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Permit CITYOFTIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY �r DEVELOPMENT SERVICES PERMIT #: ELR2000 -00185 ` -�� �! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/10/00 SITE ADDRESS: 12447 SW 69TH AVE PARCEL: 2S101AA- 09100C SUBDIVISION: TIGARD CORPORATE CENTER ZONING: MUE BLOCK: LOT: OOC JURISDICTION: TIG Project Description: protective signaling A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LAN DSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: : HVAC: PROTECTIVE SIGNAL: X INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: Owner: Contractor: RENAISSANCE HOLDING INC. SELECTRON INC 12447 7225 SW BONITA RD SW 69TH AVE TIGARDND, OR 97224 TIGARD, OR 97224 Phone: Phone: 639 -9988 Reg #: LAC 00064341 ELE 26- 497CLE FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT GWL 8/10/00 $60.00 0004393 Elect'I Final 5PCT GWL 8/10/00 $4.80 0004393 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 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. Issued by Permittee Signature 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 " \TY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: MG.; 1 'F3126 SW HALL BLVD Date Rec'd: TIGARD OR 97223 PRINT OR TYPE O V - 503 -639 -4171 X304 R .T ZB0©. 80r7 P ermit #: E. L(Z2m00 - coo /Sy F- 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIOpp Cust.Call'd: WILL NOT BE ACCEPTED 17U i'24 .00 •dto a'G f Name of Development PrpJect TYPE OF WORK INVOLVED - RESIDENTIAL ONLY u�t�/� Restricted Energy Fee $60.00 C)04AC4!J (FOR ALL SYSTEMS) JOB StreelA ddress 54)690 ADDRESS e7 Check Type of Work Involved: C Ci State �Zigtj Pl'e M n�.,� ❑ Audio and Stereo Systems S CS�� ame' ❑ Burglar Alarm V* 1 55a rtc< /1 o) oil , 1H.0 p�G �3 �` ENS OWNER , Mailing Address y / ❑ G arage Door Opener' E� pQM 12, f 6 g\ A ❑ Heating, Ventilation and Air Cor System* 7 C' /State Zip Phone # c 1 �� d e� ✓L ® zy ❑ loam Vacuum Systems* " / ,_ � i ❑ Other 7 I A� %� CONTRACTOR / p �j TYPE OF WORK INVOLVED - COMMERCIAL ONLY (Prior to issuance a C /Sta I� Z}p 7r3 � � Pt j # Q U Fee for each system $60.00 copy of all licenses l•� rI (SEE OAR 918- 260 -260 ) are required if Oseon. r-ontr. Brd LiG.#-/� r/ Check T e of Work Involved: expired in C.O.T. L.c...:• . -'.__ __ _: Cl7L - �/ Qt Type data base). Electrical Con tr. LLlc.. # p. at e 4(D-1i 7 7 &/ /9 11,_ / / aT) ❑ Audio and Stereo Systems C.O.T. or Metro Lic. # V g ate mo z,a O iluv ❑ 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 Imyation 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. • 1 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 authori to bind the applicant. FEES: 66 Si9llature ENTER FEES $ 8% SURCHARGE (.08X TOTAL ABOVE) $ 4 Authority if other than Applicant TOTAL $ (Y r° i:kdstslforms resele.doc 3/98 ZOO f j ONV9IL AO AII0 096T 865 COG %V3 t/0:£T INCA 00 /8Z /L0