Permit ELECTRICAL PERMIT -
CITY TIGARD RESTRICTED ENERGY
y lj J DEVELOPMENT SERVICES PERMIT #: ELR2000 -00149
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 06/14/2000
SITE ADDRESS: 15895 SW 72ND AVE BLDG -B #120 PARCEL: 2S112DC -00500
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: 040 JURISDICTION: TIG
Project Description: install a sound masking system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: SOUND MASK X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES CANNON COMMUNICATIONS
15350 SW SEQUOIA PKWY #300 -WMI STD INC
PORTLAND, OR 97224 3525 SE 17TH AVE
PORTLAND, OR 97202
Phone: Phone: 503 - 232 -0866 EXPIRED
Reg #: ELE 3- 411CLE
LIC 116725
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT GEO 06/14/200C $60.00 0002967 Elect'I Final
5PCT GEO 06/14/200C $4.80 0002967
Total $64.80 ORIGINAL
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. ATTEN 1 N: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those N. r= ;re s-- ' OAR
952 - 001 -0010 through OAR 952 - 001 -008 • You may obtain copies of these rule • • - • .: rh • • • ' ? a / 3)
246 -1987.
/09 Ay-
Issued by / Permittee Signatu _
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: /j DATE: %'
LICENSE NO:
CaII 639 -4175 by 7:00 P.M. for an inspection needed the next business day
06/14/00 WED 10:05 FAX 503 598 1960 CITY OF TIGARD 41002
—CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
•• 13125 SW HALL BLVD Date Recd:
TIGARD OR 97223 PRINT OR TYPE
V - 503 - 6394171 X304 Permit 4: fA>CROGb —6 0 /4T
F - 503 - 598-1980 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
1 Vol L GSret G AM Restricted Energy Fee 560.00
(FOR ALL SYSTEMS)
JOB Street Address Ste*
ADDRESS 1 5 y5 _SW iz 'sr 1 2 O Check Type of Work Involved:
Zip Phone # ❑ Audio and Stereo Systems
T L)
l& y O 'Y 7 Z?,S
Name ❑ Burglar Alarm
V oitcsr2ca , •‘
OWNER Mailing Address
ED Garage Door Dinner'
/ 0 7 2 S 5,4 8p, R 6,A Bi-JO ❑ Heating, Ventilation and Air Conditioning System'
ela Zip P h one A
Pr,r- City /St ?t.nrrp vR, [ 9 ? C1 I ❑
Name 5 7? pa C., Vacuum Systems'
C ANOD4 Cof , Nrn uMILAT * 104j ❑ Other
CONTRACTOR Mailing Address
3 5 2 5 56 / r..° A /G TYPE OF WORK INVOLVED • COMMERCIAL ONLY
(Prior to Issuance a City /State Ip Phone # Fee for each system 560.00
copy of all licenses Qp2TLAd 0 0a jJ2.02 232•4 fl6‘ (SEE OAR 918- 260 -260)
are required if Oregon Contr. Brit Lic. # F�c p.�ate
expired in C.O.T. k67 Z 5 55/19! Ov Check Type of Work Involved:
data base). Electrical Contr. Lic. # Ex to
3 — j /r C (.-E _ jo/c Ioo 4 E Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. to
❑ Boller Controls
Owners Name
OWNER - Mailing Address ❑ Clock Systems
APPLICANT ❑ Data Telecommunication Installation
City /State 12ip I Phone # Fire Alarm Installation
I E]
This permit is issued under OAE 918. 320-370. This applicant agrees to
make only restricted energy Installations (100 volt amps or lass) under this ❑ HVAC 4
permit and to do the following: ❑
Instrumentation
1. Only use electrical licensed persons to do installations where required. ` l
Certain residential and other transactions are exegtgtlrom licensing. ❑ Intercom and Paging Sys `� '
These have asterisks(). At others need licensing;
2. Call for inspections when Installation under this permit are ready for ❑ Landscape Irrigation Control*
Inspection at 603639.4176; ❑
Medical
3. Purchase separate permits for all installations that ere not ready for an Nurse Cats
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. loll Other - l7 VI 0 JA 5t : IA) 6—
Permits are non - transferable and non - refundable and expire If work is not '"'C
started within 180 days of Issuance or if work is suspended for 180 days. I Number of Systems
The person signing for this permit must be the applicant or e person • No licenses are required. Licenses are required for ail other installations
authorized to palicaM.
� FEE$:
ENTER FEES $
6°‘
Sign a r1
890 SURCHARGE (.08X TOTAL ABOVE) 5 . 7 r 80
Authority if other than Applicant TOTAL $ C i l r iS 0
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