10200 SW GREENBURG ROAD STE 212 0
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_10200 S'V GREENBURG RD. , STE 212_.
CITY QF TIGARD
DEVELOPMENT SERVICES
ELECTRICAL PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 -
RESTRICTED ENERGY
PERMIT #: El_R96-033O
DATE ISSUED: 11/O1/96
PARCEL: 1S.35AB-007011,
SITE ADDRESS. . . : 10200 SW GREENBURG RD #21c'
SUBDIVISION. . . . : TOWN OF METZGER ZONING:C-P
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .*7
Project Description: installation of of data telecommunication.
A. RESIDENTIAL----------- B.
AUDIO & S FEREO. . . : AUDIO & STEREO. . : INTERCOM & PAGING. . :
BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. . :
GARAGE: OPENER. . . . . CLOCK. . . . . . . . . . . . MEDICAL. . . . . . . . . . . . .
HVAC. . . . . . . . . . . . . : DATA/TELE r,OMM. . : X NURSE CALLS. . . . . . . .
VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR LANDSC LITE:
OTHER: : : HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . :
T NSTRUMEN TAT I ON. : OTHER. . : . .
TOTAL # OF SYSTEMS: 1
Owner,: ----------------------------------------------------------- FEES
MELVIN MARK BROKERAGE CO type amount by date recpt
10220 SW GREENBURG RD PRMT t 40. 00 DRA 10/24/96 96-285S8,21
SUITE 150 SPCT $ 2. 00 DRA 10/24/96 96-2851;83
PORTLAND OR 97223
Phone #:
Contractors ----_-_--___.--_-.,.____________________________________________...------__._
AL & I..- TELEPHONE SERVICE $ 42. 00 TOTAL_
61.7 NW 4TH AVE
--------- REQUIRED INSPECTIONS
-- - -- --
ONTARIO OR 97914 Ceiling Cover Elect' l Final
Phone #: 541-889-3030 Wall Cover- _
hterg it. . : OO7416
This permit is issued subTect to thp regulations contained in the
Titard Municipal Code, State of Ore. Specialty Codes and all other jermit� ';,gnat _ire
applicable laws. R11 wo-* will be done in accordance with
approved plans. This permit will expire if work is not started
within 188 days of issuance, or if work is suspended for more
than 188 days. Issueyl "By
INSTAL_LA1 I NLY_._.._______._.___..__.___.___..._._.___._.__._._
The installation is being made on property I own which is not intended for
',ale, lease; or rent.
OWNER' S SIGNATURE: —a � DATE �-
_________.__.___.
---CONTRACTOR INSTALLATION
SIGNATURE OF SUPR. ELEC' N: DATE s
LICENSE NO:
Call. for- inspection -- 639-4175
10 04 913 (19 (111 $503 1384 7297 CITY GIF TIC;ARID iQo02 0o2
Community Development RESTRICTED ENERGY ELECTRICAL APPUCATION
13125 SW H&1 Blvd
Tigard, OR 47223 PFRMIT# i -
Phone(503)639.4171
FAX (503)684.7297 DATE ISSUED _______�__� ___--
TOD No (503)684-2772
CITY OF TIGARD Inspection (503)6.34-4175 ISSUED BY
PLL.45F C(-)h4PI..FTF At! Sty TIONS
1. LOCATION OF INSTAItAIJOA r7 1 4. TYPE OI-WORK
J-Sd Green U_U 9, F �/�e -2/.L
Address U AEs1DFNTIAI —Restricted Enemy Fee . . . . . . . . . ion
(FOR ALL SYSTEMS)
cit state zip1>>tm1M-
PERMITS ARE NON.i RANSF(MBtI ANL)NON-R(FUNOARIE ANC)EXPIRE IF WOO, ❑ Audio and Stereo Systems
IS NOT STARTED WITHIN IF30 Din of t55UANCE OR IF W(�0.K IS SUSP[NpEO rOR
1 WuArs ❑ Burglar Alarm
2. CONTRACTOR APPLICATION U Garage poor Opener'
_ U Heating,ventilation and Air conditioning System'
Contractor �ljd&.�ru04ype e3{ohs ❑ vacuum Systems*
Address / 7 �jp 471/1 / U other— - --- -- - - --- -�
�2.1X --- - -tv-o_
D.w COMMFRCIAt- EF for c918-260 ee2 . . . . . . . 140-00
SOAR 601
Property Owner /- _ Cherh T�of k Involved:
Contractor's Board Reg No. __12h?�Lf�'. k I! �_ ❑ Audln and Stereo Systems
❑ Boller Cuntruls
Phone # , _�� frY9 3G�0 _ ❑�( Clock Sysiems
Jbl- Data Telecummunicabun Installations
3. OWNER APPMATION
0 Fire Alarm Installation
❑ FIVAC
— �� —
Print Owner's Name Phone No U Instrumentation
❑ Intercom and Paging Systems
Address
11 Landscape litigation Control*
City State lip rl Medical
Thn perms rs issued under OAR 918 32U.370.Thn&ppb ant agrees to make ooh' t 1 Nurse Calls
ressncied energy mstallaorim 0go volt amps or Ind under this per•nII and m do the ❑ Outdoor landscape Lighting'
leae..1Mg
❑ Protective Signaling
t only use ekctncal hrrnsed persons to do installations where requlred ICenasn t'�
residentialb
and ober tronsacvons are exempt FromhcensinR TI,W hove LJ other
ailitim st'I All others need hcensinR!
2 [:all for an initomion when all of the installations under this permit are ready
tar inspecvon at 501.639.4175 ❑ Number of Systems
1 Purchasr separate permin im all Inwtllaunns that are not ready for inspection
whc n the inswior is out In imt-iert under thil permit. •No bearsaes ah►aqulnd Liess am Isq., Im an attar wen allo na.
4 Amume responsibility for assuring that all cotrKtlons required by the inspecttx --are done,and
5 Assume responsibility foo galling fnr a final rtnper uon when all of the S. FEES
cortecuons are completed
The person signing for this permit must be the applicant or a person a. Enter Fees
authorized to hind the applicant.
b. 5%Surcharge(.05 x total above) 0-0
signatCar
TOTAI
ority if'other than applicant
FNERCAPCHP