Permit ctTYOF T ELECTRICAL PERMIT —
' COMMUNITY DEVELOPMENT DEPARTMENT RESTRICTED ENERGY
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PERMIT #: EL R96 - 0138
DATE ISSUED: 05/06/96
PARCEL: 2S112DC -00100
SITE ADDRESS...: 15705 SW 72ND AVE
SUBDIVISION SP TIGARD INDUSTRIAL PARK ZONING:I —L
BLOCK LOT • °2
Project Description:
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
Applicant: FEES
NIKE — TETRA type amount by date recpt
ONE BOWERMAN DRIVE PRMT $ 40.00 CJS 05/06/96 96- 278994
SPCT $ 2.00 CJS 05/06/96 96- 278994
BEAVERTON OR
Phone #: 503- 671 -2017
Contractor:
Ldf' gN $ 42.00 TOTAL
APT Secu',ty
70.. NP .4on� / REQUIRED INSPECTIONS
P 6 rflo� d O r, 973/ Wall Cover Elect' 1 Final
Phone f #: Elect' 1 Service
Reg #..
This permit 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
within 180 days of issuance, or if work is suspended for sore ("A n r /Pr S A rfr, -
than 180 days. 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
AUTHORIZED SIGNATURE: On off / J e DATE: 5- 6- 9,('
LICENSE NO:
Call for inspection — 639 -4175
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
1Q
13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT # ELR Q - O 13 b'
m'arl„� � t II Phone (503) 639 -4171
FAX (503) 684 -7297 DATE ISSUED s - 6-Q6
. J I I
� a - TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY CI, r, f /c' c h „-1, cl
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION]) 4. TYPE OF WORK
Ka
/74s 72
Address., . RESIDENTIAL - Restricted Energy Fee $40.00
/ 7 (9 (FOR ALL SYSTEMS)
City / �� h / State Zip • Check Type of Work Involved:
PERMITS ARE NON- TRANSFERABLE AND NON - REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems
15 NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
180 DAYS. ❑ Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
Contractor= SFCI SYSTEMS.'NC. Type i /.;?i 41 5 Vacuum Systems*
_
703 NE HANCOCK ❑ Other
Address PORTLAND, OR 97212
03) 284 3265
Date .- / ? 6 COMMERCIAL — Fee for each system $40.00
(SEE OAR 918- 260 -260)
Property Owner /.Q Ad % kiLdirAle-j C =check Tvoe of W .�
/ ork Involved:
Contractor's Board Reg. No. 5-9 % Q Y" ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone # ❑ Clock Systems
3. OW ER APPLICATION ❑ Data Telecommunication Installations
�1 r)q ❑ Fire Alarm Installation
: : (Lr :i .,/ _ ...eta 6-4 /L�L�L ci -0, /�j ❑ 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 OAR 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 5. FEES
corrections are completed. �
The person signing for this permit must be the applicant or a person a. Enter Fees $ / " , v
authorized to bind the applicant. �)
921-1,12--r/ b. 5% Surcharge (.05 x total above) $ u
Q
Signature TOTAL $ /,. D6
Authority if other than applicant
ENERGAP.CHP