Permit CITYOFTIGAR
% I; '' � + ���, i �
DEVELOPMENT SERVICES ._
ELECTRICAL PERMIT Hall Blvd., Tigard, ( 6
) RESTRICTED ENERGY
PERMIT , Pe ELR97-0316
DATE ISSUED° 11/06/97
PARCEL: 2S1 1Q'DC - -tZi2 20 i '
SITE ADDPESS... e 15532 SW PACIFIC H lY a C -,1.
SURD I V I S I ONa = . , °WILLOW BROOK FARM Z.ON I NG s C•• -C
BLOCI._no73,,. LOT ona n„nn011. J•URISDICTNe TIC
Project Description: Installing burglar; elan]
A. RESIDENTIAL------ _- ._._.._ 13. COMMERCIAL--------------- ------------------
AUDIO & STEREO.., e AUDIO & STEREO—: a INTERCOM. & PAGING..:
BURGLAR ALARM= ... o BOI LER. o e :, a .ono . = LANDS CAPE / I RR I GAS'•„
GARAGE OPENER....: CLOCK...........: MEDICAL.,..........
DATA /TEL_E COMM..: NURSE CALL S,: t .. o ., a . b
VACUUM SYSTEM....: FIRE ALARM. e ..... OUTDOOR . L ANDSC LITE:
OTHER: n ne
o a iVFir� . . e � � r 'RO1"E_CTI VE SIGNAL—:
a
INSTRUMENTATION.: OTHER.. a BURGLAR N:
TOTAL .: OF SYSTEMS: 0
Owner: ._._.-_._._ _.___._____.___._. ___._.._..- .--- .._...__.:._____
.i IGARD CENTER LP type amount; by date r
9777 WILSHIRE BLVD PRMT i 40.00 B 11/06/97 97- -300731
STE 609 • SPCT 2.00 B 11/06/97 ?7 -300 7 3 1
BEVERLY HILLS CA 90212
Phone e
•
Cont r•act or e ---------
WIL.l_AME TTE VALLEY SECURITY $ 42•, 00 TOTAL
.RYAN J ACOBSEN •
24190 PEACH ST ------ REQUIRED INSPECTIONS
•
L,A�Cover " OR 97013 Ceiling Cover Low Voltage Ins;p
"Y �.
Phone #e Wall Cover Elect' 1 Final
Reg *.. 009693
This pes`cit is issued subject to the regulations contained in the Tigard Municipal ,ode, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This peroit will expire if :cork is not started within 1S
days of issuance, or if work is suspended for pore than 180 days. ATTENTION: Oregon law requires you to follow rule adopted by the
Oregon Utility Notification Center. Those rules are set forth in ORR 9527001-0010 through ORR 952- rBZi- +0o80. You nay obtain copies 'of'
these rules or diKr question, to OUNC at (503)246 -1937. '
Issued by 1 / L./ Per°mi Signatur '`_'_
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 l: N'STAL.LA T I.ON
SIGNATURE OF S ►JPR. ELEC' N s _—_ _ _ DATE e _.__�_ __ _.--.--_�_—
LICENSE NO e
-?--I- -i--s-+-F-f"-r--t•4-4-- 4.4.-'ri--F++.1 -4.4. . +4- 1- -I- 1-i--I -1-4-4-4-• i-- F- I-° I-• i-- I-- I-- h•• I°- r-- h• f- r•+°i-•-r--I- •f-ii-- 1--t--F•i -•f• -I-- 1- ..r--i--t•-i 1--k•-i-1--i- -#...i-4.{..;. 1±
Call 639-4175 by 7 :00 P.M. For an inspection needed the next business day
+± +±-S --r l-•}• ±+•i-+ +± + + ++ +±-M±±. +.+ +±-1--.±.+ ±++4•+-r•- ti-- h7-• i-- F. ..f... ±.;..f.r....r--[.•- `-1-,' 1 -a-- }. ..r--r..±.r..±,. -- ++ + +.;-± +•t- #4++.i..
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: 16 . 1 6 i .-
13125 SW HALL BLVD Date Rec'd: / , –'
TIGARD OR 97223 PRINT OR TYPE n� /
V - 503 - 639 -4171 X304 .. Permit #: �K (G� 7 -et (�
F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
705-66L ( A LL Energy Fee $40.00
Avw (FOR ALL SYSTEMS)
JOB Street Address Std,#
ADDRESS ti, �Z v ( �`_1 Check Type of Work Involved:
City/State Zi Phone # ❑ Audio and Stereo Systems
T m7 ( i '7 zzq Ggq — coup
Name f GS .74-K -K r
\ \OAM/ -I � GAAIIC L1 ❑ Garage Door Opener'
OWN R Mailing Address-) \ 9 1/7 1�` f FS
411` /S�' Heating, Ventilation and Air Conditioning System'
e � �
i Li 4I\\
-L a City /State Zi 2 (4 68 4 Ph # � -yam Vacuum Systems*
Name ( (((.
o llomt/* va iY� wet,' I ❑ Other
CONTRACTOR Mailing Addres 1
2(II`iD Y�CIr1 C �' TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /State Zip Phone # Fee for each system $40.00
copy of all licenses eptv%blq r 2 Q' "5Z13 (SEE OAR 918 - 260 -260)
are required if Oregon Cbntr Brd Lic. # Exp. Date
expired in C.O T. 001 32 2/ f r Check Type of Work Involved:
data base). Ele rical �(p ate
7 0/ ❑ Audio and Stereo Systems
C.O T. or Metro Lic. # Exp. Date
❑ Boiler Controls
O er's Name
' A rt ,S D'b5en ❑ Clock Systems
OWNER - Mailing Addre \,., <g-
APPLICANT 2`�UQb +ALL% ❑ Data Telecommunication Installation
City/ fate Zip � 14L Phone ❑
Fire Alarm Installation
This permit is issued under OAE 918 -3/0 -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
corrections are completed. IY I Other ,Gil 2 / /,Q J ,r�
Permits are non - transferable and non - refundable and expire if work is not 7�
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 a licant.
? , FEES:
SignsAhe
ENTER FEES $ c��'vo
5% SURCHARGE (.05 X TOTAL ABOVE) $ , / 1 �
Authority if other than Applicant TOTAL $ Z
i \dsts \resele doc 7/97 —