13500 SW PACIFIC HIGHWAY STE 42-1 ADDREGS:
4LDO 2� 9,ac C. H ;q hj�d� S�akl
i:\records\microflm\targets\buildirq.duc
t
P
CITY QF TIGARD
DEVELOPMENT SERVICES
I 13125 SIN Hall Blvd., Tigard, OR 97223 (503)639.4171 ELECTRICAL PERMIT —
RESTRIC'TED ENERGY
PERMIT #: EL_R97--0140
DATE ISSUED: 05/12/97
PARCEL: 2S 102CC—OO 1 O0
SITE ADDRESS. . . * 13500 SW PACIFIC HWY #42
SUBDIVISION. . . . : ZONING:R-3. 5
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTN: TIG
ProJ ect Description: INSTL PROTECTIVE SIGNALING
----------------------------------------------------------------------
A. RESIDENTIAL--------- B. COMMERCIAL—
AUDIO & STEREO. . . : AUDIO li STEREO. . : INTERCOM R PAGING. . :
BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. . :
GARAGE OPENER. . . . . CLOCK. . . . . . . . . . . : MEDICAL. . . . . . . . . . . .
HVAC. . . . . . . . . . . . . . DATA/TELE COMM. . : NURSE CALLS. . . . . . . . .
VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR L.ANDSC LITE:
OTHER: : : HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . :X
INSTRUMENTATION. : OTHER. . : . .
TOTAL_ # OF SYSTEMS:
Owner _____._______________ FEES
PERFECT LOOK #36 type amatint by date recpt
13500 SW PACIFIC HWY #42 P FiMT $ 40. 00 TAT 05/12/97 97-294469
TIGARD OR 97223 7-PCT $ 2. 00 TAT 05/12/97 97-29446
9
Phone #: 684--7952'
Contractor: ---__
ADT SF_CURITY ALARMS $ 42. 00 TOTAL
'703 NE HANCOCK
--•----- REDUI RED INSPECTIONS --- -
PORTLAND OR 97212 Ceiling Cover Elect' '. Service
Phone #: 284-3265 Wall Cover Elect' l Final.
Reg #. . : 000599
This pereit is issued subject to the regulations contain,-A in the
Tigard Municipal Code, State of Ore. Specialty Codes ;+nd all other pier-m i ,e S i gnat�.ir .�
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 _ _3�, __
than 180 days. I ST..?Ied By
INSTALLATION ONLY---_ _
The installation is being made on property I own which is not intended for
sale, lease, or rent.
OWNER' S SIGNATURE: DATE:
I/N/STALLATION ONLY----__._.____._._ ____----------
SIGNATURE OF RUPR. ELEC' N: _ .._._!" _--_---.� _ DATE-
LICENSE
ATE:LICENSE NO:
Call for inspection - 639-4175
CITY OF'TIGARD RESTR(TED ENERGY ELECTRICAL APPLICATION F ec'd by:—___—
13125 SW HALL BLVD Date Recd_ _
TIGARD OR 97223 PRINT OR TYPE
V- 503-639-4171 X304 Permit#:
F-503-684-7297 INCOMPLETE OR ILLEGIBLE APPL.ICATION3 Cust.Call'd:
WILL NOT BE ACCEPTED M
Name of Devel,ipment Project TYPE OF WORK INVOLVED -RESIDENTIAL
) �, Restricted Energy Fee........................................ _ $40.00 �—
,j . (FOR ALL SYSTEMS)
JC d Street Afldress Ste lk
ADDRESS , a,'r S4t� l�C GC y�c �t Check Typo of Work Involved:
Ci y/Sta'e p Phone ❑ Audio and Stereo Systems
-----
Na� ❑ Burglar Alarm
CLz/-"— +c Jf�e ❑ Garage Door Opener'
OWNER Mailing Address
City/State Zip Phone p ❑ Heating,Ventilation and Air Conditioning System'
Name ADT SECURITY E5, iNL
SERVICES, ❑ Vacuum Systems'
"
103 NE HANCOCK ❑ Other _
ON I
CONTRACTOR Mailing Address-- MNAf�
(503)284 3265 TYPE OF WORK INVOLVED-COMMERCIAL
(Prior to issuance a City/State Zip Phone# Fee for each system.............................................. $40.00
copy of all licenses L (SEE OAR 918-260-260)
are required if Oregon Contr. Bird Lic q Exp. Date
expired in C O.T. `j 1J 9P Check Type of Work Involved:
data base). Electrical Contr.Lic.p 7 Exp.Date
C ❑ Audio and Stereo Systems
C.O.T.or Metro Lic.A Exp.Date
❑ Boiler Controls
Owner's Name
El Clock Systems
OWNER - Mailing Address
APPLICANT ❑ Data Telecommunication Installation
City/Stele Zip Phone#v ❑
i L Fire Alarm Installation
This permit is issued minder OAE 918-320-370. This applicant agrees to
make only restricted anergy installations(100 volt amps or less)under this ❑ HVAC
permit and to do the following:
❑ fnslrumentation
r, Only use electrical licensed persons to do installations where required
Certair residential and other transactions are eAempt from licensing ❑ Intercom and Paging Systems
These have asterisks(') All others need licensing,
❑
2 Call for inspections when instailstion under this permit are ready for Landscape Irrigation Control'
inspection,it 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 correrru-is required by the ❑ Outdoor Landscape Lighting'
inspector are done,and,
Protective Signaling
5. Assume responsibility for calling for a final insper'ion when all of the
corrections are completed. ❑ Other _
Permits are non-transferable a non-refundable and expire If work is not
started within 180 days of Is { nce or if work is suspended for 180 days Number of Systems
The person signin or /permit must be the applicant or a person Nn.licenses are required Licenses are required for all other installations
authorized to in plicant.
FEES:
gnat f ENTER FEES s _
5%SURCHARGE(.05 X TOTA_A50VE)
AuYrority if other than Applicant — TOTAL
i Vesele doc 12196