Permit / .
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.
_ _.
. ELECTRICAL PERMIT - .
COMMUNITY DEVELOPMENT DEPARTMENT RESTRICTED ENERGY •
• • , 13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PERMIT #: E L R 9 6 -0 i 61 .
. DATE ISSUED: 05/16/96 •
•
PARCEL: 15136DD -00700
SITE ADDRESS...: 11535 SW 67TH AVE . -
'SUBDIVISION ^ WEST PORTLAND HEIGHTS ZONING:C -P
BLOCK..... .... LOT -3.
Project Description: Installing protective signaling.
A. RESIDENTIAL B. COMMERCIAL .
AUDIO ' &. STEREO...: AUDIO & STEREO..: INTERCOM & PAGING. '. :
BURGLAR ALARM BOILER...........: LANDSCAPE /IRRIGAT..: '
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
HEALTH type • amount by date recpt
11535 SW 67TH AVE PRMT $ -40.00 CJS 05/.16/96 '96- 279499
5PCT -$ • 2.00 CJS 05/16/96 96- 279499
TIGARD OR 97223
Phone , #:
Contractor: - .
0
PHILLIPS ELECTRONICS 42.00 TOTAL
1110 NW FLANDERS
•
REQUIRED INSPECTIONS
PORTLAND OR 97209 . Wall Cover Elect' 1 Final
• Phone #: 503- 227 -0571 Elect'1 Service
Reg 1#..: 43343
This per ®it is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. 'Specialty Codes and all other Perm i t e e Signature
applicable laws. All work will be done in accordance with •
• approved plans. This permit will expire if work is not started ,
[/1
within 180 days of issuance, or if work is suspended for sore p r 1(0 ( SCLI i,vi `c/ ,-
than 180 days. 0 • Issued By
. 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: Oil cip
> >;-, -, iLi,;r, DATE: 5-- 4
l6-
LICENSE NO: -
Call for insper_tion.T 639-4175
•
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT # ELR V:,- 91, /
gr
b 9 ,,, , Phone (503) 639 -4171 5-16 96 l 11 FAX (503) 684 -7297 DATE ISSUED
TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY Chi r lex -llm,, -//-
,., PLEASE COMPLETE ALL SECTIO
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
Address r RESIDENTIAL — Restricted Energy Fee 540.00
/ /I 4 ' (FOR ALL SYSTEMS)
CIty tate . Zip Check Type of Work Involved:
PERMITS ARE NON - TRANSFERABLE AND NON - REFUNDABLE AND EXPIRE IF WORK . ❑ Audio and Stereo Systems*
IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK 15 SUSPENDED FOR
180 DAYS. ❑ Burglar Alarm
❑ Garage Door Opener*
2. CONTRACTOR APPLICATION
❑ Heating, Ventilation and Air Conditioning System*
Contractor z Type /I . ..;� ❑ Vacuum Systems*
? 7 ❑ Other
Address ��' / (� � (� �
f'T
Date 5 (3 ' ' � COMMERCIAL — Fee for eac
c s tem 6 0) i
Property Owner ,�(, cCJJ_e)?-. / k Cit), Check Type of Work Involved:
Contractor's Board Reg. No. 4 03 ( ) ❑ Audio and Stereo Systems*
❑ Boiler Controls
Phone # 2-7- 2 7( ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No
❑ Instrumentation
Address • ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
City State Zip ❑ Medical
This permit is issued under OA 918- 320 -370. This applicant agrees to make only ❑ Nurse Calls
restricted energy installations (100 volt amps or less) under this permit and to do the ❑ Outdoor Landscape Lighting*
following: '
1. Only use electrical licensed persons to do installations where required. (Certain
Protective Signaling
residential and other transactions are exempt from licensing. These have Other
asterisks( *). All others need licensing).
2. Call for an inspection when all of the installations under this permit are ready
for inspection at 503- 639 -4175.
❑ Number of Systems
3. Purchase separate permits for all installations that are not ready for inspection
when the inspector is out to inspect under this permit. * No licenses are required. Licenses are required for all other installations.
4. Assume responsibility for assuring that all corrections required by the inspector
are done, and
5. Assume responsibility for calling for a final inspection when all of the corrections 5. FEES
are completed.
CO
The person signing for this permit must be the applicant or a person a. Enter Fees $ ( 6:9
authorized to bind the applicant.
b. 5% Surcharge (.05 x total above) $ 9■ Q:L)
Signature
TOTAL $ I f 2.---
Authority if other than applicant
ENERGAP.CHP
Et a-q4 -6014
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: /�
Date: (ePta 7 iq ( A.M. P.M. E:
ntry
Address: I � ,S ,3.5 6 7
Tenant: Ste: MST:
j BUP:
Con /Own: f .ke-1 E 4 ,4' MEC:
PLM:
ELC: '7,O / (o(
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
•
•
c
— c — 410
Inspector: �/ . i Date4 ^7—
X APPROVED DISAPPROVED /CALL FOR REINSP. 4 010 CO