Permit CITY OF TIGARD
,G x,:�� . � ", r DEVELOPMENT SERVICES ELECTRICAL PERMIT —
,1- 11. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 RESTRICTED ENERGY
PERMIT #: ELR98 -0051
DATE ISSUED: 02/19/98
PARCEL: 1S134BC- 00200
SITE ADDRESS...:12186 SW SCHOLLS FERRY RD
SUBDIVISION ZONING:C —G
BLOCK • LOT • JURISDICTN: TIG
Pro .j ect Description : Add data telecommunication installation to an existing
tenant occpy.
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
PGE type amount by date recpt
YP Y P
1`1 SW SALMON PRMT $ 40.00 GEO 02/19/98 98- 303427
PORTLAND OR 97201 5PCT $ d.00 GEO 02/19/98 98-303427
Phone #: 464 -8000
Contractor:
CHRISTENSON ELECTRIC INC $ 42.00 TOTAL
111 SW COLUMBIA
STE 480 REQUIRED INSPECTIONS
PORTLAND OR 97201 Low Voltage Insp
Phone #: 241 -4812 Elect'l Final
Reg #..: 000004
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 180 days. ATTENTION: Oregon law requires you to follow rule 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 es ' tL m1 C at (5831246 -1987.
Issued by 4_ 71%_-__ Permittee Signature .�
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 j
SIGNATURE OF SUPR. ELEC' N: DATE: /7`9r
LICENSE NO:
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + ++ + + + + + + + + + ++
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
fil
CITY OF CCARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
13125}5 LL BLVD Date Rec'd:
TIGA OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X304 JOB: 509 -5378 Permit #: Et, 0" 00 5/
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
Restricted Energy Fee $40.00
PGE (FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS 12186 SW SCROLLS FERRY RD Check Type of Work Involved:
TIt
Cit ARD /State OR 61224 Phone # ❑ Audio and Stereo Systems
Name ❑ Burglar Alarm
OWNER Mailing Address ❑ Garage Door Opener*
City /State Zip Phone # ❑ Heating, Ventilation and Air Conditioning System'
Name ❑ Vacuum Systems'
CHRISTENSON ELECTRIC, INC. ❑ Other
CONTRACTOR Mailing Address
111 SW COLUMBIA ZZ SUUITE 480 TYPE
Q # TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a ) RaL D OR 3 7�L 01 2 lne4 Fee for each system $40.00
copy of all licenses (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Brd Lic. # Exp. Date
expired in C.O.T. 458 Check Type of Work Involved:
data base). I ct�i al Contr. Lic. # Exp. Date
3C n Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date
❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT Er 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. El 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:
Signature
- ENTER FEES $ 40.
873S 2/12/98 2. .
5% SURCHARGE (.05 X TOTAL ABOVE) $
Authority if other than Applicant TOTAL $ 42.
is \dsts\resele.doc 7/97 —
7p' --
• •
•
• RECEIVED
FEB 17 1998
COMMUNITY DEVELOPMEN t
•
I1
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: - 5 '1 A. M. P.M. MST:
Location: I? p � O __, /l, - /�� / / BUP:
AP
Tenant: alla _AI lirM / ' i rdflor
Suite: Bldg: MEC:
Contractor: $ ��/ 3 / Phone: 9 6 ¥33 PLM:
Owner: _ ( � Phone: ELC
L-/Cryj.-, / /L_.- _. l/ — _ Ali& , /^ / 6 .-- 17/ ELR: Z..-/
%la
SIT:
BUILDING B (con't) •PLUMBING MECHANICAL SITE
Site Post/Beam Post/Beam Post/Beam Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
/
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump 'w 9 // /14 a-
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL ( INA) FINAL
•
1 10 1 / — �Q'SS
1
.......„.._.'
O Call for reinspection 1/ 4 next einspection fee of $ required before xt inspection O Unable to inspect
Inspector: G�r�'' ) Date: C/ ? — 0 ?g-- Page of