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9110 SW BURNHAM STREET
CITY
DEVELOPMENT SERVICES
EN
13125 SW Hall Blvd., Tigard,OR 9722.3 (.503)639.4171 RESTRICTED
E S T
E,,TRR R I C A I_ PERMIT
ICTEE:) E. E:FZr;Y
PERMIT #: ELR96-0359
DATE ISSUED: 12/02/96
PARCEL.: S 1'i'�2AC -OC�c Oc'
I TF PDDRU35. . . : 1759110 SW DURNHAM ST
SI..IHDIVISION. . . . : BURNHAM TRACT 7Oh1TNG:Cl3D
BL OCIi. . . . . . . . . . . LOT. . . . . . . . . . . . . :3
Pt-o,ject Descr-iption : add protective signaling
A. RES IDENT TAI.._---- - -__.._._. B.
AUD T O 8 STEREO. . . : AI_.1D I O R• STERE U. . : T NI E ROOM R PAGING. . -
BURGLAR
AGING. .BURGLAR ALARM. . . . : BOIL..ER. . . . . . . . . . : LANDSCAPE/IRRTGAT. . :
GARAGE. OPENER. . . . . r;l_OCI.4. . . . . . . . . . . . MEDIC;A1.. . . . . .. . . . . . . ..
1VAC. . . . . . . . . . . . . : DATA/TELE COMM. . : NURSE CALLS. . . . . . . . :
!ACUUM SYSTEM. . . . : E=IRE ALARM. . . . . . : OUTDOOR I.-ANDSC LITE:
1_1THER: : : HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL.. . : X
INSTRUMENTATION. : OTHER. . ,
TOTAL # OF SYSTEMS: 1.
it4nera _.__..._.._.__.____.____._____.___.._______.___________..__..._..______.__.___ FEES
ONITROL._ PACIFIC type a.mor..knt by date rer_pt
1975 SW 6TH AVr. PRMT i 40. 00 TAT
PORTLAND DR 97201 SPCT $ 00 TAT' 12:/0,-:/96 96-287086
Phone #: 223•-582;-'
Contractor: ---_._______.__---•--.______----._.. __...________---__._._____.________.__._._____.._.__......__
SON I T ROI_ PACIFIC $ 42. 00 TOTAL..
1974 SW 6TH AVE
__...--.._..__ REQUIRED INSPECTIONS
---
PORTLAND OR 97201. Ceiling Cover Elect' 1 Final
Phone #: 503-223-5822 Wall Cover
Rag it. . . 0005:35
This persit is issued subject to the regulations contained in the
Tigard (Municipal Code, State of Ore. grscLalty Codes and all other Perm i t el Si gnat l.ir•e )
applicable laws. All work will be done in accordance with
approved plans, This persit will expire if worts is not started
within 1N dAys of issuance, or if work is suspended for sore
than 191 days. --- -
y I s. r.ied By
_-__.__...- -- ._........-._. ..__. OWNER INSTPLI-ATION ONLY—
The installation is being made on property I own which is not intended fat-
sale, leas(-, or, rent.
OWNER' S SIGNATURE: - _ __. DATE:
T NSTAI.-I..AT T ON nNl_Y- - -----------------------
S I GNATUPF OF UPR. EIEC' N: DATE:
I_I LENSE NO:
Call for inspection -- 639--4175
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
t 13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT#
Phone(503)639-4171
FAX(503)684-7297 DATE ISSUED JA l
TDD No. (503)684-2772 — --
CITY OF TIOARD Inspection (503)639-4175 ISSUED BY
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
Address RESIDENTIAL—Restricted Energy Fee. . . . . . . . . 140.00
TIM., [;n y1111 > (FOR ALI. SYSTEMS)
City State Zip Check Type of Work Involved:
PERMITS ARE NON-TRANSFERARLE AND NON-REFUNDAF I E AND D(FIRE IF WORK
IS NOT STARTED WITHIN tun DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR ❑ Audi(-)and Stereo Systems
1911 DAYS. ❑ Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener*
' / / /� ❑ Heating,Ventilation and Air Conditioning System*
Contractor_JAS.J, �r�//, Type --4�•��'f'��)y` ❑ Vacuum Systems'
Address IfZ�11– j� l�j�� `%,�.1i/ ❑ Other- ---
Dale � 4) COMMERCIAL—Fee for each system . . . . . . . 140.00
(SFF ')AR 918-260-260)
Property Owner_
--- -- Clleck TvneTvnellf.bLOtk'eYsalYed:
Contractor's Board Reg. No. S .3�J J _ — ❑ Audio and Stereo Syslvms
Phone# .1 ❑ Boiler Controls
--- -- ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
❑ 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 919 320.370 This applicant agrees to make only ❑ Nurse Calls
restricted energy Installations(I x1 volt amps or fess)ander this permit and to do the El
Outdoor Landscape Lighting
follrnvinq: ,,..�-�,,
�
1. Only use elerirical licensed persons In do installations where required.(CertainliYProtective 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.
❑ _ z 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 insiallat)ons.
4. Assume mspouisibility 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 completed.
The person signing for this permit must he the applicant or a person a. Enter Fees
$�C,
authorized to Ind the applicant.
xJ� c
.( -L- 1 c.= b. 5% Surcharge(.05 x total above) $ .�
Signature
G`J
TOTAL �A---
Authority if other than applicant
ENtRGAP.CHP