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Permit
ELECTRICAL PERMIT — Cw OF T RESTRICTED ENERGY COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #: ELR96 - 0122 13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 DATE ISSUED: 04/17/96 PARCEL: 29112DC -00701 SITE ADDRESS...: 15957 SW 72ND AVE SUBDIVISION • FANNO CREEK ACRE TRACTS ZONING:I —P BLOCK • LOT -38 Project Description: Install protective signaling for NW Rug Galleries. 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 NW RUG type amount by date recpt 15857 SW 72ND PRMT $ 40.00 CJS 04/17/96 96- 278323 5PCT $ 2.00 CJS 04/17/96 96- 278323 TIGARD OR 97223 Phone #: Contractor: CSAFFRASTOI! PM Ott RME 42.00 TOTAL ADTSecur 743 Nandcocic REQUIRED INSPECTIONS Por7f/o 97a1 Wall Cover Elect' 1 Final Phone #: Elect'l Service Reg #..: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Bre. 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 1 • days of issuance, or if work is suspended for more CMG r ! P c .37-A than 188 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 S I GNATURE : ©/1 Opp � cc� �.on DATE: y- / 7-- 9C LICENSE NO: / Call for inspection — 639 -4175 Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 PERMIT # ELi96 0 / a /n,viib Phone (503) 639 -4171 DATE ISSUED y- /7 96 FAX (503) 684 -7297 -- TDD No. (503) 684 -2772 CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY Ch ar /e.r SCA M . cC f- l 59 5 7 PLEASE COMPLETE ALL SECTIONS 1. LOCATION OF INSTALLATION 4. TYPE OF WORK z S 0 ). 7 1(4/ Addt�.4 � .1.-- � � �� � / RESIDENTIAL — Restricted Energy Fee $40.00 / J f " / C,G (FOR ALL SYSTEMS) City State 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 *DT SECURITY SYSTEMS, IN ' Type • / i1 j / 4.. ,,# qC.121 Vacuum Systems* 703 NE HANCOCK PORTLAND, OR 97212 / ❑ Other Address 0031 284-32 26 Date 1 /'O COMMERCIAL — Fee for each system $40.00 / (SEE OAR 918- 260 -260) Property Owner 4A_ ,L i . , _ ./L _ / v — / e • Check Type of Work Involved; Contractor's Board Reg. No. 6-99 1 ❑ Audio and Stereo Systems ❑ Boiler Controls Phone # ❑ Clock Systems ❑ Data Telecommunication Installations 3. OWNER APPLICATION r1 ❑ Fire Alarm Installation 4 AA Ilt . , /0f 11 l�J�! q /l ❑ HVAC Print Owner's Name JJt 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 A 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 signin; for this- rm st be the applicant or a perso //}} T a. Enter Fees $ . U � authorized to .. , , the a s ' i ca `1 b. 5% Surcharge (.05 x total above) $ - Signature Li TOTAL $ < s a o Authority if other than applicant Nu) u) R u & ENERGAP.CHP 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 ICED Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg. San. Sewer Gas Line Appr /Sdwlk Reins. Other: Date: �7?-5 iq k A.M. P.M. Entry: Address: 1 5 1 95 -7 "1 Z i Tenant: N `\ Ste: MST: BUP: Con /Own: J MEC: �y PLM:�_ - .-- l v. Q C� ELC: ir;m �.�: THE FOLLOWIN ORRECTION R EQUIRED: ELR: Y n epi A- 17 T FL& cr‘ '-m l' 2 - 2 - i 5i � ILc , ee ^ 6 7 7 ... ry ow / - Inspector:) € D I ( XitGC!' Date. �' �S— X APPROVED _ DISAPPROVED /CALL FOR REINSP. C CO ,