Permit CITY OF TIGARD
ELECTRICAL PERMIT -
COMMUNITY DEVELOPMENT DEPARTMENT RESTRICTED ENERGY
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PERMIT #: EL R9 6 —0214
DATE ISSUED: 07/02/96
PARCEL: 2S102CC -00600
SITE ADDRESS...: 13555 SW PACIFIC HWY
SUBDIVISION • ZONING:C —G
BLOCK • LOT •
Project Description:
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
VINTAGE CORNER type amount by date recpt
13555 SW PACIFIC HWY PRMT $ 40.00 CJS 07/02/96 96- 281243
5PCT $ 2.00 CJS 07/02/96 96- 281243
TIGARD OR 9723
Phone #:
Contract or:
AAA ALARM CO OF OREGON $ 42.00 TOTAL
7865 SW CIRRUS DR REQUIRED INSPECTIONS
BEAVERTON OR 97008 Wall Cover Elect' 1 Final
Phone #: 771 -7572 Elect' 1 Service
Reg #..: 93892
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t e e 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 /he r lP c
than 180 days. I s sued 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: DATE: Or/A
LICENSE NO:
Call for inspection — 639 -4175
• A
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT # EL 1 96 - 0 a IL/
AiAl flu ,\ Phone (503) 639 -4171
il° ;�I�I� FAX (503) 684 -7297 DATE ISSUED �/a 4tS
TDD No. (503) 684 -2772 /
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY Ch 4 s -
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
13555 SW PACIFIC HIGHWAY
Address RESIDENTIAL — Restricted Energy Fee $40.00
TIGARD, OREGON 97223 (FOR ALL SYSTEMS)
City State Zip Check Type of Work Involved:
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. ❑ Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning Systems
Contractor AAA ALARM CO. T ype LIMITED ENERGY ❑ Vacuum Systems*
Address 7865 SW CIRRUS DRIVE, BEAVERTON 97008 ❑ Other
Date 07 -01 -96 COMMERCIAL — Fee for each system $40.00
(SEE OAR 918 - 260 -260)
Property Owner TENANT – VINTAGE CORNER Check Type of Work Involved:
Contractor's Board Reg. No. 93892 I a. /I /9r ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone # 646 -2700 _ ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ 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 ❑ Other
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.
The person signing for this permit must be the applicant or a person a. Enter Fees $ 4o.Q0
authorized to bind the applicant.
�110 442,i � A��t b. 5% Surcharge (.05 x total above) $ . 00
Signature
TOTAL $ �a i
Authority if other than applicant
ENERGAP.CHP
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
Plbg.Und/FIr/Slab Plbg. Top Out Insulation lect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: R:R-
Date: �7-- I o - 1‘4 A.M. P.M, Entry:
Address: 1355 S S w 7
YCr. 1/ w y
Tenant: U i ti+A-c/ € Co2N E2 Ste: v MST: /
BUP:
Con /Own: /.4 (f J MEC:
6`./ — 7U 0 PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: 76-62.1 4.
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Inspector: Zd .a — c Date:/ 0
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APPROVED _ DISAPPROVED /CALL FOR REINSP. 0 CO
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