Permit FROM : 011 I ELECTRIC PHONE HO. : 503 635 1391 Sep. 13 1 9 ' i l 5 0 i ' : 2 .'tall P
^9!12/95 14:43 0503 684 7297 CITY OF T1CARI) ZUU2'002
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
PERMIT #
13125 SW Hall Blvd.
Tigard, OR 97223 1 / ,R S _ 01
„� A „�. , Phone (503) 639 -4171 17�TE ISSUE 3 R � '
' % II FAX (503) 684 -7297 i
TDD No. (503) 684 -2772
CITY OF TICARD Inspection (503) 639.4175 ISSUED By
i/
PLEASE COMPLETE ALL SECTIONS
1, LOCATION OF INSTALLATION 4. •TYPE OF WORK
9400 SW Washington Square Rd.
Address RESIDENTIAL — Restricted Energy Fee , S30t41!
Tigard Oregon 97223 (FOR ALL SYSTEMS)
City Stale Zip Chprk Type of Work Involved:
moors ARE NON- TRANSFERABLE AND NON - REFUNDABLE AND EXPIRE IF WORK 0 Audio and Stereo Systems` •
IS NOT STARED WITHIN 150 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
lab DAYS ❑ Burglar Alarm
❑ Garage Door Opener'
2. rC WRR AP.PLICATI9N . Inc. 6 ❑ Heating, Ventilation and Air Conditioning System'
onic on r
Contractor L EC S n d & C o mmType L im E ri e r qv _ . ❑ Vacuum Systems.
124 SE 11th Ave., Portland, OR 27214 ❑ Other_
Address _. - -
Data 9 –1 3 – 9 5 COMMERCIAL — Fee for each System $41OU
(SEE OAR 918- 260-260)
Property Owner Mervyn ' s Ch k Tv of LNnrk Ittralse ds
—
Contractor's Board Reg. No. 6 5 3 81 - - El Audio and Stereo Systems
❑ Boiler Controls
Phone # ( 503) 234 - 3044 - _ ❑ Clock Systems
El Data Telecommunication Installations L i c R 31 6 5 C L E
3. OWNER APPLICATION Q Fire Alarm Installation
❑ HVAC
Print Owner's Name Pone No ❑ Instrumentation
O intercom and Paging Systems
Address
❑ Landscape Irrigation Control'
City State Zip ❑ MadiCal
❑ Nurse Calls
Thls permit la Issued under OAR 918- 320 -370. This applicant agrees to ma only
restricted energy inyWtlatiOns 1100 watt amps or lest' under this permit and ro do the ❑ Outdoor Landscape Lighting*
following:
0 Protective Signaling
1. Only use electrical licensed persons to do Installations where required. (Certain
residential and other transactions are exempt from licensing. These have ❑ Other —_
tuterlsksi'l. All others need licensing).
2. Call for en Inspection when all of the installations under this permit are ready
for inspection at 303.639.4175. ❑ 2 Number of Systems
3. Purchase separate permits for all installations that are not ready for inspection
when the Inspector is out lu 'Motet under this permit. - No licenses are required. Licenses ate required (or till other installations.
4. AsSVme respr)nsiblllty for assuring that all corrections required by the Inspector - '”
are done. rend
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 S 80 . 00
authorized to bind the applitanl.
.. ` , b. 5% Surcharge (.05 x total above) $ 4 . 0 0
Signature TOTAL $ 84.00
Authority If other an applicant
cr.var.Aa rwn
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4171
Inspection: ✓rte j / i • it! - ...ia C
Footing Susp. Ceiling Sprink. Rough -in Appr /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 Gyp. Bd. - Elect.
Date Requested: 7 / 51,5" Time: AM PM
Address: ' 7 T00 t'i[j/q . S V`. V c
Builder:A ; 0'3 4-36 tp-1 Permit #: EL1 SU ( 1
THE FOLLOWING CORRECTIONS ARE REQUIRED:
�u - (iQ �� 4., � - li�l7`
?'(t- � Pli
ate /cc-.) e 1
y s f
Inspector: fj r C4,de / �c,{ Date: — ��5 - ---
A PPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
_ Call For Reinsp. EL V f2