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Permit V ; SIN O F T I CARD RESTRICTED ENERGY COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #: ELR95 -0206 13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 DATE ISSUED: 1 1 / 14 / 9 5 • PARCEL: 1S134DD -00102 SITE ADDRESS...: 10505 SW TIGARD ST SUBDIVISION....: ZONING :I -P • BLOCK LOT . ° Project Description: Protective signal. 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 Applicant: FEES - - - - - -- ADT type amount by date recpt 703 NE HANCOCK PRMT $ 40.00 CJS 11/14/95 95- 272812 5PCT $ 2.00 CJS 11/14/95 95- 272812 - PORTLAND OR 97212 Phone #: 503 -284 -3265 Contractor: ----- CONTRACTOR NOT ON FILE $ 42.00 TOTAL REQUIRED INSPECTIONS • Ceiling Cover Elect' 1 Service Phone #: • Wall Cover Elect' 1 Final Reg #..° This permit is issued subject to' the regulations contained in the Tigard Municipal Code, ,State of Ore. Specialty Codes and all other Perm i t e e Signature applicable laws. All work will be done in accordance with approved plans. This.per ®it will expire if work is not started within 180 days of issuance, or if work is suspended for more _ than 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: 077). DATE: ,J - /y- 9s LICENSE NO: Call for inspection - 639 -4175 Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION .,r-r. , 13125 SW Hall Blvd. � 'p � Tigard, OR 97223 PERMIT # E /r9c- O D. 06 11,1 "_ 1 Ph (503) 684-7 847 297 DATE ISSUED // - /y 9S * TDD No. (503) 684 -2772 // // CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY (1h? - .S SC// , , 9 PLEASE COMPLETE ALL SECTIONS 1. LOCATION OF INSTALLATION 4. TYPE OF WORK t t� %% / `, / A•dre ' RESIDENTIAL — Restricted Energy Fee $40.00 t CiV (FOR ALL SYSTEMS) City 4 State Zip 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 ❑ Garage Door Opener* 2. CONTRACTOR APPLICATION ❑ Heating, Ventilation and Air Conditioning System* Contractor Tyse d ,/ � ❑ Vacuum Systems* �/� /� i) / ` ❑ Other Address --- ����, /0./... � � Date 0 — / '- COMMERCIAL — Fee for each system $40.00 ' (SEE OAR 918- 260 -260) Property Owner _.0 M Check Type of Work Involved: Contractor's Board Reg. No. c: 5 - 9q 5/4 ❑ Audio and Stereo Systems* 3 ❑ Boiler Controls Phone # � ❑ Clock Systems 3. OWNER APPLICATION ❑ Data Telecommunication Installations �^ /^� ❑ Fire Alarm Installation 'c J Q7 ❑ 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. rn � �- 1. Only use electrical licensed persons to do installations where required (Certain Ll��Yfo 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. /'/J�� The person signing for this permit mus the applicant or a person a. Enter Fees $ 4 / 11V autho 'te o bind the applicant. / b. 5% Surcharge (.05 x total above) $ 66 Signature — TOTAL $ 14.60 Authority if other than applicant ENERGAP.CHP 11/10/1999 Activities for Case #: ELR95 -00206 9:05:55 AM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELRC001 Application Received 11/14/1995 CJS RECD TMP 11/14/1995 ELRC003 Permit Created 11/14/1995 CJS RECD TMP 11/14/1995 ELRC700 Ceiling Cover 11/14/1995 11/14/1995 TMP 11/14/1995 ELRC720 Wall Cover 11/14/1995 11/14/1995 TMP 11/14/1995 ELRC730 Elect'I Service 11/14/1995 11/14/1995 . ' TMP 11/14/1995 ELRC799 Elect'I Final 11/14/1995 11/14/1995 TMP 11/14/1995 ELRC500 (F) Issue permit 11/14/1995 CJS PASS TMP 11/14/1995 ELRC799 Elect'I Final 11/30/1995 MJR PASS . MJR 11/30/1995 ELRC800 Case finaled 11/30/1995 MJR YES MJR 11/30/1995 Page 1 of 1 CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4171 Inspection: L- 4' .4� /—':-a- , Footing Susp. Ceiling Sprink. Rough -in Appr /Sdwlk Foundation Plbg. Underslab Mech. Rough -in Fireplace Post /Beam Struct. Plbg. Top Out :. 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: /1/3o/55" Time: AM PM_ Address: / b SD Builder:4 1) T Permit #: �4. f S Da THE FOLLOWING CORRECTIONS ARE REQUIRED: ,e4r1/14 ......, Cr Inspector: M ®Z/ / 1 4 ( jel Date: l / 3 PPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE _Call For Reinsp. -P- 5