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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Re(c-O-Phone): 639-4175 Business Phone: 6311-4171
Inspection: g t- _ v 2
Footing Susp, Ceiling Sprink. Rough-i I Appr wlk
Foundation Plbg. Underslab Mech. Rough-n Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Hough-,n FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect
Date Requested: L Time: AM(1 PM
Address: r��,c 5 `J•l� ( (y
Builder:_ Permit #:$yp—�"'—tLT
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: _ Date:
WO-ROVE') DISAPPnOVEO APPROVED SUBJECT TO ABOVF
__Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone)- 639-4175 Business Phone: 639-4171
Inspection: i ^
Footing Susp. Ceiling Sprink� ough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post;Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underiloor Rain Drain Framing -Plumb.
Alarm Water line .y I Insulation -Meeh.
Underilr. Insul 'hear W II � Gyp. Bd. -Elect.
i
Date Requested:_. ' Time. KtPM
Address:
Permit #:�
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: S Date:—� ~�
LAPPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE
____Call For Reinsp.
C.:I'IY' or" "f II:+ARI:► -- REMPT OF PAYWFNT RI•'CEIPT NCI. :9`i•-x'671
C IAE:CK, AMCII_INT a 42. kills
�'Jf�MF a AUT C A aN AMOUN I' a V.I. thin
ADDRE5S a 703 NE. HANCOC K E!A\'MFNT •DATE. a 06/P3/95
PnRTI_AND, 13H CS I J.0 D I V 17I ON a
97212-
PURPOSE
7G_'12-PURPOSE. OF= PAYMENT 0MOLJN'I PAII) PLIRPCIi;F: CII' PAYMENT AMOUNT PAID
F I. Tl
IC.AI- PERMIT 40. H0 RT. BUILD PER 2. 00
t5603 SW 114TH COURT 016
TCITOL AMOUNT F'AID - —> 42. 00
WASHINGTON COUNTY RESTRICTED
Department of Land Use & Transportation
Electrical Inspection Section ELECTRICAL ENERGY
155 North First P.venite, #350-12
Hillsboro,0340-34 0 +7124( APPLICATION
information: 503 640-3470 .=ax: 503 693.4412
PRINTPJFASE
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Please complete all sections, j throughPermit No. e_ L
1. Location of intai ation Date c j��
Address U r �/ ( 7
City1 44A Zip Code 4. Type of work:
Map No. Tax Lot RESIDENTIAL Restricted Energy Fee $40.00
9 (for all systems)
Thomas Map ook: Page Section
Check type of work involved:
Directions
r ' Itso and Stereo Systems'
Commercial [� Resi ential g!lar Alarm
Telephone Systems'
Tenant Name Garage Door Opener'
(if commercial) —_ Fire Alarm
Heating,Ventilation and Air Conditioning Systems*
2. Contractor ap lication: Vacuum Systems*
Other
Electrical Contractor
Addre COMMERCIAL Fee for each system $40.00
City State Zip - (see OAR 918.266 260)
Date_6 — Job Number — Check type of work involved:
Property Owner
Contractor's Licen o. —
Contractor's Board Reg. No. Clock SysCooler Systems
tials
Phone No. 41'
Data Telecommunications Installations
3. Owner application: Fire Alarm Installation
HVAC
r Instrumentation
Print Owner's Name hone No. Intercom end Paging System
Landscape Irrigation Control"
Address –- -- Medical
Nurse Calls
City State Zip Outdoor Landscape Lighting*
This permit is Issued under OAR 918-320-370. The applicant agrees Protective Signaling
to make ,)nly restricted energy installations(100 volt amps or less) Other
under this permit and to do the following:
1. Only use electrical licensed persons to do installations where
required. (Certain residential and other transactions are exempt Number of Systems
rx from licensing. These have asterisks("). All others need licens-
ing.)
V) •No Irrenses n,e required Licenses are required for all other installations.
2. Call for an Inspection when all the installations under this permit 4
> are ready for Inspection.
3. Purchase separate permits for all installations that are r of ready 5. Fees
for Inspeation when the Inspector is out to Inspect under this a
permit. Enter fees $
4. Assume responsibility for assuming that all corrections required
LO b the Inspector are done,and �)
J S. Assume responsibility for calling for a final Inspection when all of 9% Surcharge (.05 X total above) $the corrections ere completed.
The person signing this permit must be the pllcant or a person Trust Account $ _ A
autho iod_ d the applicant _
Signature Cf �_ - � Total $
r '
Authority If other than applicant —__ _—_ This per,;,It becomos null and void If the work authorized by the
permit it wit commenced within 180 days from date of Issuance
For Inspections tall of such permit or If the work authorized Is suspended or abandrmad
0. ^ ` at any time after work Is commenced for a period of 180 days.
640-3561 or 69.3-44 1 F; Electrical Permits are non-refundable and non-transferable.
24-hour rrcorder, one working day In advance of need BL?4-114