Permit CITY OF TIGARD
,, DEVELOPMENT SERVICES ELECTRICAL PERMIT —
RESTRICTED ENERGY
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1 , L 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT #: E L R97 -0282
�� DATE ISSUED: 10/07/97
lip PARCEL: 2S1 3CD— 7400
SITE ADDRESS...:1380O SW 118TH CT
SUBDIVISION ZONING:
BLOCK • LOT JURISDICTN: 7
Project Description: Install burglar alarm to an exisiting single family
dwelling.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM •X 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
Owner: FEES
RICK KLETTKE type amount by date recpt
13800 SW.188TH COURT PRMT $ 40.00 GEO 10/07/97 97- 299836
TIGARD OR 97223 -0000 5PCT $ 2.00 GEO 10/07/97 97- 299836
Phone #:
Contractor:
ALLTEC SECURITY $ 42.00 TOTAL
(A.K.A. SEQUENCE SYSTEMS INC)
PO BOX 55310 REQUIRED INSPECTIONS
PORTLAND OR 97238 -5310 Low Voltage Insp ,
Phone #: 232 -1188 Elect'l Final
Reg #..: 001188
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 follow rule adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001-0010 through OAR 952-001 -0080. You may obtain copies of
these rules or direct ' estions t. OUNC a. 503)246 -1987.
Issued by / // ____ Permittee Signature
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: /d�d Q-
LICENSE NO:
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + ++ + + + + + + + + + + + + + + + + + + + + + + ++
A Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd. PERMIT # . CI - OA a
Tigard, OR 97223
i �� 0 It, s r� P hone (503) 639 -4171
1 DATE ISSUED
j A r 1 FAX (503) 684 -7297
11 " 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
13800 SW 118th CT RESIDENTIAL — Restricted Energy Fee $40.00
Address
Tigard 972 7.3 (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 IS SUSPENDED FOR ® Burglar Alarm
180 DAYS.
❑ Garage Door Opener`
2. CONTRACTOR APPLICATION ❑ Heating, Ventilation and Air Conditioning System*
Contractor Alltec Security Type ❑ Vacuum Systems*
❑ Other
Address PO Box 55310 - Portland, OR 97238 -5310
Date 10 / 0 3 / 9 7 COMMERCIAL — Fee for eac
c s 260) $40.00
(SEE Property Owner Rick Klettk Check Type of Work Involved:
Contractor's Board Reg. No. 118839
❑ Audio and Stereo Systems
❑ Boiler Controls
Phone # 331 -2620 ❑ : Clock Systems
❑ Data Telecommunication Installations
3. OWNER APPLICATION • ❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No ❑ Instrumentation
❑ Intercom and Paging Systems
Address ❑ Landscape Irrigation Control*
S Zip ❑ Medical
City ❑ Nurse Calls
This permit is issued under OAR 918 -320 -370. This applicant agrees to make only ❑ Outdoor Landscape Lighting"
restricted energy installations (100 volt amps or less) under this permit and to do the
following: ❑ Protective Signaling
1. Only use electrical licensed persons to do installations where required. (Certain ❑ Other
residential and other transactions are exempt from licensing. These have
asterisks('). All others need licensing).
2. Call for an inspection when all of the installations under this permit are ready ❑ Number of Systems
for, inspection at 503- 639 -4
3. Purchase separate permits for all installations that are not ready for inspection • No licenses are required. Licenses are required for all other installations.
when the inspector is out to inspect under this permit.
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 applicant or a person a. Enter Fees $ 40. 00
The person signing for this . • •• ' •• t ''
authorized to bind 2. 00
b. 5% Surcharge (.05 x total above) $
i��
Signature TOTAL $ 4 2 . 0
• Authority if other than applicant
ENERG \P.CHP
5/9/00 Activities for Case #: ELR97 -00282 EVD' DE®
4:48:33 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRA003 Application received 10/7/97 GEO RECD GEO 10/7/97
ELRA010 Permit created 10/7/97 GEO PASS GEO 10/7/97
ELRA725 Low Voltage Inspection 10/7/97 10/7/97 GEO 10/7/97
ELRA799 Electl Final 10/7/97 GEO 10/7/97
ELRA500 (F) Issue permit 10 /7/97 GEO PASS GEO 10/7/97
ELRA845 Request inspection research 3/28/00 JMT DONE No Hold JMT 3/28/00
ELRA580 Expired by limitation 4/18/00 HAP DONE No Hold AKJ 4/18/00
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