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Permit CFIYv OF TIG4RD ELECTRICAL PERMIT — COMMUNITY DEVELOPMENT DEPARTMENT RESTRICTED ENERGY PERMIT #: ELR96 -0005 13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 DATE ISSUED: 01 /03/96 PARCEL: 2S103DD -01 200 SITE ADDRESS...: 13970 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 Applicant: -- FEES BBRINKS HOME SECURITY type amount by date recpt 8059 SW CIRRUS DR PRMT $ 40.00 CJS 01/03/96 96- 274537 SPCT $ 2.00 CJS 01/03/96 96- 274537 BEAVERTON OR 97007 Phone #: 503- 641 -0574 Contractor: -- CONTRACTOR NOT ON FILE $ 42.00 TOTAL REQUIRED INSPECTIONS Ceiling Cover Elect' 1 Service Phone #: Wall Cover Elect' 1 Final Reg #.. This permit is issued subject to the regulations contained in the Hoard Municipal Code, State of Ore. Specialty Codes and all other Permit 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 C,r�ar e1'f' than 180 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: /e _ DATE: _ f =3— LICENSE NO: Call for inspection — 639 -4175 • I Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION 13125 SW Hall Blvd. ' - Tigard, OR 97223 PERMIT # ELR 95 - 0/70 5 /��„r Phone (503) 639-4171 FAX (503) 6847 297 DATE ISSUED /- 3- 9.S - - TDD No. (503) 684 -2772 CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY C `i ar /,o f 5i,7,,,/f PLEASE COMPLETE ALL SECTIONS 1. LOCATION OF INSTALLATION 4. TYPE OF WORK /3 9 7 D Sze A / af;o:� ielely Address 6 ` RESIDENTIAL — Restricted Energy Fee $40.00 (FOR ALL SYSTEMS) ity 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 y 180 DAYS. Burglar Alarm 2. CONTRACTOR APPLICATION /_ Garage Door Opener* � t `�� ` e4e -A -,i %iti (p Q �.�O , ❑ Heating Ventilation and Air Conditioning System* Con ractor e�j p ❑ Vacuum Systems* !' ❑ Other Address c7 OFef / ajeee A.--; Date / X.) COMMERCIAL Fee for each system $40.00 � (SEE OAR 918 - 260 -260) P Property Owner v(l�(/(�� _ .....n Check Type of Work Involved; l Contractor's Board Reg. No. ` L 2 _ / ❑ Audio and Stereo Systems* 6v/ ❑ Boiler Controls Phone# © � ❑ 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: EZ 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 corrections 5. FEES are completed. The person signing for this permit must be the applicant or a person a. Enter Fees $ 1[J authorized to bind the applicant. b. 5% Surcharge (.05 x total above) $ Signature 1 TOTAL $ 9L 1• e Authority if other than applicant ENERGAP.CHP 03/30/2000 Activities for Case #: ELR96 -00005 10:11:44 AM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELRC001 Application Received 01/03/1996 CJS RECD TMP 01/03/1996 ELRC003 Permit Created 01/03/1996 CJS PEND TMP 01/03/1996 ELRC700 Ceiling Cover 01/03/1996 TMP 01/03/1996 ELRC720 Wall Cover 01/03/1996 TMP 01/03/1996 ELRC730 Elect'I Service 01/03/1996 TMP 01/03/1996 ELRC799 Elect'I Final 01/03/1996 TMP 01/03/1996 ELRA500 (F) Issue permit 01/03/1996 • CJS PASS B 01/03/1996 ELRC800 Case finaled 05/22/1996 MJR YES MJR 05/22/1996 • Page 1 of 1