Permit CITY OF T I GA R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
411 � DEVELOPMENT SERVICES PERMIT #: ELR1999 -00241
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/15/1999
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD PARCEL: 1S126BC -01506
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: Install protective signaling for entire building.
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: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
PORTLAND OFFICE ASSOCIATES HONEYWELL INC
BY WINDSOR CAPITAL C/O RETS 15495 SW SEQUOIA
BY CUSHMAN + WAKEFIELD OF OREG STE 100
PORTLAND, OR 97201 PORTLAND, OR 97224
Phone: Phone: 968 -3300 ORIGINAL
Reg #: SUP 941 -JLE
LIC 00057824
ELE 26207CLE
FEES Required Inspections
Type By Date Amount Receipt Elect'l Service
PRMT KJP 10/15/199E. $60.00 99- 319103 Elect'l Final
5PCT KJP 10/15/199E $4.80 99- 319103
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 suspendedfor 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 R 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by A 4/Mii,„) Permittee Signature aj
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
RECEIVED
S ...
b 0 . I .
£0 'd 12 1999 0961 86S LOS 617:91 6661 -TO -inr
u..,,..,.,,+ifY DEVEI Iu
CITY OF TIGARD CTED ENERGY ELECTRICAL APPLICATION Recd by:_ 13125 SW HALL BLVD Date Recd:
PRINT OR TYPE 00 AV/
TIGARD OR 97223
F - 503- 598 -1960 INCOMPLETE OR ILLEGIBLE Perms #: L 2 «a 9 -
V - 5Q3- 639 -4 X304 Cust.Call'd:
APPLICATIONS
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL $60 ONLY
Restricted Energy Fee
C C e/' (FOR ALL SYSTEMS)
JOB Street Address Check Type of Work Involved:
ADDRESS 90 . . s ii . i I • • • A'
r mil Phone • El Audio and Stereo Systems
:me •: El Burglar Alarm T : me
- Tram u e D - CO . ❑ Garage Door Opener'
OWNER Mailing Address
it • • SW Gem/ 111 DI ❑ ,Heating, Ventilation and Air Conditioning System*
Cit /State Phone •
IS a • • - • ❑ vacuum Systems"
Name
HONEYWELL ❑ Other
CONTRACTOR ng Address
#100 TYPE OF WORK INVOLV - COMMERCI ONLY
15495 SW W - •r • • • •• ` Fee for each system $60.00
copy o
Phone •
(Prior of issuances P9tylStete 968-3300 (SEE OAR 918 - 260 -260)
f all licenses Portland • : Ex.. Date v
�
are required If Oregon Contr. Brd Lie. • Ex• �� Check Type of Work Involved:
expired in C.O.T. 0
data base). Electrical Contr. tic. • Exp. Date
10 •• El Audio and Stereo Systems
2 6 - 2 0 7
C.O.T. or Metro Lic. E xp. Date • 11 ❑ Boiler Controls
Owner's Name ❑ Clock Systems
OWNER - Mailing Address
El Dala Telecommunication Installation
City/State APPLICANT ® ❑ Phone # Fire Alarm Installation
This permit is issued under OAE 918 -320 -370. This applicant agrees to ❑ HVAC
make only restricted energy Installations (100 volt amps or less) under this •
permit and to do the following: ❑ Instrumentation
1. Only use electrical licensed persons to do installations where required. Intercom and Paging Systems
Certain residential and other transactions are exempt from licensing. El
These have asterisks(7. All others need licensing; ❑ Landscape Irrigation Control*
2 Call for inspections when Installation under this permit are ready for El Medical at 503439-417
3. Purchase thpermits spector is out to l inspect under thisperrnit for an ❑ Nurse Calls
El Outdoor Landscape Lighting'
4. Assume responsibility for assuring that all corrections required by the
Inspector are done, and; tg Protective Signaling
5. Assume responsibility for calling for a final inspection when all of the ❑ Other
corrections are completed.
Permits are non - transferable and non- refundable and expire if work is not Number of Systems
started within 180 days of issuance or if work is suspended for 180 days.
The person signing for this permit must be the applicant or a person
• No licenses are required• Licenses are required for all other installations
aut ed to bind the applicant.
:
-.
ENTER FEES $ 60.00
Signature • SURCHARGE (.05 X TOTAL ABOVE) $ "I' 0
TOTAL
Authority if other than Applicant
...m.,•vrn isvesele.doc 9/98