Permit -- � --�-7 — 1�nW -- 7 — � - . ' ----__ _ � ____�________ _
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�� ` )1 T ELECTRICAL PERMIT -
~--�m�'�UU�0 � � �`����-�&��&N�� RESTRICTED' ENERGY • ' . COMMUNITY DEVELOPMENT DEPARTMENT' . , � � ' PERMIT #: ELR96-Q10!
13126 Swm�m,�r�*�.op�o m�u�mvn��p�m��1n 4.' " . DATE ISSUED; 03/21/96
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� ^ � ' ' PA�CEL: 1S
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' 3:TE ADDRU3S...@ 11507 SW PACIFIC HWY #D .
3UBDIVIGION.... VILLA RIDGE (PART ONLY) ZONING:C-G
B�CCK. —0•„ . . . ... ; LOT. .... .. . . . ... 17 .
Project Description,: Install prptective signaling, '
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A. RESIDENTIAL --------- �. COMMERCIAL_------------------�---�-----__-------
AUDIO & STEREO. .. : AUDIO & STEREO-2 . INTERCOM & PP8IMG'. :
BURGLAR ALARM....: . BOILER..........: 'LANDSCAPE/lRRIGAT..:
GARAGE OPENER..... : CLOCK........ ... : . MEDICAL... ...',. .... ,
HVAC. . . . . . . . , .; . . . : ' DATA/TELE COMM; . : ., NURSE CALLS. . -. . . . . . :
VACUUM CYST[M.,. .. ; FIRE ALARM.... .. : OUTDOOR L�NDSC LIT[:
. OTHER: , :: : HVAC..^.......:..: PROTECTIVE SIGNAL...:X
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' INSTRUMENTATION.: OTHER.. : � ::
. ' . . � . 'TOTAL # OF SYSTEMS: 1
Applicant - ' - ' - ��--------- ----- - ----�------------ FEES -----------'---
BENCHMARK MORGt �A8E INC � ype amoun t b y date t
a e ' recpt
SW PACIFIC .. PRMT $ 40.00 CJS,03/21/96 96-277290
' . ' 5PCT $ 2.00.CJS 03/21/96 96-277290
TIGARD OR 97223 ' ' .
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T SECURITY ALARMS ` � ' � ` �2.00 TOTAL ' ^ '
, N. E. HANCOC|< '. ` .. ' ' . '
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' ' � , �----- REQUIRED INSPECTIONS------- . PORTLAND OR c',7212 . 7212 � ^ Ce i l ihg Cover ' : Elect ' l Sep �e �i� '' • " Phone #: 503-2�-1�9 . ' '` . �` Wail Cover . Elect" l Final.
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Re g t). � : 59944 � ' . ' ' '
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the regulations contained in the � � �
, Ti Code, State of Om. Specialty Codes and ail other Perm t ee Si gnat ur e ' '' apP iCab}�' �xs All work' will be done in Ecca Ia�ce with � . . '
' approved `plans. This peoa will oxpir6 if work is not 'started .
within D8S a s of issuance, or if work is suspended for _more �/
u e ��` /~, '..e-- • �___ '
� t�a: �� da�. ' ' ' Iss�ed By
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--� '-'-------: INSTALLATION ,ONLY---------.-- -------.------- ' '
The'installatipn is being made on property I own.which is not intended for ,
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- sale. ) lease, or rent. ` `
OWNER'S SIGNATURE: � __�_____�_ DATE: -,---- ____�
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- - , -----------------�---CONTRACTOR INSTALLATION ONLY----'----------------'---
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AUTHORIZED SIGNATURE; aJ��i^�° yio� ' DATE: .3 �S .
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' LICEi��E N0,1 ' � • .
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, Call for 'inspection -.639-4175 -
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Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 RERMIT # EL 896 -oroo
/�n, ; \ Phone (503) 639 -4171
jll I FAX (503) 684 -7297 DATE ISSUED .3 d I - 96
- TDD No. (503) 684 -2772 / /
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY Cha f lex' Schif..a
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATJQN o i 4. TYPE OF WORK
//507- D keo). 1 Yd (,'
Add, -, , ,i_ ��r�� 6 RESIDENTI - Restricted Energy Fee $40.00
(FOR ALL SYSTEMS)
City 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
2. CONTRACTOR APPLICATION ❑ Garage Door Opener*
ditittAX_Y■i ❑ Heating, Ventilation and Air Conditioning Systems
Contractor i#DTSTCURITYSYSTEMS,INC. Type .s .s .;.4/ / / I Vacuum Systems*
703 NE HANCOCK ❑ Other
Address PORTLAND, OR 97212
X55031284.3265
Date / a -6 COMMERCIAL — Fee for each system SALM
�� Amiga. (SEE OAR 918 - 260 -260)
Property Owner dent A/ / chec Ty pe of Work Involved;
Contractor's Board Reg. No. 1:599 1. ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone # ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
f, ❑ Fire Alarm Installation
CQfkt NCI o c r-S .5 ❑ HVAC
Print 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 ❑ Out rLandscape 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 final inspection when all of the 5. FEES
corrections are completed
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The person signing for. s p • it must be the applicant or a person a. Enter Fees $ "/ l/• Q `�
authorized to . the appl'' ant.
� � b. 5% Surcharge (.05 x total above) $ c9- C d
Signature 4. Q t
TOTAL $
Authority if other than applicant
ENERGAP.CHP
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line A /Sdwlk Reins.
Other .�..I
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Date: II ( g l Co A.M P.M. Entry:
Address: D `'t"
Tenant: e■■ • - - : Ste. MST:
4 BUP:
Con /Own: I♦':_!� .. S. MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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WOJIMAPPIIF
Mill= I 110 1
Inspe tor: 'i_ /�71 1
� / Date: — �i" '
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(APPROVED _ DISAPPROVED /CALL FOR REINSP. SO CO