Permit CITY OF TIGARD
^ .�, �, i DEVELOPMENT SERVI ELECTRICAL PERMIT -
PERMIT #: ELR97 -0170
DATE ISSUED: 06/12/97
PARCEL: 2S1O9AB -02200
SITE ADDRESS...:14383 SW 134TH DR
SUBDIVISION -THREE MOUNTAIN ESTATS ZONING:R -7
BLOCK LOT.... ....... ..:5 JURISDICTN: TIG
Project Description: instl burglar alarm
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
ED PARECKI type amount by date recpt
14383 SW 134TH DR PRMT $'• 40.00 TAT 06/12/97 97- 295866
TIGARD OR 97223 5PCT $ 2.00 TAT 06/12/97 97- 295866
Phone #:
Contractor:
ADT SECURITY ALARMS $ 42.00 TOTAL
703 NE HANCOCK
REQUIRED INSPECTIONS
PORTLAND OR 97212 Ceiling Cover Elect'l Service
Phone #: 284 -3265 Wall Cover Elect'l Final
Reg #..: 000599
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 1: 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 952-1-0080. You may obtain copies of
these rules or direct s o 1 I- at (503)246 -1987.
Issued b ./� l � 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:
LICENSE NO: IV/
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + ++ + + + + ++
Call 639 -4175 by 6:00 P.M. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
r r.
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CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: ' I
13125 SW HALL BLVD Date Rec'd: Mill
TIGARD OR 97223 PRINT OR TYPE i
V - 503 - 639 -4171 X304 Permit #: e1,03
F - 503 - 684 -7297 IN OMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
6/6 7 64 , j f N-/ ,( - wlLL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL
Restricted Energy Fee $40.00
(FOR ALL SYSTEMS)
JOB Street Address J/� Ste #
ADDRESS /'/3g (,J 7:91±11(4- Check Type of Work Involved:
City /St r Zip Phone # ❑ Audio and Stereo Systems
Name iEr Burglar Alarm
e ca Pc u 1 12.4_0( OWNER Mailing Address ❑ Garage Door Opener*
City /State Zip Phone # ❑ Heating, Ventilation and Air Conditioning System*
Name min =AM SYSTEMS. In ❑ Vacuum Systems*
103 HANCOC$ Other
4ORTAANO, OR 91212 ❑
CONTRACTOR Mailing Address 2503) 284.3265
TYPE OF WORK INVOLVED - COMMERCIAL
(Prior to issuance a City /State Zip Phone # Fee for each system $40.00
copy of all licenses (SEE OAR 918- 260 -260)
are required if Oregon Contr. Br Lic # Exp at
expired in C.O.T. J 9`9' y 9 Check Type of Work Involved:
data base). Electrical Contr. Lic. # Ex . Date
❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date
❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT ❑ Data Telecommunication Installation
City /State Zip Phone # ❑
Fire Alarm Installation
This permit is issued under OAE 918 - 320 -370. This applicant agrees to
make only restricted energy installations (100 volt amps or less) under this ❑ HVAC
permit and to do the following:
❑ Instrumentation
1. Only use electrical licensed persons to do installations where required.
Certain residential and other transactions are exempt from licensing. ❑ Intercom and Paging Systems
These have asterisks( *). All others need licensing;
❑ Landscape Irrigation Control*
2. Call for inspections when installation under this permit are ready for
inspection at 503 - 639 -4175; ❑ Medical
3. Purchase separate permits for all installations that are not ready for an ❑ Nurse Calls
inspection when the inspector is out to inspect under this permit;
4. Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting*
inspector are done, and;
❑ Protective Signaling
5. Assume responsibility for calling for a final i : • : ction when all of the
corrections are completed. ❑ Other
Permits are non - transferable : % non-r- = ble and expire if work is not
started within 180 days of i- : nce • • ork is suspended for 180 days. Number of Systems
The person signing fort per P ust be the applicant or a person * No licenses are required. Licenses are required for all other installations
authorized to d the - !'•pli : t.
. ip FEES:
ENTER FEES $ ' '
'
Si ature
5% SURCHARGE (.05 X TOTAL ABOVE) $ OC ✓
d' !J
Authority if other than Applicant TOTAL $ l. /
is resele.doc 12/96 —
6/6/00 Activities for Case #: ELR97 -00170
1:56:31 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRA003 Application received 6/12/97 TAT RECD JDA 12/17/97
ELRA010 Permit created 6/12/97 TAT 6/12/97
ELRA799 Elect'I Final 9/18/97 BRP PASS JT 11/8/97
ELRA500 (F) Issue permit 6/12/97 TAT PASS TAT 6/12/97
ELRA800 Case finaled 11/8/97 • JT 11/8/97
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