14595 SW 91ST AVENUE ADDRESS:
ov;cm Sw Cl/ Avwc.
i:\records�microllm\targels\huilding.doc
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT RESTFUICTED ENERGY
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)e3g.4171 PERMIT #: EL-R96-'-01 79
DATE'. ISbUPD: 06/1113/96
PARCEt : 2SI11AC--00700
SITE ADDRESS. . . : 14595 SW 91ST AVE
SUBDIVISION. . . . : PINLBROOK TERRACE Z ON ING:R-4. 5
BLOCK. . . . . . . . . . LO-1.. . . . . . . . . . . . . :48
Pr-oject Description:
A. RESIDENTIAL--—————— N. COMMERC I
AUDIO & STEREO. . . : AUDIO & STEREO. INTERCOM & PAGING. . :
BURGLAR ALARM. . . . :X BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. . -
GARAGE OPENEF.. . . . : ',LOCK. . . . . . . . . . . : MEDICA1.. . . . . . . . . . . .
HVAC. . . . . . . . . . . . . )ATA/TELE COMM;. . : NURSE CALLS. . . . . . . .
VACUUM SYSTEM. . . . : FIRE. ALARM. . . . . . : OUTDOOR LANDSC LITE:
01 HER: HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . :
INSTRUMENTATION. : OTHER.
TOTAL # Ol`-_ SYSTEMS' 0
Owner-:
NORMA, JIM WALTERS type amol-tnt by date v,e c-pt
14J95 SW 9151 AVE PRMT 3 40. 00 CJG) 06/03/96 96-280118
5PCT J 00 CJS 06/03/96 9E,--.=8 11 ,3
I-IGARD OR 97223
Phone #:
Contractor-:
ODT SECURIiY ALARMS 42. 00 TOTAL
703 NE HANCOCK
REQ(lIRED INSPECTIONS
PORTLAND OR 97212 Wall Covev^ Elect' I Final
t1hone 503--LIJ4-3265 Elect' I Bei-vice
peg #. 59')44
Phis permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other per-mitee SignAtl.tv,e
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
withi,i ILI@ days of issuance, or if work is suspended for more
than 180 days. IssLied By
I NS TAL ATION
The installation is being made on pt-opet,ty I own which is not intended for-
-sale, lease, or r-ent .
L)WNERIS SIUNCITURE - DATE:
INSTALLATION -—————————————————
13IGNATURE OF: SUPR. FLLCIN- DATE:
LICLNSE NO:
Call for- inspection
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Se;vice FINAL:
Foundation Water Line Ceiling -Dumb.
Post/Beam Mech. Shear/Sheath Framing -Mech.
Plbg.Und/Fir/Slab Plbg Top Out Insulation -Elect
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: �_ A.M. P.M. Etry:
Address: l 7 cJ.5: / _ _ _
Tenant:_ _ i Ste: MST:
BLIP:
Con Z i MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: E L R:
r
I Spector. �—�--� — — Date:`
APPROVED __DISAPPROVED/CALL FOR REINSP. C CO
V,
GI I Y 0 1 114ARV M. I 11, 1 (if POYMI*N T HF- CF.- I P I Nt 14, ,801 14.)
GI ICiGK AMI INA T 0111
NAME s FAD f SECUR I *f Y CASH f4MAINI 0. C40
44r11)REHT-� v 70,3 NL HANCULA PPYMI*-'M I D14 I t-, o Illb Or 03 9C.
PORTLAND OR SUSD I V t IN
9 7e I P.-
PURP01--ik OF P(010:-N 1 "MUIAN 1 PtI.1 1) N)HPUSt', UV NI 141,11 it 114 1 1 If-1.1 I
LA. 00 !=i1 141111 I I
Ci
HW 911`1 W-T
MIAL PMOUNI 1-'111 t7
Community Developmert RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd. -0179
Tigard, OR 97223 PFRM11 # ,F,i/?9F, _
Phone(503) 639-4171
FAX(503)684-7297 DATE ISSUED 6-,3 96-
TDD
6TDD No. (503)684-2772
CITY OF TIGARD Inspection (503) 639-4175 ISSUED BY Ch c, r le,� _S: Ayr 11//
PLEASE COMPLETE ALL SECT)0NS
1. LOCATION OF INSTALLATIO 4. TYPO OF WORK
Addr s.�+�f' RESIDENTIAL—Restricted Energy Fee. . . . . . . . . �Q,QQ
" /k-4� Qr (FOR ALL SYSTEMS)
City U State Zip Check Type f Work Involved:
PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND EXPIRE IF WORK
15 NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK 15 SUSPENDED FOR ❑ Audio anti Stereo Systems
180 DAYS. fGarage
Burglar Alarm
2. CONTRACTOR APPLICATION Door Opener"
❑ Heating,'Ventilation and Air Conditioning System'
Contractor AOT>) CURlE1►SYSTEAAS<INpe [703 NE IONCOCK ,L���C',yt�.B Vacuum Systems'
�- 1OR1n 214-M5 -- ❑ Other
Address '-�
Date ti ,� COMMERCIAL—Fee for each system . . . . . . . . . 1140.00
�} — (SEE OAR 918-.260-260)
Property Owner0 -4
Ch�k Tyne of Work Involved:
i
Contractor's Board Reg. No. G _ _ ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone# ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
__ W"���(Gs✓9 ❑ HVAC
Print Owner's Name Phone Na //
❑ Instrumentation
Address ❑ Intercom and Pagirn Systems
❑ Landscape Irrigation Control*
City Srate Zip ❑ Medical
Tlds permit is Issued under OAR 918.320-370.This applicant agrees to make only ❑ Nurse Calls
restricted energy installations(I(H)volt amps or less)under this permit and to do the ❑ Outdoor Landscape Lighting•
following
u_ 1. Only use electrical licensed persons to do installations where required,(Certain El Protective Signaling
residential and other transactions are exempt from licensing.These have ❑ Other
j_ asterisks(•).All others need licensing).
2. Call for an Inspection when all of the Installations under this permit are ready
for inspection.rt 903-039-4175. ❑ Number of Syster, -
I Purchase separate permits for all installatinns that are not ready for inspection
when the inspector is out to inspect+order this permit. •No licenses am required. Licenses are required for all other Installations.
w 4. Assume respon.0hility for assuring that all corrections required by the Inspector
L7 are done,and
5. Assume responsibility for calling for a final inspection when all of the $• FEES
corrections are completed,
The person signing For this permit must be the applicant or a person a. Enter Fees $�
authorized to hind the applicant.
®' � b. 5% Surcharge (.05 x total above) $ cz 00
2 - - -
SiRnatum
TOTAL
Authority if ether than applicant
ENERGAP.CHP