Permit CITY OF TIGARD
^ !fin, 9�
DEVELOPMENT LOPMEN R SERVICES
ELECTRICAL
ENERGY
PERMIT #: ELR97 -0034
DATE ISSUED: 02/03/97
PARCEL: 2S110DB -00700
SITE ADDRESS...: 15520 SW PACIFIC HWY #D
SUBDIVISION • WILLOW BROOK /TIGARD PROMENADE ZONING:C -G
BLOCK • LOT -10
Project Description: Installing audio stereo system
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO...: AUDIO & STEREO..:X 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..:
INSTRUMENTATION.: OTHER..:
••
TOTAL # OF SYSTEMS: 1
Owner: FEES
CARL KARCHER ENTERPRISES type amount by date recpt
800 MELLON AVENUE PRMT $ 40.00 B 02/03/97 97- 289830
SPCT $ 2.00 B 02/03/97 97- 289830
MANTECA CA 95337
Phone #: 823 -9251
Contractor:
MUZAK LTD $ 42.00 TOTAL
12595 NE MARX
REQUIRED INSPECTIONS
PORTLAND OR 97230 Ceiling Cover Elect'1 Service
Phone #: 503 -253 -7573 Wall Cover Elect' 1 Final
Reg #..: 86695
This permit is issued subject to the regulations contained in the ,/ _5
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permitee Signature
applicable laws. P11 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 ..'Svtivt,ti �-./
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 IN TALLATION 0►
SIGNATURE OF SUPR. ELEC' N : . / ! DATE: „ - T - 91
LICENSE NO: 6 3--LE
Call for inspection - 639 -4175
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: . it
13125 SW HALL BLVD Date Rec'd: Z—' 3 _9 7
TIGARD OR 97223 PRINT OR TYPE ',,pp
V - 503 - 639 -4171 X304 Permit #: FL- 17-004
F - 503 -684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE TYPE OF WORK INVOLVED - RESIDENTIAL
' " `t S `, O O / Q 8 ((FOR ALL SYSrTEEMS) $40.00
JOB Street Address Ste #
ADDRESS /s�a 0 S �J S)1Acci j `4 li q Check Type of Work Involved:
Cjtat/�State 1 I�p hone # ❑ Audio and Stereo Systems
Nan ❑ Burglar Alarm
c 1, 4 v 2 -5 U k - Co ❑
Garage Door Opener*
OWNER Mailing Address
I.Y5 - 2 d S uU 0,4ct. sc C. 0 LA ❑ Heating, Ventilation and Air Conditioning System*
City /State I ?lip I Phone
224 -i ❑
Name Vacuum Systems*
PRO I(
Other
CONTRACTOR Mailing Address
1 3595 A v4 A X TYPE OF WORK INVOLVED - COMMERCIAL
(Prior to issuance a ty /State Zip Phone # Fee for each system $40.00
copy of all licenses re •/1.. 9 230 ' 53-35 13 (SEE OAR 918 - 260 -260)
are required if O on Con BLic. # Exp. Date
expired in C.O.T. !�, (� (p 9 . r .
.7 Check Type of Work Involved:
data base). Electrical Contr. Lic # Exp. Date
6 — 6 U (�^ Er Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date
a7 h Z ❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT ❑ Data Telecommunication Installation
City /State I 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. ❑ 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. 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 applicant.
f / ___________ FEES: �j�
/� �"� La &.J ENTER FEES $ `40 •
Signature
5% SURCHARGE (.05 X TOTAL ABOVE) $ Z . 00
Authority if other than Applicant TOTAL $ 1 4 2 • tO
i:kesele.doc 12/96 —
Page No. 1 CASE HISTORY FOR CASE NO.: ELR97 -0034
CARL KARCHER ENTERPRISES
15520 SW PACIFIC HWY Unit: D
09/16/97
Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done- Dame Date By
ELRC001 Application Received 02/03/97 / / 02/03/97 RECD B 02/03/97 DST
ELRC003 Permit Created 02/03/97 /. / 02/03/97 PASS B 02/03/97 DST
ELRC500 (F) Issue permit / / / / 02/03/97 PASS B 02/03/97 DST
ELRC700. Ceiling Cover 02/03/97 / / / / 02/03/97 DST
ELRC720 Wall Cover 02/03/97 / / / / 02/03/97 DST
ELRC731 Elect'1 Service 02/03/97 / / / / 02/03/97 DST
ELRC799 Elect'1 Final 02/03/97 / / 02/11/97 PASS MJR 02/12/97 MJR
ELRC800 Case finaled / / / / 02/11/97 PASS MJR 02/12/97 MJR
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