Permit CITY O F TIGARD ELECTRICAL PERMIT -
• RESTRICTED ENERGY
,1I DEVELOPMENT H B I MEN � T r S OR R 972 2 3 , (116�� -/� DATE PERMIT ELR1999-00128
21/99
SITE ADDRESS: 09845 SW WALNUT PL PARCEL: 2S102BD -01600
SUBDIVISION: FREWINGS ORCHARD TRACT ZONING: R -12
BLOCK: LOT: D -I JURISDICTION: TIG
Project Description: Installation of data telecommunications system. Job No. 50 -01080
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:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
TIGARD COMMUNITY METHODIST CHU CHRISTENSON ELECTRIC INC
9845 SW WALNUT PL 111 SW COLUMBIA
TIGARD, OR 97223 STE 480
PORTLAND, OR 97201
Phone: Phone: 241 -4812
Reg #: LIC 000458
SUP 3289S
PLM 2468S
ELE 26-34C
FEES Required Inspections
Type By Date Amount Receipt Elect'l Final Low L
PRMT DRA 5/21/99 $40.00 99- 315589
•
5PCT DRA 5/21/99 $2.00 99- 315589
Total $42.00
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 gon • • Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may
obt . n copies of thes rules or direct questions to OUNC at (503) 246 -1987.
1
Is ued by n 1,0.i L r4 „Aid d Permittee Signature I, 1 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
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION t I Rec'di�
1,3-1.25 SPIV HALL BLVD �j1/A Date Rec'd: 6 -- tg
TIGARD OR 97223 PRINT OR TYP �'p Aj CeAv�� n�
V - 503 - 639 -4171 X304 � Permit #(f--64/99q ""(901.911? F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS , Cust.Call'd:
_J0, 150 =)1080 WILL NOT BE ACCEPTED @���( 7' `` u�
`Nam S IT
Development Project TYPE OF WORK INVe ,'RESIDENTIAL ONLY
Restricted En $40.00
TIGARD UNITED METHODIST CHURCH (FOR ALL S S)
JOB Street Address Ste #
ADDRESS 9845 SW WALNUT PLACE Check Type of Work Involved:
City /State Zip Phone # ❑ Audio and Stereo Systems
TIGARD 97223 295 - 2727
Name ❑ Burglar Alarm
TIGARD UNITED METHODIST CHURCH ❑
OWNER Mailing Address Garage Door Opener*
City /State Zip Phone # ❑ Heating, Ventilation and Air Conditioning System*
QUESTIONS? Name
Li
Systems`
CONTACT:LUKE CHRISTENSON ELECTRIC, INC. ❑ Other
CONTRACTOR Mailing Address
111 SW COLUMBIA, SUITE 480 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /State Zip Phone # Fee for each system $40.00
copy of all licenses PORTLAND, OR 97201 241 -4812 (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Brd Lic. # Exp. Date
expired in C.O.T. 458 5/1/03 Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp
26 - 34C 10/99 ❑ Audio and Stereo Systems
C.O T. or Metro Lic. # Exp
5246 i // yy ❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT Eb Data Telecommunication Installation
City /State I 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;
2. Call for inspections when installation under this permit are ready for
❑ Landscape Irrigation Control*
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.
—C-12----------' J FEES:
�, �� �� ENTER FEES $ 40.
gignature r
5% SURCHARGE (.05 X TOTAL ABOVE) $ 2.
Authority if other than Applicant TOTAL $ 42.
r\dsts\resele doc 7/97 —