Permit '
orif OF TIGARD
ELECTRICAL PERMIT –
dOMMUNITY DEVELOPMENT DEPARTMENT RESTRICTED ENERGY
1u1osBw Hall Blvd. Tigard, Oregon 97223081e (503) 639-4171 PERMIT #: ELR96-0242
DATE ISSUED: 07/29/96
PARCEL: 2S102CB-00100
SITE ADDRESS...: 12850 SW GRANT ST
SUBDIVISION....: NORTH TIGARDVILLE ADDITION ZONING:R-12
BLOCK..........: LOT.............:41
Project Description: Low voltage control system.
___________________ _______ _
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..
INSTRUMENTATIQN.: OTHER.. :CONTROL SY::X
TOTAL 4* 'OF SYSTEMS: 1
Owner: - ------ ----- FEES -------
TIGARD ELEMENTARY type amount by date recpt
12850 SW GRANT ST PRMT $ 4121.1210 CJS 1217/29/96 96-282222
5PCT $ 2.00 CJS 07/29/96 96-282222
TIGARD OR 97223
Phone #:
Contractor: – ----- ------- -- – –
CHRISTENSON ELECTRIC INC $ 42.00 TOTAL
10250 SW GREENBURG ROAD
– REQUIRED INSPECTIONS -------
TIGARD OR 97223 Wall Cover Elect'l Final
Phone #: 503-241-4812 Elect'l Service
Reg #..: 00548
This permit 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 permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more d`a/`i-r
than 18111 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------ ----------
SIGNATURE OF SUPR. ELEC' N: __ r7a/(r- __ DATE: 9
LICENSE NO:
Call for inspection – 639-4175
Community Development tY p RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT # P'/ p q6 -Q ac e
Phone (503) 639-4171
_ FAX (503) 684-7297 DATE ISSUED 14.9706
�-' - - --� TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY qC �PS??���
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
98� —SW GRt t3`
0'D Pin <f.y (-;")e-; ti-7" cr
Address RESIDENTIAL — Restricted Energy Fee $40.00
TIGARD OR 97223 (FOR ALL SYSTEMS)
City State Zip Check Type of Work Involved:
TIGARD GRADE SCHOOL
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
180 DAYS QUESTIONS? ?CONTACT SANDY @ 285 -3780 ❑ Burglar Alarm
❑ Garage Door Opener*
2.
N APPLICATION g Conditioning System*
CONTRACTOR E ❑ Heating, and Air Conditionin 5 stem*
ContractorCHRISTENSON ELECTP4e, INC CONTRACTOR ❑ Vacuum Systems*
111 SW COLUMBIA, SUITE 480 ❑ Other
Address PORTLAND, OR 97201 -5886
Date
7/22/96
COMMERCIAL — Fee for each system $40.00
(SEE OAR 918 - 260 -260)
Property Owner TIGARD SCHOOL DISTRICT Check Type of Work Involved:
Contractor's Board Reg. No. 26 - 34C/00458 ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone # 241 - 4812 JOB:447 - 50 9 6
❑ Clock Systems
❑ Data Telecommunication Installations
3. OWNER APPLICATION
❑ Fire Alarm Installation
❑ HVAC
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 TN Other LOW VOLTAGE CONTROL SYSTEM
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.
40.
The person signing for this permit must be the applicant or a person a. Enter Fees $
authorized to bind the applicant.
l (}/ 2.
��
b. 5% Surcharge (.05 x total above) $
Signature 42.
TOTAL $
Authority if other than applicant
ENERGAP.CHP