Permit Comm Develo ment /
ty p RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 uni SW Hall Blvd. PERMIT # , F/
Tigard, OR 97223 R 95-
0070
i46711 i �
Phone
FAX (503) 684-7297 1 DATE ISSUED 7 -2) -95
�- TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY Charles Schrn ;a0'
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
/ 3752 J.W. •:).5L( C,4.
dd RESIDENTIAL — Restricted Energy Fee $40.00
' `i»4 '-0( 17 . q 7.02-2-g (FOR ALL SYSTEMS)
City State Zip Check Type of Work Involved:
PRMITS ARE S NOT STARTED WITHIN DAYS OF SSUANCE OR IF WORK AND SUSPENDED OOR ❑ Audio and Stereo Systems
180 DAYS. ■Burglar Alarm
2. ONTRACTOR APPLICATION
❑ Garage Door Opener*
�,, (� / , ❑ Heating, Ventilation and Air Conditioning System*
Co tra ,, br I ICS AllA _ G� WW ❑ Vacuum Systems*
Address e0S 9 £W • l�C .c�
11 .tCx, • ❑ Other
Date- ` .S/ j S COMMERCIAL — Fee for each system $40.00
i � 2 r (SEE OAR 918-260-260)
Property Owner r � lJ� Check Type of Work Involvedd ;
Contractor's Board Reg. No. '6 �' ( ❑ Audio and Stereo Systems*
/ O S� Y ❑ Boiler Controls
Phone Y # c� ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
4 &s � ! . S7 ? -/2r2 ❑ Fire Alarm Installation
t� ❑ 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 corrections 5. FEES •
are completed.
•
The person signing for this permit must be the applicant or a person a. Enter Fees $ 9d `
authorized to bind the applicant. T
b. 5% Surcharge (.05 x total above) $ 0.2–
Signature
TOTAL $ V)--- r
Au or ty if other than a
ENERGAP.CHP
5/24/00 Activities for Case #: ELR95 -00070
2:05:00 PM
Assigned . Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRA003 Application received 7/31/95 CJS RECD TMP 12/28/95
ELRA010 Permit created 7/31/95 CJD PEND TMP 12/28/95,
ELRA700 Ceiling Cover 7/31/95 TMP 12/28/95
ELRA720 Wall Cover 7/31/95 TMP 12/28/95
ELRA730 Elect'l Service 7/31/95 TMP 12/28/95
ELRA799 Elect'I Final • 7/31/95 7/31/95 MJR PASS MJR 3/31/97
ELRA500 (F) Issue permit 7/31/95 CJS PASS . TMP 12/28/95
ELRA800 Case finaled 7/31/95 MJR PASS MJR 3/31/97
•
•
•
Pagel of
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4171
Inspection:
Footing Susp. Ceiling Sprink. Rough -in ppr /Sdwlk
Foundation Plbg. Underslab Mech. Rough -in Fireplace
Post /Beam Struct. Plbg. Top Out Elec. 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 I , Gyp. Bd.
Requested: G
Time: AM PM
Address: a-
WZ: Permit #: are-, S 66)-16)
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspec Date e4c)./C6-'''
AP" OVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.