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Permit A CITYOFTIGARD , 1 i ��A DEVELOPMENT SERVICES ELECTRICAL PERMIT — 13125 SW RESTRICTED ENERGY PERMIT #: ELR99 -0039 DATE. ISSUED: 03/04/99 PARCEL: 19136DB -02400 SITE ADDRESS...:1164O SW PACIFIC HWY SUBDIVISION • ZONING:C —G BLOCK • LOT • JURISDICTN: TIG Project Description: Install protective signaling. 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.. :X INSTRUMENTATION.: OTHER..: .. TOTAL # OF SYSTEMS: 1 Owner: FEES SONITROL SECURITY type amount by date recpt 1975 SW 6TH AVE PRMT $ 40.00 GEO 03/04/99 99- 313434 PORTLAND OR 97201 SPCT $ 2.00 GEO 03/04/99 99- 313434 Phone #: 223 -5822 Contractor: SONITROL PACIFIC $ 42.00 TOTAL 1975 SW 6TH AVE REQUIRED INSPECTIONS PORTLAND OR 97201 Low Voltage Insp Phone #: 223 -5822 Elect'1 Final Reg #..: 000535 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 wore 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 - 881-010 through OAR 952 - 801 -8080. You way obtain copies of these rules or direct questions to at : )246 -1987. Issued by Permittee Signature (. 4 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: •d//9-- DATE: LICENSE NO: +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ RECEIVED CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: 13125 SW HALL BLVDAR ti 1999 Date Rec'd: TIGARD OR 97223 PRINT OR TYPE V - 503 - 639 -4171 X304 Permit #: F"---R /9— 00 3? F - 503 - 684- 7297COMMUNIIY DEVELOPMENT NCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd: WILL NOT BE ACCEPTED Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY CiN I CS Restricted Energy Fee $40.00 (FOR ALL SYSTEMS) JOB Street Address n � 1 I Ste # Check Type of Work Involved: ADDRESS 11(-0 LAO S.1...) � OQItC. � City /State h Phone # - Audio and Stereo Systems 7 kae 3 (oa0 -aCf� I Name ❑ Burglar Alarm OWNER Mailing Address ❑ Garage Door Opener' City /State Zip Phone # El Heating, Ventilation and Air Conditioning System* Naam,,e,� 1--k , L ❑ Vacuum Systems' o` r S\ —QQ (,- A ❑ Other CONTRACTOR Mailing Addres 'C� 1� S C E c je_dmiksz. TYPE OF WORK INVOLVED - COMMERCIAL ONLY (Prior to issuance a ity /State �c Zip Phone ._.# Fee for each system $40.00 copy of all licenses Va `T ,t�✓NC\ q - 1 ail aa3- Sg aa. (SEE OAR 918- 260 -260) are required if OregonrLr. 3 c. # Exp. Date expired in C.O.T. Check Type of Work Involved: data base). Electrical Contr. Lic. # Exp Date D Co - 3 -it� cl � ❑ Audio and Stereo Systems C.O.T. or Metro Lic. # Exp. Date ❑ Boiler Controls Owner's Name 0 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. I I 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 non - refundable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. I Number of Systems The person signing for this permit must be the applicant or a person • No licenses are required. Licenses are required for all other installations authorized to bind the ap licant. kr 0 C50 FEES: ENTER FEES $ AO Signature 5% SURCHARGE (.05 X TOTAL ABOVE) $ a ' On M Authority if other than Applicant TOTAL $ L 4 ■ (50 i:tdststresele.doc 7/97 —