Correspondence •
CITYOFTIGARD
Astot i DEVELOPMENT SW SERVICES ,
Tigard, 0 97223 (503)639-4171 PERMIT ERMIT -
RESTRICTED ENERGY
PERMIT #: ELR98 -0233
DATE ISSUED: 08/26/98
PARCEL: 2S101AA -06400
SITE ADDRESS ° °:12323 SW 66TH AVE
SUBDIVISION • °WEST PORTLAND HEIGHTS ZONING:C -G
BLOCK LOT °° ° ° ° ° ° ° ° °° °:024 JURISDICTN: TIG
Pro j ect De script i on : Installation of data teleconsunications system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO ° °.: AUDIO & STEREO-1. INTERCOM & PAGING ° °:
BURGLAR ALARM ° BOILER LANDSCAPE/ IRRI GAT.
•
GARAGE OPENER— ° °° CLOCK ° ° ° ° ° ° ° ° ° ° °° MEDI CAL ° ° ° ° ° °°°° ° ° °°
HVAC ° DATA /TELE COMM ° °:X NURSE CALLS ° ° ° ° ° °
VACUUM SYSTEM FIRE ALARM— ° ° °: OUTDOOR LANDSC LITE: •
OTHER: :: HVAC PROTECTIVE SIGNAL ° °:
INSTRUMENTATI ON. e OTHER— : •
TOTAL # OF SYSTEMS: 1
Owner: FEES
BETTS TECOM type amount by date recpt
•
6815.N RICHMIND PRMT $ 40 °00 DEB 08/26/98 98- 308619
PORTLAND OR 98203 • 5PCT $ 2.00 DEB 08/25/98 98- 308619
Phone #: 735 -4123.
Contractor:
BETTS TELCOM INC $ 42.00 TOTAL •
6815 N RICHMOND AVE
REQUIRED INSPECTIONS •
PORTLAND OR 97203 Low Voltage Insp
Phone #: 735 - 4123, Elect'l Final
Reg #.. : 125312
This per ®it is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Code's 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 Utilit •cation Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0080. You may obtain copies of
these rul or direct q' Lions t. OUNC at (503)246-1987.
•
I s s u-• by `. • t�/ ��/;% '' P e r m i t t e e S i g n a t u r e l - I1:
/ •
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 .
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + ++ + + + + + ++
■
CITY tJF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
13125'SW HALL BLVD Date Rec'd: g --(t -
TIGARD OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #: G--
�
F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee $40.00
(FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS is 3,23 S w bg AID Check Type of Work Involved:
City /State Zip Phone # ❑ Audio and Stereo Systems
— F7(-;AR b, 012
Name ❑ Burglar Alarm
OWNER Mailing Address ❑ Garage Door Opener*
City /State Zip Phone # ❑ Heating, Ventilation and Air Conditioning System'
Name "� ,i ❑ Vacuum Systems*
8Er1S I e ec ❑ Other
CONTRACTOR Mailin Address
(o0 N. K iC H Mein D TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a ty /St to ip Phone # Fee for each system $40.00
copy of all licenses Kat IAA),I) OR Yl 735" si/a3 (SEE OAR 918 - 260 -260)
are required if Oregon Contr. a Lic. # Ex Da e
expired in C.O.T. 0 2,6 -q (o9i g t' to 0/ 0
o1 y Check Type of Work Involved:
data base). Electrical 3 Contr. / Lic. # to
❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # xp. Date
❑ Boiler Controls •
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT 0 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
started within 180 days of issuance or if work is suspended for 180 days. 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.
/ 1 . FEES: o
...di = 1 . ` • .� '14"� .1 "` -% % D ENTER FEES $
ignature / / / n O
5% SURCHARGE (.05 X TOTAL ABOVE) $
670 Authority if other than Applicant TOTAL $ ya
is \dsts \resele.doc 7/97 —