Permit ELECTRICAL PERMIT —
RESTRICTED ENERGY
PERMIT #: ELR96-0278
ACITYCIFTIGARD
DATE ISSUED: 09/09/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd Tigard, Oregon o7000°u�oo (503) moe~*�r�
' ' ' PARCEL: 2S113AD-01700
SITE ADDRESS...: 16920 SW 72ND AVE
SUBDIVISION....: ROSEWOOD ACRE TRACTS ZONING:C—G
BLOCK ~ LOT -30
Project Description:
_
A. RESIDENTIAL--------- B. COMMERCIAL ------- --- ----------
AUDIO & STEREO...:X 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..:
INSTRUMENTATION.: OTHER..:
TOTAL # OF SYSTEMS: 0
'wner: ---------- — — FEES
BOARDERS BOOKS & MUSIC type amount by date recpt
16920 SW 72ND AVE PRMT $ 40.00 CJS 09/09/96 96-283726
5PCT $ 2.00 CJS 09/09/96 96-283726
TIGARD OR 97223
Phone #:
Contractor: — --
ENTOUCH SYSTEMS INC $ 42.00 TOTAL
3732 SW MOODY
REQUIRED INSPECTIONS
PORTLAND OR 97201 Wall Cover Elect'l Final
Phone #: 503-624-6500 Elect'l Service ______
Reg #..: 69287
This peroit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permitee Signature
applicable laws. All work will be done in accordance with
approved plans. This peroit will expire if work is not started
within 180 days of issuance, or if work is suspended for oore
than 180 days. Issued /y
------ 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: �� t w __ - .
Call for inspection — 639-4175
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
A 13125 SW Hall Blvd.
Tigard, OR 97223
Phone (503) 639 4171 PERMIT # .R96
; O 75
N gr l �� _ 46
I FAX (503) 684 -7297 DATE ISSUED
TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY1 f/e.s tir7:04
PLEASE COMPLETE ALL SECTIONS
1. ,,LOCATION OCATION Of INSTALLATION 4. TYPE OF WORK
'LO 'S ix), '
Address RESIDENTIAL — Restricted Energy Fee $40.00
6- /v, crl 'L 3 (FOR ALL SYSTEMS) •
City State Zip Check Type of Work Involved:
PERMITS ARE NON - TRANSFERABLE AND NON - REFUNDABLE AND EXPIRE IF WORK VA • udio and Stereo Systems
IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
180 DAYS. • Burglar Alarm
❑ Garage Door Opener*
2. CONTRACTOR APPLICATION
❑ Heating, Ventilation and Air Conditioning System*
Contractor ENkCt. Type ❑ Vacuum Systems*
Address
313 - 2_ S kkeQ, k. l ( o 6 1 1 2o 1 ❑ Other
Date 1 _ I COMMERCIAL — Fee for each system $40.00
(SEE OAR 918- 260 -260)
Property Owner Check Type of Work Involved;
Contractor's Board Reg. No. V `O 1 �3 1 Audio and Stereo Systems
-� 2Z � ^ Zd � � ❑ Boiler Controls
Phone # 933 ❑ Clock Systems
❑ Data Telecommunication Installations
3. OWNER APPLICATION
❑ Fire Alarm Installation
❑ H VAC
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 $ 4/6 . "
authorized to bind the applicant.
b. 5% Surcharge (.05 x total above) $ G°
Signature
TOTAL $ ya '
Authority if other than applicant
ENERGAP.CHP