Permit I/
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd. 1-� 9s" -6a g
Tigard, OR 97223 PERMIT #
D, vg ∎ Phone (503) 639 -4171 DATE ISSUED � � � ��
*I I FAX (503) 684 -7297
^'^� - TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY
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PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
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Address RESIDENTIAL — Restricted Energy Fee $40.00
tY�' �r.1 X12 G722y
Ci (FOR ALL SYSTEMS)
State Zip / Check Type of Work Involved:
PERMITS ARE IS NOT STARTED WITHIN NON-TRANSFERABLE 8 DAYS OF I ISSUANCE OR IF WORK I SUSPENDED OFOR Audio and Stereo Systems*
180 DAYS. Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
Contractor Type ❑ Vacuum Systems*
Address ❑ Other fl 1
Date COMMERCIAL — Fee for each system $40.00
(SEE OAR 918 - 260 -260)
Property Owner Check Type of Work Involved:
Contractor's Board Reg. No. ❑ Audio and Stereo Systems*
❑ Boiler Controls
Phone # ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
� ❑ Fire Alarm Installation
L= Ri J F-L (5 636 - 'S Z ❑ HVAC
Print Owner's Name Phone No
3 76 S ❑ Instrumentation
Address ❑ Intercom and Paging Systems
LAKE 6Svaray„. L# c - 73u ❑ Landscape Irrigation Control*
City State Zip l ❑ 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 corrections 5. FEES
are completed.
The person signing for this permit must be the applicant or a person a. Enter Fees $ 4.,
authorized to bind the • .
b. 5% Surcharge (.05 x total above) $ 09-6 Signatu µ r�
TOTAL $
Authority if other than applicant
ENERGAP.CHP
5/24/00 Activities for Case #: ELR95 -00083 •
2:08:34 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRA003 APPlication received 8/15/95 JIM RECD TMP 12/28/95
ELRA010 Permit created 8/15/95 JIM PEND TMP 12/28/95
ELRA700 Ceiling Cover 8/15/95 TMP 12/28/95
ELRA720 Wall Cover 8/15/95 8/25/95 MJR PASS JF 6/10/96
ELRA730 Elect'l Service 8/15/95 TMP 12/28/95
ELRA799 Elect'I Final 8/15/95 TMP 12/28/95
ELRA500 (F) Issue permit 8/15/95 JIM PASS TMP 12/28/95
ELRA800 Case finaled 6/10/96 MJR YES MJR 6/10/96 •
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4171
Inspection: aL)-02
Footing Susp. Ceiling Sprink. Rough -in Appr /Sdwlk
Foundation Plbg. Underslab Mech. Rough -in Fireplace
Post /Beam Struct. Plbg. Top Out 40 Rough -in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing - Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. - Elect.
Date Requested: O I �C I / 5 Time: AM PM
Address: / 3 - 7 4 3 C..
Builder: 69 •5 — S j 2 Permit #: E 7 0$3
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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I spec ` C i J Date: T�, 9C--
PPROVED DISAPPROVED _APPROVED SUBJECT TO . : •
_Call For Reinsp.
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