Permit CITY OF TIGARD
DEVELOPMENT SERVICES
ENER 13125 SW Hall Blvd., Tigard, OR 97223 (503) GY
ELECTR
PERMIT #: ELR97 -0203
DATE ISSUED: 07/18/97
PARCEL: 2S1O4BB -03700
SITE ADDRESS.° °:14104 SW LIDEN DR
SUBDIVISION -CASTLE HILL ZONING:R -12 PD
BLOCK ° LOT •030 JURISDICTN: TIG
Project Description : instl 1 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 - - - --
ROBERT BRYAN type amount by date recpt
14104 SW LIDEN DR PRMT $ 40.00 TAT 07/18/97 97- 297313
TIGARD OR 97223 5PCT $ 2.00 TAT 07/18/97 97- 297313
Phone #:
Contractor:
ADT SECURITY ALARMS $ 42.00 TOTAL
703 NE HANCOCK
REG!UIRED INSPECTIONS
PORTLAND OR 97212 Ceiling Cover Elect'1 Service
Phone #: 284 -3265 Wall Cover Elect'1 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 180 days. ATTENTION: Oregon law requires you to follow rule adopted by the
Oregon Utility Notification enter. Those r es are set forth in OAR 952 -u'1 -0010 through OAR 952- 001 -0080. You may obtain copies of
these rules or direct st'ons to OUN a )246 -1987.
Issued by , .. / . .4111. /..i P e r m i t t e e 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 SUP R. ELEC' N: DATE:
LICENSE NO:
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 P.M. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
r
. CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
13125 SW HALL BLVD �y Date Rec'd: '1
TIGARD OR 97223 f //oJg7 PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #: C -12L91 O
F - 50-6 4 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
7/7 ' I D-Ub411- ?Ili - / 509 / WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL
Restricted Energy Fee $40.00
(FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS /yip Jp y Z, /� 5 - _ Check Type of Work Involved:
City/ fate , Pho e # ❑ Audio and Stereo Systems
7 173 caq-i//
N e f2• Alarm
1.1111/11 ' OWNER Mailing Address ❑ Garage Door Opener*
City /State Zip Phor.e # El Heating, Ventilation and Air Conditioning System'
V- ❑ Vacuum Systems*
Name UT mI
� El Other
CONTRACTOR Mailing Address MI) 280.326
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. Brd Lic. # Exp Da
expired in C.O.T. ,59'9 L/ 4i 4{ Check Type of Work Involved:
data base). Electrical Cddntr. Lic. # Exp. 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 I Zip I 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 p 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 inspection when all of the
corrections are completed. ❑ Other
Permits are non - transferable and . n -refu #.le and expire if work is not
started within 180 days of issuan 1 or if i, is suspended for 180 days. Number of Systems
The person signing for is p ' m - 1 be the applicant or a person • No licenses are required. Licenses are required for all other installations
authorized to bind • -1pp1" - n .
FEES:
OW
Signature ENTER FEES $
�0
5% SURCHARGE (.05 X TOTAL ABOVE) $ `�
0
Authority if other than Applicant TOTAL $ .--
i:tresele.doc 12/96 _
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: / — 10 1 7 A.M. P.M. MST:
Location: / 4/0 Y-�C- j - 2�}. BUP:
Tenant: Suite: Bldg: MEC:
i
Contractor: i` 41'2. / Phone: _ - — 0 PLM:
Owner: II I i
Phone: �. — o ELC:
Lel L At L 0 ' - A - L-OA —10014P---- ELR: 7-0.20 5
- Al/ n
• /"/V1 IT:
B ING BLDG (con't) PL is ING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam o : Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C m
Shear /Sheath . Fire Spk1r /Alm Crawl/Found Dr Heat Pump Low Volt A-UT .
Approved Approved Approved A &ppr Approved
Appr /Sdwlk Not Approved Not Approved Not Approved NoL AppiSved Not Approved
FINAL FINAL FINAL FINAL FINAL
L- 4/ 6 PD tv E4 ,5'v PAk ./
1
0 Call for reinspection .• l: - inspection fee of $ d� ed before ; ext ' spection O Unable to inspect j " .
Inspector: / �� Date: , ir ` v 6 Page of