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10260 SW GREENHURG
ELECTRICAL -
�\ CITY OF TIGARD RE.STRIC EDENERIGY
DEVELOPMENT SERVICES � PERMIT#: ELR2000-00265
13125 SW Hall Blvd., Tiqard. OR 97223 (503) 639-4171 DATE ISSUED 11/6/00
SITE ADDRESS: 10220 SW GREFNBURG RD PARCEL: 1S135AB-01002
SUBDIVISION: THREE LINCOLN-TOWN OF METZGER ZONING: R-12
BLOCK: LOT: 009 JURISDICTION: TIG
Proiect Description: Installation of telco equipmen! in telco closets on each floor. Located in building - Three Lincoln.
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:
KNICKERBOCKER PROP, INC XXIV DAY WIRELESS SYSTEMS
B' NORRIS, BEG,GS + SIMPSON 234 NW 14TH
10300 SW GREENBURG RD STE 200 PORTLAND, OR 97209
PORTLAND, OR 97223
Phone: Phone: 503..228-9292
Reg#: ELE 3.356CLE
LIG 94950
FEES __ _ Required Inspections
Type By _ Date_ Amount Receipt _ Low Voltage Inspection
PRMT CTR 11/6/00 $75.00 2720000000 Elect'I Final
5PCT CTR 11/6/00 $6.00 2720000000
Total $81.00 —
This Permit is issued subject to the regulations contained in the Tigard Municipal Coda, 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 Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-W80. You may obtain copies of these rules or direct questions to OUNC at (503)
246-199�
Issued b'y (� Permitter? Signature ,
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale. lease, or rant. `
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
ti VA )U.5 7Nd 1 iptjU l.i l r lot' t l(aNKU
vy VUs
Electrelad Permit Application
-
City of Tigard Projecdtppl.rw. -y p� he r
('11yn/7YgeYnj address: 13125 SW I[fill Blvd, 'riygtrd,OR 97221 _._-_--___- --
Ph,,tle: (5173) 639-4171 Dateirsued:
rex: (503) 598-1960 Case Me no.: Payment type: -�
Land use approval:
U t Rr 2 family dwel[ipp or actx:vsory Qi C'ommr tiaVlncluslrifil U hfulti-ram))y U'1'nraont impmaernent
U New constnictiove U Adrlifirndttlleration/reph,cement OOther. _._ J Pnrtinl
lob nddtrale: rj BW .no.: 9Wto no.: 7'ax tnepitaa lotfeccount no.:
Lott: Block: Sulxlivi'-qlo - ----
-'sn:
project name: l_;
i� Desctipl iun and location of work on premises:
Fetimated date of con letimilin>; cation xr, 'Allot o` ;t-N TRA `o
Job toot
Business name: _ na.n lttn
rs l fio.Ira
Address- 7.,;,i_ , �.y�Merutcr Tota
C - awaltlrt�radt•Ian inelr+r�Marlrrd tt>Maae.
Statu:aQ. za
city: ZIP:
Phone: ,L flax: tag- B rtall#'A too)hfij.n.artera 4
CCB no.. 6,� � Bite.bus.lir.no: rine li'VA3ooi. or andlsreot' -`
-____-__,3-X35 �
Cit /metro lic.no.: Li,nitedem
eny,re0derti 2
Un*dt"anew,nun-residential - 2
tbaer�tnfio; turedho'nenrmalufardwellinv -
Sl �t eupervhity eleatrklsn ulred�u 111W x - flervioo and/or feakr 2
Sup.elrxt.nstrte nQ: l ice nx rm �~ tierrkesurfeesore-Ieatatlatlon, -
•Itereflon or r*loea low..
200 fir Irbs_ 2
Natttc ul): S A c y r Q 201.air"to 400 sunpe-_ 2
S_,�_ _ __� 401 to fi00 r 2
Mailing address: t, c�a�.n _
1H-1 am to 1000 am 2
City: Stale: ZIP: } �----� - -
Q a r!v _ 7 Over 11100!:mm o alto
fyttotle; _ - c Pex: q�, mail: �, tf% ionq t
Owner installatimr the insist Winn is being made on rmpr,rty 1 lklz1 L"oTana}orerysertkatorfaaaen•�
which is not intended for Rala,lease,rent,nr exchange according In irrmr64rMen,af(rrsrMsr.rtrrrt/ocsttloa
OPS 447,455,474,670, 101. 200 mvp or tees 2
201 to 406-m"
0 wpa 2
Owner's signature: Uatns: Am toIMM-Pi - - 2
t►nsreh rirrsdtr-tall►,• ,
PIatne: •r asieerloe per parrarL
A. Fee for branch circuits with f+urrhsse of
AddtsiR: service or%ZSder fee.each branch circuit 2
C'it 6 re;,rnr branch caret lu without paretz -�
of service a fecda
�- Fax: B-Ir>ttli: fbc tint branchdreult: 2
Ewew1 Jana[ troch tircuet
Q•( et�t sw1INC11601151�
U Service pvm 223 anpa-mo rre'•ai 4 Neailtb csrofanUlty RachptoW m irrigoloa tittle 2
O Servien ower 320 ampe-mint of 1 Q2 3 Ha wdoae lotned"n t3ecb alp or oudins n irdo - - -- -2
%mll dwellln a --�--�_— ---- - ------.--
Y i URaIMIrn�nverlO,Ilt:Oegnatrhrtfoutex Vltna rcull(s)txelirr,It1.dnnertyPa^�•
U.iynern over 600 volts noadaal rmne residetriisf units in one stract im alrnstinn,ter extension• 2
O Ruildint ova daea atcrris U Feeders,400 rips„r more •t� ---- --.--- ----
U(kcupent lad oover"pennns U martofacivrtd Rune girls rte av park n��n
j*Q : UnomM ever iM si9ewaMe aro if.
erg.
-:l ptt"oWlitllnpplen U Odra- _ Per lr.a tion -`-'
fctrMrtt --orts etaasa•rhh ---- --� - - - --_ - t-
N aaT of t!♦e nlrorr.
I be above fits[fiat tglpllerlbie 1•tetapetw�rotosttattlo>,seirlce. Other
,tor Ol IQ Wit Kexpt ardt tarda,viem tilt larfsdictlon for oars lcdar anion. Notit t:This permit applicatlon Permit fee.....................S ---
U vara U massert find expires If a pe mk is not tftined Pian review(at _„ %) $ -
rrwdlt card narrtbrr -_ _ within ISO dart anet it Iles been State surcharge(9%).-S
r
s� accepted#a ectnplete. 'TOTAL ................. .....S g4 Ism
ea Mem-"'
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