Permit (9) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
ry
COMMUNITY DEVELOPMENT Permit#: ELR2015-00253
T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 4 Date Issued: 10/22/2015
Parcel: 2S102AB01902
Jurisdiction: Tigard
Site address: 9398 SW TIGARD ST
Project: Black Tie Detail 401720400 Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot:
Project Description: Black Tie Detail 401720400-87407601 11/18/15, REVISED to correct project description to:Low voltage for(1)
security alarm.
Contractor: ADT LLC Owner: ALLRED INDUSTRIAL LLC
7989 SW CIRRUS DR 17902 S HIDDEN LAKE DR
BEAVERTON, OR 97008 OREGON CITY, OR 97045
PHONE: 503-469-7241 PHONE:
FAX: 503-469-7110
FEES
Description Date Amount
Specifics:, Restricted Energy Permit 10/22/2015 $75.00
12%State Surcharge-Electrical 10/22/2015 $9.00
Type of Use: COM Misc Administration Fee 11/18/2015 $45.00
Class of Work: ALT
Total Number of Systems: 1
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 0 Fire Alarm: 0
HVAC: 0 Instrumentation: 0
Intercom/Paging: 0 Landscape/Irrigation: 0
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
Security Alarm: 1 Other: 0 Total $129.00
Other Desc: Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in acc. • • - ith approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATT- ' ION: Oregon requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0 010 through OAR 952-00 009 . ou obtain a copy of the rules or direct questions to OUNC b - = , • or 1.800.332.2344.
Issu-• By: f / Permittee Signature. ,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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
My CITY OF TIGARD j11/18/2015
13125 SW Hall Blvd,Tigard OR 97223 2 16 08PM
503 639 4171
000 Activity Listing 1‘\1(-1
Case #: ELR2015-00253 a.
Project Name Black Tie Detail 401720400
Site Address 9398 SW TIGARD ST
CODE DESCRIPTION DATE DONE DISP DONE BY NOTES
(Descending Order) 1
. -!•
198 Low voltage final 11/04/2015 FAIL Chip Barnett Date. 11/4/2015
Revised permit to adequately describe work done
on-site.
No inspection at this time
Not Ready
CaseActivityShortForm.rpt Page 1 of 1