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CITY GF TIGARD FELECTRICL PERMIT
iESTRICTf D ENERGY
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #: ELR96--02'97
1?.25 SW Hell Blvd Tigard,Ors;yon 97223.8199 (503)639-4171 DATE ISSUED: 09/25/96
PIR
PARCEL.: 2S104AA- O '31JZI
STl-C. A1;�1"iF:E"'.i`,�. . . : J ,1285 SW 1217TH
SURD I V T S I ON. . . . BEL_LWOOD D ZONING: R--4. S
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :72
Project Desc:ric)tion:
A. RESIDENTIAL--------- B.
AUDIO & STEREO. . . : AUDIO & STEREO. . : INTERCOM & PAGING. . .
BURGLAR (iLfil-M. . . . : X Boll-C:R. . I . . . . . . . : LANDSCAPE/IRRIGAT. . :
GARAGE OPENER. . . . . CL.00K. . . . . . . . . . . . MEDICAL.. . . . . . . . . . . . .
HVAC. . . . DATA/TELE COMM. . . NURSE CALLS, . . , . . . . .
VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR LANDSC LITE:
OTHER., . . HVAC. . . . . . . . . . . . . PROTECTIVES SIGNAL. . .
INSTRUMENTA-F I0N. : O*THER. . : . .
TOTAL. # OF SYSTEM i: 0
I RACY GRANTHAM type amof_Int by date rrecpt
12'285 SW 1.='7'TH AVE PRMT $ 40. 00 CJS 09/25/96 96-213436c'
5PCT $ 2. 00 CJG) 120/25/96 96-284362
T16ARD OR 97223
Phone #:
Contr-actor-.. -----------------------------------------
HOME
--__--._--.----__-....._.__.--_.._-__-...__._._._..__.HOME:. SECURITY A 42. 00 TOTAL
8059 SW CIRRUS 1?R
REQUIRED INSPECTIONS --- - --_
BEAVERTON OR 97008 Wall Co. r- F_1 ect' 1 Final
nal
Phone #: 503-641-0574 EIect' 1 Service
Reg #. . : 44421
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, 'Mate of Ore. Specialty Cody and all other Perm it ee S i gnat!-Ire
applicable laws. All work will he done in accordance with
approved plans. This permit will expire if work is not started `
with-in IN days of issuance, or if work is suspended for more
than IN days. I s s i_I e d By
INSTALLATION
llil? installation is being macle on pt-operty I 000 vihich is not intended for-
sale, lease, or^ tent.
OWNER' S SIGNAIURE: DATE:
INSTALLATION
M' S l bNATURE OF SUVI R. ELEC' N.- (PCc DATE.
Q-
a
LICE=NSE NO r
n
{' Call for, inspection 639--4175
w
w
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
3.25 SW Hall Blvd.
Tigard, OR 97223 PERMIT# EL)DCtG -6)aq7 - -
Phone(503)639-4171
FAX(503)684-7297 DATE ISSUED q6__.
TDD No. (503) 684-2772
CITY OF YIGARD Inspection (503; 639-4175 ISSUED BY tF�r,(-1C-<
PLEASE COMPLETE ALL SEC TIONIS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
Addr RESIDENTIAL—Restricted Energy Fee. . . . . . . . . 140.00
—Cl /n/ (FOR ALL SYSTEMS)
GfY 6 State Zip Check Type of Work Involved:
PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND EXPIRE IF WORK ❑ Audio 3 Stereo Systems*
15 NOT STARTFD WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
180 DAYS. �. Burglar Alarm
7.9 El Garage Door Opener*
CONTRACTOR APPLICATION
❑ Heating,Ventilation and Air Conditioning Systern*
on racier ! type ❑ Vacuum Systems*
�• Y
Ct ElOther
Address
Date- 9// << _ COMMERCIAL—Fee for each system . . . . . . . . 40.00
(SEE OAR 918-260-260)
Property Owner K0 4 _ ChecType-of Wcirk Involved:
. No. ' El Audio and Stereo Systems*
Contractor's Board Reg. �e
❑ Boiler Controls
Phone # C) S ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No ❑ Instrumentation
Address �- ❑ Intercom and Paging Systems
L] Landscape Irrigation Con!rol*
City State Zip ❑ Medical
This permit Is issued under OAR 918-320.370.This applicant agrees to r lake unly ❑ Nurse Calls
restricted energy installations(100 volt amps or less)under this permit:.nd to do the ❑ Outdoor Landscape Lighting*
following:
1. Only use electrical licensed persons to do installations where required.(Certain ❑ Protective Signaling
residential and other transactions are exempt from licensing.These have ❑ Other
asterisks(•)•All others need licensing).
Z Call for an Inspection when all of the installations under this permit are ready
639
t 503
ti
i
for Inspection a . -4175.
CL ❑ _Number of Systems
�-- 3. Purchase separate permits(or all Installations that are not ready for inspection
t—
when the inspector Is out to inspect under this permit. •No licenses are required. Licenses are required for all other installations.
N 4, Assume responsibility for assuring that all corrections required by the Inspector
- -------------------------------
> are done,and
5. Assume responsibility for calling for a final Inspection when all of the corrections 5. FEES
—� are completed.
The person signing for this permit must he the applicant or a person a. Enter Fees $
Uj Uj authorized to bind the applicant.
b. 5% Surcharge (.05 x total above) $
Signature TOTAL $
— 17
Autir ,rity if other an applicant
ENERGAP.CHP