Permit CITY OF TIGARD ELECTRICAL PERMIT- .
RESTRICTED ENERGY
, �r�i� n . DEVELOPMENT SERVICES PERMIT #: ELR1999 -00260
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/3/99
SITE ADDRESS: 12376 SW QUAIL CREEK LN PARCEL: 2S103C6 -09400
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 052 JURISDICTION: UR
Project Description: Installation of low voltage for audio & stereo system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: X 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:
INSTRUMENTATION: OTHER: .
TOTAL # OF SYSTEMS:
Owner: Contractor:
JASON BIRD OWNER
1276 SW QUAIL CREEK LN
TIGARD, OR 97224
Phone: 968 -5717 Phone:
Reg #:
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRM3 DEB 11/3/99 $60.00 99- 319512 Elect'l Final
5PC2 DEB 11/3/99 $4.80 99- 319512
Total $64.80
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all • er applica • - aws. All work will be done in accordance with approved plans. This permit will expire if work is
not arted within 180 day of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
re- uires you to follow rules - ..opted • • i e Oregon Utility Notification Center. Those rules are set forth in OAR
9.2- 001 -0010 hrough OA .;52 -0' 1! :1 •. may obtain copies of these rules or direct questions to OUNC at (503)
2 ,, - I e___:/ Is ed by - = - ? ' 4 /" :/ i Permittee Signature r ,... �
OWNER INSTALLATION ONLY
The installation Is being made on property I own which is not intended for sale. lease, or rent. c
OWNER'S SIGNATURE: )� 'e..-.---/ DATE: 3 -/ / c
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELECN: DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd b
18125 SW HALL BLVD Date Rec'd: / /' 3 -re
TIGARD OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X304 W' Permit #: E ,260
F - 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIO ► `�V Cust.Call'd:
WILL NOT BE ACCEPTED V`
Name of Development Project TYPE OF WOR ► • LVED - RESIDENTIAL ONLY
Restricted Energy Fee $60.00
(FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS 1025 Gat? 749 �5..p) Q »1 L Check Type of Work Involved:
/� � 0 77 O �' Audio and Stereo Systems
Name "' vv Ogg ❑ Burglar Alarm
OWNER M cling ❑ Garage Door Opener'
IU DAddress . 4.40 ❑ Heating, Ventilation and Air Conditioning System*
City /State Zip Phone #
Name ❑ Vacuum Systems*
❑ Other
CONTRACTOR Mailing Address
TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /State Zi Phone # Fee for each system $60.00
copy of all licenses (SEE OAR 918- 260 -260)
are required if Oregon Contr. Brd Li . Exp. Date
expired in C.O.T. Check Type of Work Involved:
data base). Electrical C r. Lic. # Exp. Date
❑ Audio and Stereo Systems
C.O . or Metro Lic. # Exp. Date
❑ Boiler Controls
Owner's Name , D
SO ✓� I' ❑ Clock Systems
OWNER - Mailing Address
APPLICANT f a3 76 SGU Q( ; 1 creek. ❑ Data Telecommunication Installation
City/State Zip Phone #
e D e %7223 f49 -57/7 ❑ Fire Alarm Installation
This permit is issued under`6AE 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 bind the applicant.
• FEES: / CO .
Sign re E_NTiR FEES .es? $ `(- ✓''
S URCHARGE (.05 X TOTAL ABOVE) $
Authority if other than Applicant TOTAL $ 64-g
is \dsts \forms\resele.doc 3/98
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01/05/2000 Activities for Case #: ELR1999 -00260
10:58:38 AM
Assigned Hold ' Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRA003 Application received 11/03/1999 DEB DONE No Hold DEB 11/03/1999
ELRA010 Permit created 11/03/1999 DEB DONE • No Hold DEB 11/03/1999
ELRA725 Low Voltage Inspection 11/03/1999 DEB No Hold DEB 11/03/1999
ELRA799 Elect'I Final 11/03/1999 11/03/1999 12/29/1999 BRP PASS No Hold AKJ 12/29/1999
ELRA500 (F) Issue permit 11/03/1999 DEB DONE No Hold DEB 11/03/1999
ELRA800 Case finaled 12/29/1999 AKJ DONE No Hold AKJ 12/29/1999 •
ELRA800 Case finaled • 12/29/1999 AKJ DONE No Hold AKJ 12/29/1999
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