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Permit CITY OF TIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY I t REVELOPMENT SERVICES PERMIT #: ELR2000 -00098 c ' - " 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/4/00 SITE ADDRESS: 15930 SW 74TH AVE PARCEL: 2S112DC-01300 SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -L BLOCK: LOT: 035 JURISDICTION: TIG Proiect Description: Installation of HVAC system for new HVAC unit. 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: X PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: LA RUSSO CONCRETE AMERICAN HEATING 15930 SW 74TH 1339 SW GIDEON ST TIGARD, OR 97224 PORTLAND, OR 97202 Phone: 684 -3701 Phone: 239 -4600 Reg #: LAC 00033135 ELE 26- 683CLE FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT DST 5/4/00 $60.00 0001913 Elect'I Final 5PCT DST 5/4/00 $4.80 0001913 Total $64.80 EXPIRED This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you_to_fo low rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OA'` 952 -011 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules ordirec u -stions to • /� at (503) 24^ -1987. Iss k ed by /-. -e- - 4.-(/tc A_I Permittee Signature y #/ iP' OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale. lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N DATE: LICENSE NO: Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day ,, .. Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION ....,, A 13125 SW Hall Blvd. Tigard, OR 97223 PERMIT #, /2 Paco - D Cl O P? /h�r4rrNl�i� Phone (503) 63 FAX (503) 6847 297 DATE ISSUED 5 4 ,w ` - TDD No. (503) 684 - 2772 CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY . PLEASE COMPLETE ALL SECTIONS 1. LOCATION OF INSTALLATION 4. TYPE OF WORK i s93o <SW 7t, T Address RESIDENTIAL — Restricted Energy Fee ftfittgr Nts•itc) OR 93a14 (FOR ALL SYSTEMS) City V State Zip Check Type of Work Involved: PERMITS ARE NON - TRANSFERABLE AND NON - REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK 15 SUSPENDED FOR 180 DAYS. ❑ Burglar Alarm ❑ Garage Door Opener* 2. CONTRACTOR APPLICATION � w ❑ Heating, Ventilation and Air Conditioning System* Contractor .. M4x rZ,c.D4Y / k pe {'r1� �Ntc.b ❑ Vacuum Systems* J Sr El Other Address /339 Se - / Igo4 Date 01`6V COMMERCIAL — Fee for each system ,$&lef (SEE OAR 918 - 260 -260) Property Owner JIMA LA /CUSSo GAc "tar r cE " Check Type of Work Involved: Contractor's Board Reg. No. 33 13 i /26 61-4 ❑ Audio and Stereo Systems ( p . /- ©O ❑ Boiler Controls Phone # #23.9 4600 ❑ Clock Systems 3. OWNER APPLICATION ❑ Data Telecommunication Installations ❑ Fire Alarm Installation RI' HVAC Print Owner's Name Phone No ❑ I nstrumentation 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. ❑ I 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. �j, Q 0 The person signing for this permit must be the applicant or a person a. Enter Fees $ �! / authorized to bind the applicant. J • )%j.,&_ l 7 b. 5% Su rcharg e (.05 x total ab ove) $ r � � / Signature TOTAL $ � ` � EXPIRED Authority if other than applicant -- e' °" ENERGAP.CHP