Permit CITY OF TIGARD ELECTRICAL PERMIT —
"COMMUNITY DEVELOPMENT DEPARTMENT RESTRICTED ENERGY
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PERMIT #: EL R9 6 —0159
DATE ISSUED: 06/03/96
PARCEL: 26112AD -01000
SITE ADDRESS...: 14945 SW SEQUOIA PKWY #170
SUBDIVISION ZONING:I —P
BLOCK LOT •
Project Description:
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..:X
INSTRUMENTATION.: OTHER..: ..
TOTAL # OF SYSTEMS: 1
Owner: FEES
COMMUNI (K) type amount by date recpt
14945 SW SEQUOIA PKWY PRMT $ 40.00 CJS 05/14/96 96- 279376
SUITE #170 5PCT $ 2.00 CJS 05/14/96 96- 279376
TIGARD OR 97224
Phone #:
Contractor:
ADT SECURITY ALARMS $ 42.00 TOTAL
703 NE HANCOCK
REQUIRED INSPECTIONS
PORTLAND OR 97212 Wall Cover Elect' 1 Final
Phon #: 503 -284 -3265 Elect'1 Service
Reg #. ° : 59944
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permit e e Signature
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 C.11 Or /6 c S2I -- , cl1
t han 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 INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: eln Gpf1,cr--ch6i DATE: 5
LICENSE NO:
Call for inspection — 639 -4175
. , A Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT # ELR96 - 059
a ���� I li 11 Phone
FAX (503) 684-7297 1
DATE ISSUED 5 IS' - 96
-- TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY Ck, r /e r _Cc hm :el/
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTA CATION , / k J ; TYPE /70 WORK
Ad dre , RESIDENTIAL — Restricted (FOR ALL SYSTEM Energy S)
,fa..4L
Fee $40.00
(
Ci State Zip " 724-d"
� Check Type of Work Involved:
PERMITS ARE NON - TRANSFERABLE AND NON - REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems
IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
180 DAYS. ❑ Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener*
/ ❑ Heating, Ventilation and Air Conditioning System*
wr
Contractor •e rt_sr lN(T,ype _ /l1.` __ . 0 ,! a Vacuum Systems*
703 NE HANCOCK I ❑ Other
Address PORTLAND, OR 97212
(51331184-3265 /, //
Date �% O.9 {p COMMERCIAL — Fee for each system $40.00
o (SEE OAR 918- 260 -260)
Property Owner Check Type of Work Involved:
Contractor's Board Reg. No. cce...‘9 CP. ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone # ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
i / / ' i 4 _ d1._ / i - b ❑ 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
rotective Signaling
residential and other transactions are exempt from licensing. These have Z •
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 5. FEES
corrections are completed. /�
The person signing for is p it must be the applicant or a person a. Enter Fees $ 4. UO
authorized to bi ap cant.
- b. 5% Surcharge (.05 x total above) $ c 9.6 0
Signatur
TOTAL $ �• 6O
Authority if other than applicant
ENERGAP.CHP
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: A.M. P.M. MST:
Location: 1 9 3' j ��-C . BUP:
Tenant ) .;riL AI[ .4A k Suite: i , d Bldg: MEC:
Contractor: if�� Phone: D 7 C PLM:
Owner: Phone: ELC:
ELR: / e i c l
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
.I - i /
4-4x. V e A i.4-L (o
/ /
-, -
/ /
4.,„_., / �i.d. ✓v 1a W Li _
II Call for reinspec / 0 Reinspection fee of $ required before next inspection 0 Unable to inspect
Inspector: - / - ''a_— Date: 6+ /�/V9 Page of