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Permit (111) CITY OFTIGARD A DEVELOPMENT 6 SERVICES ELECTRICAL PERMIT - - 13125 SW Hall Blvd., Tigard, OR 97223 (503) RESTRICTED ENERGY PERMIT #: ELR98 -0136 DATE ISSUED: 05/14/98 PARCEL: 25115BA -00101 SITE ADDRESS...:162O0 SW PACIFIC HWY #0 SUBDIVISION • ZONING:C -G BLOCK • LOT • JURISDICTN: TIG Project Description : Tenant modification - Protective signaling. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..: BURGLAR ALARM • BOILER • LANDSCAPE/ I RRIGAT.. : 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: 1 Owner: FEES KITS CAMERA type amount by date recpt 16200 SW PACIFIC HWY PRMT $ 40.00 DLH 05/14/98 98- 305749 SUITE 0 SPCT $ 2.00 DLH 05/14/98 98- 305749 TIGARD OR 97224 Phone #: Contractor: HONEYWELL INC $ 42.00 TOTAL 15495 SW SEQUOIA STE 100 REQUIRED INSPECTIONS PORTLAND OR 97224 Ceiling Cover Low Voltage Insp Phone #: 968 -3333 Wall Cover Elect'1 Final Reg #..: 000578 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 rule adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503)246 -1987. Issued by �G�j-4- <____. Perm i t t e e Signature / 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 S I GNATURE OF SUPR. ELEC' N : 1 ✓ /15 DATE: -91/9 cfl LICENSE NO: +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ - - - - - - - - - - - - - - - - - - a - - - - - - - - - - - - - - - CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: ,b c.h/ 13425 SW HALL BLVD RECEIVE'., Date Rec'd: s7/ y9p TIGARD OR 97223 PRINT OR TYPE V - 503 - 639 -4171 X304 pyy 19c ` Permit #: EL2 9f d/3 ro F - 503 -684 -7297 ' -INCOMPLETE OR ILLEGIBLE APPLICA +1vNS - Cust.Cail d: ;WILL,NOT BE ACCEPTED _ g p � ' , r Name of Development Project 1034 TYPE O �WVR - RESIDENTIAL iJ �// Restricted Energy Fee $40.00 Ki fs C.aMe-n?, nn Jh1c 7he/Lo (FOR ALL SYSTEMS) JOB Street Address Ste # ADDRESS O City /State / Zip Check Type of Work Involved: Avg Phone # ❑ Audio and Stereo Systems % [ a.r'� ' Ok 97,224/ 97,224/ _Nar$e - Stor0 0103 ❑ Burglar Alarm K l / 1 S (:7mer'Ct_i ()h•c t to fl'holo ❑ Garage Door Opener* OWNER Mailing Address -� . Sa.,0 w a.00" S t,1 r"ac4(.r, A{Gr� Heating, Ventilation and Air Conditioning System* T-Ci /State OR / , Phone # El O' ` `7 4 - ❑ Vacuum Systems* Honetibielb ❑ Other CONTRACTOR Mailing Addres 154'93 S ii..) Se$aoia #' 100 TYPE OF WORK INVOLVED - COMMERCIAL (Prior to issuance a t4' /St to Zip JPhone # Fee for each system $40.00 copy of all licenses pc f /Q„ (t _ 97.2. y 965' 00 (SEE OAR 918 - 260 -260) are required if Oregon Contr.43rd Lic. # Exp. Date p0 expired in C.O.T. ©S7 g .29 / -2 7- 94' 1 12 9 /Check Type of Work Involved: data base). Electrical Contr. Lic. # Exp. Date ✓ /0 '. ?07CLE / 0 - / - 9 5�' ❑ Audio and Stereo Systems C.O.T. or Metro Lic. # Exp. Date (,p 0 7 5 1--/-y7 ❑ Boiler Controls Owner's Name ❑ Clock Systems OWNER - Mailing Address APPLICANT ❑ Data Telecommunication Installation City/State 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; ❑ Landscape Irrigation Control' 2. Call for inspections when installation under this permit are ready for 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 I started within 180 days of issuance or if work is suspended for 180 days. 1 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. FEES: / l �/ 1 si 1/4..._ �/Yt /!Pit. / C ENTER FEES $ • 0 Sig atu �j 5% SURCHARGE (.05 X TOTAL ABOVE) $ c2 ' O (] • Authority if other than Applicant TOTAL $ yak . 07) i:\resele.doc 12/96 — 4/28/99 Activities for Case #: ELR98 -00136 10:01:32 AM (a0-00 Assigned _ Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELRC001 Application Received 5/14/98 DLH RECD DLH 5/14/98 ELRC003 Permit Created 5/14/98 DLH DONE DLH 5/14/98 ELRC725 Low Voltage Inspection 8/3/98 CD PASS J *H 8/4/98 ELRC500 (F) Issue permit 5/14/98 DLH DONE DLH 5/14/98 ELRC799 Elect'I Final 8/3/98 CD PASS CD 8/3/98 alarm system ELRC800 Case finaled 8/3/98 CD PASS J *H 8/4/98 • • • • Page 1 of 1 Page No. 1 CASE HISTORY FOR CASE NO.: ELR98 -0136 KITS CAMERA 16200 SW PACIFIC HWY Unit: 0 09/02/98 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By • ELRC001 Application Received / / / / 05/14/98 RECD DLH 05/14/98 DLH ELR0003 Permit Created / / / / 05/14/98 DONE DLH 05/14/98 DLH ELRC500 (F) Issue permit / / / / 05/14/98 DONE DLH 05/14/98 DLH ELRC725 Low Voltage Inspection / / / / 08/03/98 PASS CD 08/04/98 J•H ELRC799 Elect'l Final / / / / 08/03/98 alarm system PASS CD 08/03/98 CD ELRC800 Case finaled / / / / 08/03/98 PASS CD 08/04/98 J•H •