Permit 41,0
CITY OF TI G A R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
�a1l1A DEVELOPMENT H BMEN t 639 -4171 DATE PERMIT #: ISSUED: g% 3 /99
g -00220
SITE ADDRESS: 12144 SW SCHOLLS FERRY RD PARCL: 1S134BC -00101
SUBDIVISION: 1\\ + ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: Installtion of POS - cash registe `\
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:
INSTRUMENTATION: OTHER: POS /CASH R X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
WILLIAM W. SAUNDERS, TRUSTEE • AA TECHNOLOGIES
2155 KALAKAUA AVE STE 500 3439 NE SANDY BLVD
HONOLULU, HI 96815 PORTLAND, OR 97232
Phone: Phone: 756 -1151
Reg #: LAC 71662
ELE 34- 477CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT DEB 9/23/99 $60.00 99- 318559 Elect'l Final
5PCT DEB 9/23/99 $4.20 99- 318559
Total $64.20
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other 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 than 180 days. ATTENTION: Oregon law
requir- . _ - • follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9 - 001 -0010 t' • ugh OAR • 52- 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
6 -1987.
Is ued by ` , .._d y Permittee Signature
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 DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
I
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: ., 4 .
13125 A/ HALL BLVD Date Rec'd:- . -, _ -
TIGARD OR 97223 PRINT OR TYPE -
V - 503 - 639 -4171 X304 Permit #: & -ado
F - 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE AL`CEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
�p & tL 0) +` ^ L S �n ` Restricted Energy Fee
(FOR ALL SYSTEMS) $60.00
C
JOB Street Address Ste #
ADDRESS 1 2144 S t (�s ckyi Check Type of Work Involved:
City /State Zip Phone # ❑ Audio and Stereo Systems
1ic O( 9 - 123 _
Name ❑ Burglar Alarm
OWNER Mailing Address ii Garage Door Opener'
City /State Zip Phone # ❑ Heating, Ventilation and Air Conditioning System'
Name ❑ Vacuum Systems'
AA T rL.0 1 N O Li G I C 5 ❑ Other
CONTRACTOR Mailing Address TYPE OF WORK INVOLVED - COMMERCIAL ONLY
343y L) a > . � �y btu
(Prior to issuance a City/State Zip Phone #ggc) Fee for each system $60.00
copy of all licenses t?or^k(a, (3 I e l 7Z31- r 752,,—//.57 (SEE OAR 918 -260 -260)
are required if Oregon Contr. Brd Lic. # Exp. Date
expired in C.O.T. 7 I(,,(2_ (o ZS -W Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp. Date
? 77 0 -1_00 ❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date
❑ Boiler Controls
Owner's Name
❑ Clock Systems .
OWNER - Mailing Address
APPLICANT ❑ Data Telecommunication Installation
City/State 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 /� p c p ��
corrections are completed. IA Other To5 r eA J 11
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.
FEES:
1 0
Signa ure
ENTER FEES $ �O
7(D 4/
SURCHARGE (.05 X TOTAL ABOVE) $ 7
Authority if other than Applicant TOTAL $ (0 '
is \dstsVorms resele.doc 3/98
10/08/1999 Activities for Case #: ELR1999 -00220
10:41:32 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRC001 Application Received 09/23/1999 DEB DONE No Hold DEB 09/23/1999
ELRC003 Permit Created 09/23/1999 DEB DONE No Hold DEB 09/23/1999
ELRC725 Low Voltage Inspection 09/23/1999 DEB No Hold DEB 09/23/1999
ELRC799 Elect'I Final 09/23/1999 09/23/1999 10/04/1999 CD PASS No Hold AKJ 10/05/1999
ELRC500 (F) Issue permit 09/23/1999 DEB DONE No Hold DEB 09/23/1999
ELRC800 Case finaled 10/05/1999 AKJ DONE No Hold AKJ 10/05/1999
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