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CITY OF TIGARD
DEVELOPMENT SERVICES FI-FCTRICAL PERMIT
13125 SW Hall Blvd'., Tigard, OR 97223 (503)639.4171 RE=STRICTED ENERGY
PERMIT #: EL_R97-0092
DATE ISSUED: 06/ 1 :/97
PARCEL: 2S104CC--HW096
SITE ADDRESS. . . : 1.3604 SW ASCENSION DR
SUL.AD I V 1 S I ON. . . . :H I LLSH I RE WOODS ZONING: R--7 I'll
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . .. . . .096 JURISDICTN:
F'ro J ect De scr^i pt i on: Residential backflow prevention device
A. RESIDENTIAL--------- - B. COMMERC:lAL___.__.---____.____-----------.____._._____._..
AUDIO R STEREO. . . : aUD I O & STEREO. . : INTERCOM R PAGING. . :
BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. . :
GARAGE OPENER. . . . . CLOCK. . . . . . . . . . . . MEDICALL. . . . . . . . . . . . .
HVAC. . . . . . . . . . . . . . DATA/TELE COMM. . : X NURSE CR'_LS. . . . . . . .
VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR LANDSC LITE:
OTHER: : : X HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . :
INSTRUMENTATION. : OTHER. . : . .
TOTAL # OF SYSTEMS: 1
Owner: ________.__._.__._.__._____.______..____.____._______.___....--__-_-- FEES -- -
WINDWOOD HOMES INC type amol.int by date r•ecpt
14076 SW BENCHVIt=_W TERR PRMT $ 40. 00 JSD 03/26/97 97-292200
T"IGARD OR 972.x'4 5r'CT $ 2. 00 JSD 03/26/97 97-292200
F RMT $ 40. 00 TAT 06/121/97 97--295875
Phone #: 590--4700 5PCT 9 2. 00 TAT 06/12/97 97--295875
v
;on :rac or: -------.--
CEDAR LANDSCAPE $ 84. 00 TOTAL_
14:375 SW PATRICIA
--- --- REDUIRED INSPECTIONS --------
HILLSBORO OR 971 :3 Elect' 1 Final
Phone #: 628-3411
Reg 4. . : 000058
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180
lays of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rule adopted by the
Oregon Iitility Notification Center. Those rules are set forth in JAA 952-001-0010 through OAA 952-901-0090. You may obtain copies of
these riles or direct questions to OLINC at (503)246-1987.
1 s s+_i e d b y ... . _. Permittee S i g n a t f.t r e
INSTALLATION
The installation-is being made on property I own which is not intended for
sale, lease, or rent.
OWNER' S SIGNATURE: _ __ — _-- DATE �-----
_---�ONTRaCTOR INSTALLATION ONLY--------._ __-----------_-_..--_._--
S I GK,ATURE OF SUPR. ELEC' N: _ _ - �.. DATE. :
l_T CENSE NO:
+++4.4+++++++++4+4++++++++•t++++++++++4•+++++++++4; ' . ++++++4++++++4+++++++++
Call 639-4175 by 6:00 P. M. for an inspecti(in needed the next b+_isiness day
++++++++++++++++++,++++++++++++4++++++++++++++++++++++-�+++++++++++f+++++++++4
- ,r
04,'18%A7 13:05 '0503 684 7297 CITY OF TIGARD X1002-003
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by: _
1312E SW HALL BLVD Date Recd:
TIGARD OR 97223 PRINT OR TYPE
V-50"39-1171 X304 Permit#
F-503-884-7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Cell'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED -RESIDENTIAL
'(CEl-kj I(n(5u S (FOR ALL SYSTEMS)........................................ $40.0
01
JOB Street Address Ste
Check Type of Work Involved:
ADDRESS 10;N0 S.W. Uih U%
City/Slate zip Phone 0 F] Audio and Stereo Systems
UK— 'S
Name Burglar Alarm
i L r " J 6" ` ❑ Garage Door opener-
OWNER Mailinj Address
/ _S I r v f ❑ Heating,Ventilation and Air Conditioning System'
ityl tats Phone If
L' Vacuum Systems'
Name
Other.,
CONTRACTOR MailingAddiess TYPE OF WORK INVOLVED-COMMERCIAL
(Prior to issuance a City tare, Zip Phone 0 Foe for each system.. ..._.__.................................. $40.00
�g Copy of all licenses (SEE OAR 918.280-200)
1 ore required if Oregon Mr. o.0 Ev.Date
expired In C.O.T. Check Type of Work Involved:
dela bass). iset ea on r.Lic. Fxp.Onto ❑
Audio and Stereo Systems
C.O.T.or Ma156 Lic. ❑
Boller Controls
—�— owner's Rame
V r r ❑ Cloak Systems
OWNER- Melling Address
APPLICANT Date TslecommunioaHon Installation �(
fty tat! Ip hone M ❑ F're Alarm Instahtion
This permit ie IssiNO un er This applicant agroev to ❑
make only restricted energy Installations(100 volt amps or less)under this HVAC n,t , ,,W►
permit and to do the following: ❑ V��+
Instrumentation
m, 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 asteHaks('). All others Tined licensing;
I_sndscape irrigation Control'
2 Call for inspertionR when installation under this permit are ready for
inspection at 603-6394176; ❑ Medical
3 Purchase separate permits for all installations that are not ready for as 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 am completed. ❑ Ott
Permits are ,on-transferable and non-refundable end expire if work Is not
started within 100 days of lesusnoe or If work is suspended for 1E0 days. Number of Systems
The person signing for this permit must be the applicant or a person • No licenses ars required. Lienees ars required for all cOor instellsAons
authorized to b-nd the applicant,
Eli. :
Signature - ENTER FEES 8 'J�
5%suRDt4ARN to X"MAL AtW s
Authority tf other thanAppliCaflt TOTAL ti '1Z,
I voesis doe 12108
CITY OF'I'IGARD BUILDING INSPECTION DIVISION
24-!-lour Inspection Line: 6394175 Business Phone: 639-4171
c�
Date;Requested: j A.M. P.M. ivIST: � d
Location:--1 �(�. G �� � 'Z�)/) / vc--
- .. . BUP:
Tenant: Suite: Btdg: MEC;_
Con Tactor: Phone: :2e) 2 ` 5 PLM:
Owner: Phone: ELC:
ELR:
BUILDING BLDG(con't) PLUMBING MECHANICAL ELECTRICAL Si f. SITE
Site Post/Beam Post/Beam Post/Beam Cover/Service Sewer/Storm
Footing Roof UndFI/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 1VIISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sneath 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 INA FINAL
i
17
Cl Call for reinspection ICI ReinWtion fee of S__ reAuired before next inspection O t)gable to inspect
Inspector:
Date: Pape of--
CITY OF TIGARD BUILDING INSPECTIOiv DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
Date Requested. SCJ * A.M. U P.M. MST: C
`
Location: 1-3(DD �Su) c1,"-1l .LSVL BUP:
Tenant:_ / Suite:_ Bldg: _ MEC:
Contractor: ��l J(A' I QUA= Phone: _7O3- 54 Sat PLM:
Owner: Phone: ELC:
— LtA R rl �. A ELR:
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 UO Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Stonn Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire 5 klr/;itm Crawl/Found Dr I feat P_W4 Low Volt
(4provrV v pprov Approved Approved
Appr/Sdwlk oved Not Approved o pproved Not Approved Not Approved
FINAL ,FERAL FINAL FINAL
4
0 Call for reinspection O Reinspection fee of S required before next inspection O Unable to inspect
Inspector: � k _ Date —5-21 Page_---,of_--
CITY OF TIGARD MAS1'ER PIERM11-
P,ERMIT #. . . . . : MST 96- I114 10
COMMUNITY DEVELOPMENT DEPARTMENT DF41E ISSUED: 11719/16/96
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)839-4171
I:li')R(-E[-: '�-'5104CC—H14096
iITE- i:tDDPL.SG. . . 1360-1 SW ASCE-NSION DIS
)'UL4L)I V 15 1 ON. I-I-S)H I RE: WOODS ZONINO: R---7 F:11'
13LO(--I'. - . . . . . i-o-r . . . . . . 096
ieearks: Path I
------------------------------------------------------------- BUILDING -------------- --—--------------------------------------------
REISSUE: STORIES.......: 2 FLOOR AREAS--- BASEMENT...: 0 sf REQUIRED SETBACKS-- REQUIRED------------
...: 9 ME DETECTRS:
;.LASS OF WORR,:NEW HEIGHT........: 24 FIRST....: 1079 sf GARAGE.....: 688 sf LEFT...
TYPE OF USE-,- :SF FLOOR LOAD....: 40 SECOND...: 1168 sf FRONT.........: 20 PARKING SPATES: I
TYPE OF CONST.:5N DWELLING UNITS: I F I NBS14ENT: @ sf RIGHT.........:
OCCUPANCY GRP.:R3 BDRM. 3 BATH: 3 TOTAL------: 2247 sf VALUE..$: 162488 REAR..........: 85
-------------------------------------------------------—------ PLUMBING -------------------------------------------------------------
'iINKS........... I WATER CLOSETS.- 3 WASHING MACH..: 1 LAUNDRY TRAYS.- 0 RAIN DRAIN ft: 0 TRAPS..........
I
.AVAIORIES.... 4 DISHWASHERS—: I FLOOR DRAINS..: 0 SEWER LINE ft' @ 7 RAIN DRAINS: I CATCH BASINS.. : 0
'UB/SHOWERS...: 3 GARBAGE DISP..: I WATER HEATERS.: I WATER LINT ft: IN OCKFLW PREVNTRt I GREASE TRAPS—: 0
OTHER FIXTURES: ?
-------------------------------------------------------------- MECHANICN� ------------------------------------------------------------
FUEL TYPES----- FURN t 160K 0 BOIL/CMP ( 3HP: 0 VENT FANS.,...: 4 CLOTHES DRYERS: I
/GAS/ / / FURN =ION 1 UNIT HEATERS..: 0 HOODS.........: I OTHER UNITS...: I
MAX INP.: 0 BTU FLOOR FURNACES: @ DENTS.........: I WOODSTOVES....: 0 GAS OUTLETS...: I
--------------------------------------------—------------------- ELECTRICAL ---------------------------------------------------------
--RESIDENTIAL UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADD'L INSPELTIONS--
IM SF OR LESS: 1 0 - alp..: @ 0 - 200 alp..- 0 W/SVC OR FD"..: 0 PUMP/lknIGATION: @ PFR INSPECTION: 0
EA ADD'L 500SF.- 4 201 - 400 asp..: 0 201 - 400 alp.,: 0 1st W/o SK/0R. @ SIGN/OUT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 401 - 600 asp..: 0 401 - 600 alp..: 0 EA ADDL DR CIR: 0 SIGNk-1PANEL...: 0 IN PLANT......: @
M44F HM/SVC/FDR: 0 601 - ION aso. 0 601#avps-I000 q: 0 MINOR LABEL -10: @
Iowi alp/volt. 0 ----------------------------------- PLAN REVIEW SECTION
Reconnect only.: 0 )=4 RES UNITS,.- SVC/FDR)=225 A.: ) 6H V N14INAL., [IS AREA/SPC OCC:
-------------------------------------------------------- ELECTRICAL - RESTRICTED ENERGY ---------------------------------------------------
A. 5F RESIDENTIAL—-------------------------- B. COMMERCIAL-------—--------------------------------------------------------------------
AUDIO i STEREO.. VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM—: OTH: X BOILER.........: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCP............ INSTRUMENTATION: MEDICAL........: OTHR: 1.:
HVAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL # SYSTEMS: 0
'-Amer: ------------------------------------Contractor: ------------------------------- TOTAL FEES:$ 4530.96
WINDWOOD HOMES INC WINMI) HOMES
14076 SW PENCHVIEW TERA 14076 SW BENCHVIEW TERRACE
TIGARD OR 97224 TIGARD OR 97224
590-4700 Phone 0: 510-4700
Reg 0..: 050196
nis permit is issued subject to the regulations contained in the Tigard Municipal Cede, State of Ore. Specialty Codes and all other
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 than 180 days.
------------—-1-------------------------------------------- RERIIRED INSPECTIONS --------------------------------------------------------
Footing Insp PLM/Underfloor Framing Insp Gas Fireolace Water Service In Building Final
Foundation Insp Mechanical Insp Shear Wall Insp Insulation insp Appr/Sdwlk Insp Erosion Control
plost4eae Strvet plumb Top Out Low Voltage Gyp Board Insp Electrical Final
Post/Peat Meehan Electrical Servi F:-eplace lr�p Pain drain Insp Mechanical Final
Crawl orain Electrical Rough Gds Line Insp Water Line Insp Plumb Final
m : I- t e,e U L[I Y)cIt 1.1 V-v - 1, - - j L,d ..V
I L t f c t n s pec,t ion -- 639-41 75
SERE R CC L., I I UPI
PE R11 I'T
CITY OF TIGARD PERMIT #. . . . . . . - GWR96-04--
COMMUNITY DEVELOPMENT DEPARTMENT DA1'E ISSUED: 09/18/96
13125 SW Hall Blvd.Tigard,Orogon 97223981199 (503)639-4171
l.'1ARCEL : 2�)104CC-HWO96
'_;)ITE.. ADL-t 04 SW C4�3i- uv DR
SUBD I V IS I ON. . . . : HILLSHTRE WOODS; ZONING: R-7 PD
. . . . . . . . . . . :096
1^I*='.'NAI\I-r lqAME. . . . . :
IJSA NO. . . . . . . . 1 . : FIXVURE UNITS. . . : 0
CL 121.3 S I WORK. . . :NE-W DWELLING UNI,rs. . : 1.
T'Y[-,E OF.- USE. . . . . :SF'F' NO. OF BUILDINGS: I
T(\I�71 ALI... -I'YPE. . . . :BUSMP TilYIPERV SURFACE::'.: III S f
OWT-Ifer :
WINDWUOD HOMES IINIL type amol-int I, date i,e c7 p 11:
14076 SW BENCHVIEW I'E R R PRM-i' $ 2200. 00 DRA 09/ L8/96 96-284103
1 NSP $ �.3 5. 1110 0 1?0 0�j/ 18/96 96—`841111::s
T I G A R E) UR 9 7 iR 2 4
Phone #, 59111--/4700
CONT RACTOR NO7 ON FILE
Phone #: 0111 TOI'AL
Req #.
REO UIRELY INSPECTIONS
This Applicant agreeE to cosply with all the rules and regulations 'Sewer, lnspest iory
of the (Inifiea Sewage Agency. The permit expires 180 days fron
the date issued. The total amount paid will be forfeited if the
oereit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the veaqurement
given, the instailer shall prospect 3 feet in all directions frow
the distance given. If not so located, the installer shall purchase
a "Tap and Side "ewer" Peru t and the Agency will install a lateral.
P t-in i t t e e S i q n a t u r--t-!
ur
i 5 si.1,t e!d D Y :
("a 11 for i n S pec-,t i on 639--4175
^ Plan Check N:ci
,ITY OF T,GARD Residential Building Permit Application Re,c'd By � t..
13125 SYN HALL BLVD. New Construction Additions or Alterations Dae
Date Ret
'IGARD, OR 97223 Single Family Detached or Attached Date to P E. %- G
,03) 538-4171 Cate to DST
Print or Type Permit# 10
Called
Incomplete or illegible applications will not be accepted r
J
Name of Subdivision Lot N � Name
(r�
Job 1� t_r_ �+I f2 r e::0 5 C A 5% cn_ 0 /�,� �7[t� i "F —
Site Architect Mailing
Address
S Sc r�9t or^ City/State Zip Phone
Name P�•�i\.�-vt0 �1 ? 2 T.�.p/ !
Owner Mailing Address Nam
A\
I (TOrv— (1_owC`%,L
En
City/State Zip hone girter Mailing Address
O N0
o rt 9;L-.2-4`f S'it; H fir,o S c /
City/State Zip Phone
Name ��w� (l.A. io or, c1_42,J
General R: s L YZ Describe work new addition O alteration O repair O
Contractor Marling Address to be done
Additional Description of Work:
City/State Zip Phone Q
Oregon Const.Cont.Board Lic.# Ex .Date
Attach Copy of �y, w, "r a �i"} ProjectQ ,
Current COT Business Tax or Metro# Exp.Date Valuation `p `f11,
Licenses Ci c.(r- --- —
Name NEW CONSTRUCTION ONLY:
Mechanical /i i)k; C'O lSq.Ft. Yo 4} Sq.Ft.Garaage: t
Sub- Mailing Address
Contractor (-,,lie 5 r.- W�_t+Auc Corne,- Lot Yes No Flag Lot Yes No
City/State Zip Phone (check one) ✓" (check one)
�.� �•- D v? y , ;1't 3 J. 4 - 1 b Audio/Stereo Burglary
v I Restricted
Oregon Const.Cont.Board Lic.# Exp.Date Energy System Alarm
Attach Copy of C r `)F"� , 1 - 1'7l. ---
Current C 7 Bu m or ett0l xp.Date Installation Garage Door HVAC
Licenses r /�5 Opener Systems
Name (check all that i Other
Plumbirg 3 I rrn i 1't_c•,-r-1 r:J _apply)
Sub- Mailing Address —" Will the electrical subcontractor wire for ail T Yes No
t restricted energy installations?
Contractor 1 f f.�
City/State Zip Phone Has the Subdivision Plat recorded? NIA_J Yes No
L_
/7i_i „tl , �_rt ,/l0- ' (C411 `tc
Oregon Const.Cont.Board Lic# Exp.Dae Reissue of MST#fin— Solar Compliance
Attach Copy of (Calculation Attached)
Current Plumbing Lic.#, ESS ,!
. ste I hereby acknowledge that I have read this application. that the
j Licenses ..�`t 1`�.i. h 13 1 r.. 'r , information given is correct, that I am the owner or authonzed agent of
COT Business Tax or Metro# Exp. Date the owner, and that plans submitted are in compliance with Oregon
Uu(_ . I�_ i State iaws
Name Signature of Owner/Agent Date
Electrical (V17 14,- c.,7 i`L c 121 C ZWt.
Conte t Person Name Phone
Sub- Mailing Address -y,1 , ,i ,C "A 0 S 9c) kr 71:
Contractor
Contractor &`7L;Q: _S 6ult4"'J 4^M . _ FOR OFFICEUSE_ ONLY:
City/State Zip Phone Plat# MapfTL#.
I�. �l,n.,-, t •; cr,.3 z23 � 3c+-5 .33
Oregon Const ' -)nt Board Lic.# Exr. Date .i, r)f• ? 7' 7`� �_/�R '�N1�1
Attach Copy of _ s !( Setbacks Zone. Solar:
Current Electrical Lic.# — Exp.D to _'
Licenses
COT Business Tax or Metro# Exp.Date Engineering Approval: Planning Approval TIF.
r>it / 1``i J
�,�dstsvretapp dot 1
f'_etm_it_# Account Descriptis n Amount AMA_Fd, 53LJ)_o2.
cW—G /'? MST. Permit (BUILD) S C;
Plumb. Permit (PLUMB) %257, ',v
Mech. Permit (MECH) C,0 4
D75-;'— a-?, 57►—
EL.0/ELR Permit (ELPRMT) ''
571,
State Tax (TAX.)� 5
Bldg.
Plumb:
Mech: .
EL.0/EL.R:
I I •— 7?�
Plan Check
MST: (BUPPLN) c� 5Q, du / .j✓ • �}
Plumb: (PLMPLN)
Mech: (MECPLN) j� / Z
CDC Review (LANDUS)
-o q1 ' _ Sewer Connection (SWUSA) C.? )<1 - A,) v
Sewer Inspection (SWINSP) t
Parks Dev Charge (PKSDC) /U S--P f U 5,u
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT) 12-()
Water Quality MQUAL)
Water Quantity (WQUANT) /0(-/)
Erosion Control Permit (ERPRMT) y
Erosion Planck/USA (ERPLkN) v P)
Erosion Planck/COT (EROSN)
Fire Life Safety (FLS)
TOTALS:
i Asts'fnstapp doc
Rev 7/95
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CITY OF TIGARD
DEVELOPMENT SERVICES PI—LIMPTNG
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 r1FRIv1TT 4. r7l I 1111'-n 7
DATE TSSLJFT):
PARCEL : ;P91 (,1,,
1 1-7,' P D r! �711-1 Pci(J71,�173T
I IP T-)'r Y T I47U-7-iHTRF W(-)(IT)17 70h(TNrj- 9--7 Pr)
LOT. . . . . . . . I I J R T S,D T rT T 0 N
CF W)RI". AI I" GAPRP(73F DTSPnSAL !7, 0 mnSTI-F Hr)ME SPACES,
OF 117,17., . . Sr
WW')WTINIF" MACH. RPC'KFL.rW r1IRFVNrPFj. . - -1
F-PP, P7, Fl. (7)UP DRATNT). . 0 TPnP';
r")R T.175. . . . . . . . . 0 WATr7R HEPTERS. 0 7ATCH BOSTNIS. . . . . . .
TYT U RF- *, T,r4 y TP(-"i'/S. . . . . Sr PPTN r)RATNr:,,,
N V,F-4. . 10 UpThIPI-c"i. . . . . (1) GREASE TRAPS..:
r,1JATr.)PTF'*-;. . . . ! 0 OTHF'R r. T)(TLJRF-!;. , . . e L71
', IFI;!mAnwr-pq— 171 S)FWITR L. TNF (ft ) 171
CfT 01 I,4(y1"r- " t.TKIF (fi', )
0 R(ATN DRAIN (ft ) , 0
^(--; -j rJpTjt 1, b,-irk f I m-i jit-P vpiii, i ori (I r- it r
F--FFr,
t cl
171 P,m T 41 I5 rA 9) T Sr.) 0,-Tj'/ 97
1.71 79 f R 1) 0:,/1"
7101
QFQi.IT RF'T. T 11.1 C'M 1. T T
1!; vervit is i;s-ied vibiect to the -,evistitinc rnnt*ire0 in the f?n,,y-i a i,f`I r)tq r--1 I-p
icArd Municipal 7od^,, 5t;tv of ?re. Soerialtv Cvdps and W of4r Ti �ir)pri- iri
clicable laws. 1511 osirlo will be done in acc—darre wjV,
4vo-",yfd olar,5, -1-.5 per/it will expire if worl, is rot started
it�ir ISA 0mv5 vf issuance, or if work is slisvended for tort
CiTY OF TIGARD'
DEVU OP6,. 'SVT St'"RVICES
1""15 S Vi Hail Plvd., Ygard,OR 9, " 3 (503)639.4171 i':iFm R i cAL. Pr-,,:Rm ur --
RESTRTUTED C.NFPGY
PIERMIT #: 1-[_R97-0090
'-'SSUFD: 03,/P 6,/':'-7
Pl(-)R("EL.: 2S104CC--HW09C,
SW DR
;TL-.SHTPF 1400u-1 70N'JNIG: R-7 P0
.09F, JUR T P)D i("-TN-
f I r.)w r.))-,Pvpnt i c-Ti rJe v ire
P (7)MMEPC T AL.-
J7PFn. A(J�DI'O & STFREO. . TNTF-Rr.C;M, R r-,A(
,7 1 1\1(
Q(-11 74P 14 1..r4 Fj;,', Sn."LER. . . . . . . . I.-ANDSCAPE/T RR T GPI
- r"1- Ori�. . . . .. . . . . .
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17! DATE-
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd. /_ ��
Tigard,OR 97223 PERMIT# C
ti-
Phone(503)6394171 DATE ISSUED
FAX(503)684-7297
TDD No. (503)684-2772
CITY OF TIGARD Inspection (503)639-4175 ISSUED BY
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLAT,ON 4. TYPE OF WORK
Address RESIDENTIAL—Restricted Energy Fee . . . . . . . . . 14Q,QQ
rig14,42D niF�, ;FOR ALL SYSTEMS)
City State Zit, Check Type 11f Work Involved:
PERMITS ARE NON-TRANSf ERABLE 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
1&1 DAYS. ❑ Burglar Alarm
❑ Garage Door Opener*
2. CONTRACTOR APPLICATION ❑ Heating,Ventilation and Air Conditioning System*
Contractor e&MIM /RAkAc'obk Type 1,4&1 c ADS ❑,,/Vacuum Systems'
f // LJ Other .T4Q0QryAridN CoAJ7404664
Address /9•�1S S3k.; P14rW1CiA �
X41" s k0
Date 3– ;2s- - V7 COMMERCIAL—Fee for each system . . . . . . . . . ��•QQ
(SEE OAR 918-26f)-260)
Property Owner n/d UuDd /2►0�'f S __ Check of Work Involy d:
Contractor's Board Reg No. ❑ Audio and Stereo Systems
[] Boiler Controls
Phone# 3411 _ _ ❑ Clock Systems
❑ Data Telecommunication Installations
3. OWNER APPLICATION ❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No ❑ Instrumentation
Address –
El Intercom and Paging Systems
❑ Landscape Irrigation Control'
City State Zip Q Medical
This permit is issued under OAR n1B-310.370.This applicant agrees to make only ❑ Nurse Calls
restricted energy installations I I W vnl'amps or less)under this permit and to do the ❑ Outdoor Landscape Lighting'
followmn:
❑ Protective Signaling
1. Only use electrical licensed pennns to do installations where required.(Certain
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
I. Purchase sep- .e permits for all installations that are not read)for inspection
when the inspector is out to inspen under this permit. •No licenses are required. Utxnsn are required for all other ittoliatlons.
4. Assume responsibility for assuring that all corrections required by the inspector -- ---, -- — —
are done,and
S. Assume responsibility for calling for a final inspection when all of the 5. FEES
corrections are com)sleted.
The person signing for this permit must he the applicant or a person a. Enter Fees
authorized to hind the applicant.
b. 5%Surcharge(.05 x total above) $ J
Signature
TOTAL $
Authority if other than applicant
ENERGAP.CHP