Permit ,_ CITY OF TIGARD
�
DEVELOPMENT SERVI ELECTRICAL
ENERGY
PERMIT #: ELR97 -0355
DATE ISSUED: 12/15/97
PARCEL: 2S1O2AA -00602
SITE ADDRESS...:1196O SW PACIFIC HWY
SUBDIVISION •TIGARD HIGHWAY TRACTS ZONING:CBD
BLOCK • LOT •010 JURISDICTN: TIG
Project Description : Installation of protective signalling.
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
HOME AND CASTLE type amount by date recpt
11960 SW PACIFIC HWY PRMT $ 40.00 TJH 12/15/97 97- 301755
TIGARD OR 97223 SPCT $ 2.00 TJH 12/15/97 97- 301755
Phone #: 503 -620 -4534
Contractor:
PROTEC INC $ 42.00 TOTAL
2920 SW DOLPH COURT
SUITE #4 REQUIRED INSPECTIONS
PORTLAND OR 97219 Ceiling Cover Low Voltage Insp
Phone #: 293 -2134 Wall Cover Elect'1 Final
Reg #..: 000554
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 sore 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 - 0011010 through OAR 952 - 001-0080. You lay obtain copies of
these rules or direct questions to OUNC at (503)246 -1987.
Issued by &U(. Sp Permittee Signature !Ti's 4/9/214./VZrte•• Add
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:
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + ++ + ++
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
id
CITY .OF'TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: • Pr-
13125 SW HALL BLVD Date Rec'd:
TIGARD OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #: EU29703SS
F - 503 -684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd: mathej
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL
N d 1 p�S -r LE Restricted Energy Fee $40.00
(FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS 111 .oSiJ Pf1ckF l-+w Check Type of Work Involved:
City/State Zip \I El # Audio and Stereo Systems
11 A fl f e' . 1 97y2.3 4 z b - ( S: f
Na
❑ Burglar Alarm
OWNER Mailing Address ❑ Garage Door Opener'
City/State Zip I Phone # El Heating, Ventilation and Air Conditioning System*
Name El Vacuum Systems'
k fZart 4-;"1, c.... ❑ Other
CONTRACTOR Mailing Address
a-94 -0 SO 16 Cr* tl- TYPE OF WORK INVOLVED - COMMERCIAL
(Prior to issuance a ity /State Zip Phone # Fee for each system 540.00
copy of all licenses l' ov2.,T l.Arw ) cR- I 911.19 143 - x-134' (SEE OAR 918 - 260 -260)
are required if Ore on Contr. Brd Lic. # E p. Date
expired in C.O.T. S q 1 y- � i5 � 9 Check Type of Work Involved:
data base). Electrical Contr. Lic. # E p. Date
34- ) cL.E to i 9$ ❑ Audio and Stereo Systems
C.O.T or Metro Lic. # Exp. Date
4" I ' 9 Q ❑ Boiler Controls
Own 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 El 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;
lEr 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 • =rmit must be the applicant or a person • No licenses are required. Licenses are required for all other installations
a orized to bind the app ca t.
T
AAA141411 • - A ENTER FEES $
D J
gnature
14-aq 3. ( 5% SURCHARGE (.05 X TOTAL ABOVE) $ ).-
Authority if other than Applicant TOTAL $ L- 1 4
i:\resele.doc 12/96 -