the applicant or a person • No licenses are required. Licenses are required for all other installations
authorized to bind the applicant.
FEES:
•
. ENTER FEES $
Signature
5% SURCHARGE (.05 X TOTAL ABOVE) $
Authority if other than Applicant TOTAL $
i:\dsts \resele.doc 7/97 —
8/19/99 Activities for Case #: ELR97 -00368
2:24:29 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRC001 Application Received 12/26/97 JSD PASS JSD 12/26/97
ELRC003 Permit Created 12/26/97 JSD PASS JSD 12/26/97
ELRC725 Low Voltage Inspection 1/15/98 BRP PASS J'H 1/16/98
ELRC799 Elect'I Final 1/15/98 BRP PASS B•P 1/15/98
ELRC400 (F) Ready to issue 12/26/97 JSD PASS JSD 12/26/97 Must have current CCB first!
ELRC500 (F) Issue permit 12/30/97 GEO PASS DST 12/30/97
ELRC800 Case finaled 1/16/98 BRP PASS J *H 1/16/98
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