Permit ' CITYOFTIGARD ELECTRICAL PERMIT -
` RESTRICTED ENERGY
� DEVELOPMENT SERVICES PERMIT #: ELR2001 -00051
13125 SW Hall Blvd., Tigar OR 97223 (503) 639 -4171 DATE ISSUED: 2/26/01
SITE ADDRESS: 12615 SW 72ND AVE PARCEL: 2S101AC -01900
SUBDIVISION: LOWE'S HIW, INC ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Proiect Description: Cables to racks = one phone line, one fiber line, one speaker, one point -of -sales
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: : X
TOTAL # OF SYSTEMS: 4
Owner: Contractor:
LOWE'S HIW, INC DATATEC INDUSTRIES, INC.
HWY 268 EAST 37453 SOLSO DR
NORTH WILKESBORO, NC 28659 SANDY, OR 97055
Phone: 336 - 658 -7519 Phone: 503 - 826 -8745
Reg #: LIC 146022
ELE 3- 499CLE
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 2/26/01 $300.00 2720010000 Wall Cover
5PCT CTR 2/26/01 $24.00 2720010000
Total $324.00
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. _ _ 1
Issued by Permittee Signature
_ ez e lf0 / (zz . 22
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. ELECN: DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Relived: 05.Feb.01 01:55 PM From: 5035981960 To: 5093565495 Powered by dFax.com Page: 1 of 2
02/05/01 MON 12:44 FAX 503 598 1960 CITY OF TIGARD a 001
At■ . , . , .
ElecMcal Pormit4lpplication
Date received: Allg o Permit no. ' ,.O7 -
Ta ` City of Tigard PtojectlappLno.: Expire date:
City of regard Address: 13125 SW Hall Blvd, Tigan:, OR 97223 Date issued: By: Receiptuo.:
Phone: (503) 6394171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
01 & 2 family dwelling or accessory ;f4CotumerclaUndustliat O Multi - family O Tenant improvement -
0 New construction 0 Additioi/alteration/replacemedt 0 Other. 0 Partial
Job address: / g / ,S ," Z ? A Bldg. no.: • Suite no.: Tax mapftax lotlaccount no.:
Lot j Block: Subdivision: •
Project name: Lp[..tJeS ,i //0 .ie I Deacripion and location of work on :'•' . G /J . -;--0 /2£.° _ T / a ' .6E
Estimated date of cam • • • ■ - - .on: • — � ' / _ %- V a - /
1 ' S (:HLL/I: : LE
Job no /10 Fee Ma
Business name: D42' %E[ //!.,/1t s? /i ( � Qty. W.) Total sa hasp
Newreddentief -segIe waltiandly p per
Addmss: 3 7 9S' 3 5g /So ia/2 tilte llitgazdt.ktiadesattaebedgwaee. '
5.,94</,/ • l _ Q�. �'i 7C��S 9�iee
$2.6- 87 y� 1000 sq. ft. orless 4
CCB nos / 460 7_7_ J Elec. bus. lie. ao y ' C f additimi portion thereof 2
Ll City/ iic no.: CC/Z t iarited : neoteaitlta#ial , 2
.E__Zedir Pachmanafammedboomer modular dwelling
S ofsupetvisiag deoticion (requited) Dale Service; and/or feeder 2
Services orfeedem— )moo
Sup.etect name( print): Liebss alteration oreeteeadom • 200 maps or boa 2
Name (l t ). 20t amps to 400 amps 2
address: 401 amps to 600 snaps 2
Mailing .— 601 amps to 1000 amiss 2
City: I state: rim Ova 1000 amiss or volts • 2
Phone: , [E-mail: ,, Recommit only 1
Owner installation: The installation is being made on mperty 1 own Temporary eavlaattrteedas
which is not intended for sale, lease, rent, or eachang't according to t o,allerodsa,orreloeatiam
ORS 447. 455, 479, 670.701. 201 amps ce� 2
201 arms to 400 maps 2
Owner's $ I : _ f __ ____ Date: 401ta600a� , 2
_ C;IiN1 - Branch -oeW 1Resallou,
0 orextandoo per pant&
Name: A. Pee forMinch cheeks with purchase of
Acmes: service or Feeder fee, each branch errant 2
City: State: 23P B. Fee for branch circuits without purchase •
P%One: Ai Fax: E -mail: - ofseivies or feeder fee, firebrands clam t: 2
Each additional broncheuad
1'1 1( 1A ' 1I V (1'k ',c tIliAlc. Al tLa' �(Sesfbeeorfeedereat
O Service over 225amps- commddal 01leahh-caref. ire ., 13ach pump or irrigation chyle 2
O Service over 320areps atingof 1&2 0 Hazarddaatocatior Each sign or outline lightbm 2
familydweainge Q Building ova Jg0 squats feet equror Signal pm(s) uratimioed energy panel. lj
0 $ystemover600vaitsnominal more otialu tits in one snucaue alteration. or extension* 4 7 s P 2
o Stains am bamstories 0 Feeders. 400 amp; ormom •nesai
0 O c i m p m t toad over99 mama 0 blenafeeterod sanctum or K V p a r k E a t , addidoeud i m s p e d l l a e over the allowable la aaayat above!
0 B13105tAilihdaBPtau 0 Odra: Per inspection 1 l 1 1
Sett _sent of plans edth any ofthe Awe. Investigation fee
The above ate het applicable to temporary eoasoudieu LOther
Not di accept coedit coda, please call jars e ter m bderu Notice: This permit application Permit fee $ 30 0
0 Visa Q MasterCard expires if a permit is not obtained" Plan review (at — %) $
Credit card =Oa: .1__ within 190 days after it has been State surcharge (8%) .... $ __..__
accepted= complete. TOTAL $ - '� o +o
- Hmmeor cardholder as dorm on cretin card
S
Cmtibalder dares= Amos 4444615 (6100000M)