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11685 SW HAZELWOOD LOOP 0) 00 Cn S 2 N r' O O r O 0 T (3009 QOOM'13ZVH MS SB':)TT CITY OF TIGARD 24-Hour BUILDING Inspection Line: (50)639-4175 INSPECTION DIVISION Business Line: (503) 639-4171 MST BUP — Received �sDate Requested_ - _ AM .. -_ PM. _ BUP Location ,�eaQ Contact Person _ Ph( ) 147- U30 7 a PLM Gr 05 U U Contractor Ph(__ ) SWR _BUILDING _ Tenant/Owner _ ELC Footing Foundation A - --- ELC Fig Drain rAccess: 1� -,�y� ! ELF!Crawl Drain 7'P' 77 - - ---- - Slat, InspectiotlWes: / SIT - __- Post& Beam Shear Anchors -- - - - Ext Sheath/Shear ;nt Sheath/Shear Framing Insulation Drywall Nailing -- l Firewall - Fire Sprinkler Fire Alarm Susp'd Ceiling --- Roof Other F nal PASS PART FAIT. PLUMBING_ ��_ Post&Beam - Under Slab _ Rounti-In V later Service _ Sanitary Sewer Rain Drains Catrh Basin/Manhole Storm Drain --- Shower Pan Other: Jwln _PA _FART FAiL -ANIftCHAN_1C"_A1_ Post.&Bnam- Rough In Gas Lino Smoke Dampers Final PASS FART FAIL -- Fl.E_arRICAL S -rr a -- - ---- Ruugh-In UG/Slab Low Voltage Fire Alarm — -- Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Filvd. PASS PART_FAIL SITE Please call for reinspeciron RE: _ _ Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date �—= -- Inspector _Ext _ Other: E final DO NOT REMOVE this Inspection record from the,lob site. PASS PART FAIL J CITY OF T I G A R D _ ELECTRICAL_ PERMIT PERMIT#: ELC2002-00309 DEVELOMNIENT SERVICES DATE ISSUED: 7/11/02 13125 SW Hall Blvd., Tiqard. OR 97223 (E93) 639-4171 PARCEL: 1S13413D-01500 SITE ADDRESS: 11685 SW HAZELWOOD LP SUBDIVISION: ENGLEWOOD NO. 2 ZONING: R-4.5 BLOCK: LOT : 103 JURISDICTION: TIG Proiect Description: Install 1 branch circuit io hot tub. RESIDENTIAL UNIT TEMP SRV_C/_FEEDERS _ MISCELLANEOUS i 1000 SF OR LESS: 0� 200 amp: PUMP/IRRIGATION: TACH ADD'L 500SF: 2.01 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/FDR: 601+amps - 1000 volts: MINOR LABEL_ (10): SERVICE/FEEDER — BRAN_H CIRCUITS ADD'L ;NSPECTIONS _ 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 2C1 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 01 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: F0'• - 1000 arnr: _ _ PLAN REVIEW SECTION 10004- amp/volt: >=4 RES UNITS: p �> 600 VOLT NOMINAL: _ Reconnect onIV _ SVC/FDR >=225 AMPS: _ CLASS AREA/SPEC OCC: Ow-ler: Contractor: BRAD NE LL WEST SIDE_ ELECTRIC CO INC 11685 SV\ HAZE�WOOD LP. 1834 CE 8TH AVE TIGARD, ''C. 97224 PORTLAND. OR 97214 Phone: 503-530-3072 Phone: Reg #: W-1 5006 SUP 1556s ELE 26-135c FEES Required Inspections Type By Date Amount Receipt Wall Cover PRMT CTR 7/11/02 $46.85 2720020000( Eleck'I Final 5PCT CTR 7/11/02 $3.75 2120020000( Total $50.60 rhis Permit is issued subject to the regulations contain A in the Tigaid Municipal Code, State of OR Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans This permit will expire if A/ork is not started within 1FO days of issuance,of if work is suspended for more than 180 days ATTENTION Oregon law requirus yoo to follow rules adopted by the Oreg, n Utility Notification Center Those rules are set forth in OAR 952.001-0010 through OAR 952-001-Cj6dG. You may obtain copies of these rules ordirect questions to OUNC at(503) 246-6699 or 1-800-332-2344 Permit Signature: J,r �/ Issued By: �,, �" --�C4�U l OWNER INSTALLATION ONLY The installation is being made on property I own which is not inter ided for sale, lease, or rent. OWNER'S SIGNATURE: _ _ — y _ _ DATE: CONTRACTOR INSTALLATION ONLY SIGNAL URE OF SUPR. ELEC'N: ? DATE:_ LICENSE NO: Call S39-4175 by 7:00pm for an inspection the nex, business day electrical Permit Application T- Aute receivud % Ycrmll nn City �.of Ti card , -- - - --- i,, r ',r ;,..•• ProJect/appl.no.: tixpire date: A<'droas; 13125 SW Hall Blvd,' • 97223 nate ismled. By: 'J� Receipt no: Phone: (50.1) 639-4171 Fax: (503) 598-1960 C Ise file nu,: Payment type: Land rive approval: &2 tamely dwcII ng or accessory 0Upinmercial/indumrial CJMuI i-lilmily U Tenant improvement _l Now etrnstruction U Addition/ultcrntion/rcpinccmcnt U Other. _ _U Partial JOB SITE INFOI' Joh aJdrrxr' ZSols S u tJq bldg, nu.: Suite no Tax map/tax htVuccounl nu,: Lot [clock: SuhI ivislon: -- Pruiuct name; — Ucscnption and location ot'work nti rrctrtises; 17'aiml.bxl date of c•ompl tion/inspection: 'CONTRACTOR Job nn: O 1 o E• recht.. Business nnmc: fl .v j -� G r���- DRtcriptlon Qry (ri) 'feed nn,ince Address: Q y ~Y Now ry.ldenlbll-c'ngtcnrnwltl-family par dwc111pRtlrrM.flxlwknonachedkarar r. City. State: 7,IP: L I - Servlceiridadedi Phone: - ,L I Fn x j •n/ u-mail: 1114)0w1 n nr Ise — - -4 w I..,h lirktlmmnl_%W sq_ n,or portion Hemel _ ('CR nn. rlcc. hUs. IiC.net. Z� l I rmdexl energy,iesidential t t'ityll n I .no. e I ma-Ai tnwrgy, non-maidcntial__ 7 �Z y�z Iiach nlanufachmd home or modular'Iwehlas - $1 alum nl o rsin cleclrician (requrrwl) _ Mile Nrvviec nntllor Ihrvictnor feeder,,-Inar c llal ion, Stop,elect,nnmc(pnm► Service.n i„t,tZ ,,�p, .oh Lirxnnc res,:LbL;f ■ticrw.ionorrebcalioa: __PROPt.RTY OWNER 7.I0amps or Icia 2 Nt.Ine(print): , J 201 ompv w 4110 amps 2 401 - _ _ ... nntl,sMot.lin address 1 M)l uurlry to I tNNI mmPI - 2 f.'IIY' T t-t qr. - State: rLII' e1 Z- -Over I(100 amps or volts I'hone: 19 74 Pnx; Email: Reconnect only, Owner installation:The;installation is being made on property I own Temporary wilvicexorfeedert- which is not w :ndod for sale,lease,rant,ur oxchnnge according to inatallatlnn,aMaratlna,prrelscatlor• QRS 447,455,479, 670. 701. 200 empa or Ices -- 1 201 am /to 4(10 am OwnciJR st nature ---- Unta _ 401 In(Mnm , �1 Nronch cineeil,,-new,alteration, or extenarc�per panel• Name! -- _ A pec for branch circuits with purcha%c ur Addross' service or fccder fee,Inch hmneh virudt 2 City: Statc: ZII' Il. Pn far lttamh circuits widaan r,o utivic - --- of ccrvittv,w Iinshr ii:cl lir-,t branch circuit. !� 2 rhea,,: ,, r rel., l _.. _ liwh:aldiliannl hnmch rimnit: lluc.(Slervice or fcedernot ineladed): ❑Sr:rvk¢ uvr.•r 22S ampt-wmr,,err;ml U tle;.n6-con• 0011ty Hach primp res Iwiptition Circle — 1 O Service twer M i mps-rating of 1&2 O ilaratdn'11% ha:uhan Pesch tip•,ur uullirat lighting 1 Ihmily dwellinp U nuildurg over 10,00((witurne Ibet lien or Signal clrcult(a)or a hnulcd cncri•y pmol, -- U Nynlcm ever 6M vote nominal men:msidettial units in one attucturr _Aler:d­n, nr ,,stenion' 1 U nodding Over three stonas U 14vxlun,40111 nmps eN mtxe •U_.ariplion: _—_--. .... _ U(X.alpanl land over 99 persdn< U ManuOa•rerred stntchtrca or RV park khat.rllmrnlitwpertionever the allowable Inany ofthe above: U L'gressAighting plan L Other:.. _--- Per mspcdiat -- Submit -_srt.a of plan+,with any of the alnrve. Inysiffl tion"the rhe above are not applicable to temporary cotwlruclion service. 1)thor - - -- -- rtlla ell(nnAdirtions acoem. viv c J,,please cell jUH wlirllnn 6w rnprr inromuhrnl. Nuticc: 'Mls unlit application Pcrmit tcc _....... ...... . ...f �Vlaa 11!4nic"'. cxpirm if if permit is not obtained Plan review Ot — 0%) S emdii card nun`,her q, Q3 038 / '1101 within 1x0 days after it lint been Stale surchartrt:(8%).,...S S0, �) accepted as cunpWlu. TOTAL... ............... ....S I wnl ,derhn ^ ret „ Qb M Cly:41widcr eiaria u�m 7Am,nt,ia— 440.44 13(6000MM) t 'd Ll_9U-9ELIEU51 '03 011.1120at2l aPTS QSaih 4SU :20 20 BU tnf CITYOF TIGARD _ PLUMe:e!- rERMI'T DEVELOPMENT SERVICES PERMIT M PLM2002-00500 13125 SW Hall Blvd., Tigard, OR 97223 (503' 639-4171 DATE ISSUED: 12/26/02 SITE ADDRESS: 11685 SW HAZELWOrD LP PARCEL: 1S134BD-01500 SUBDIVISION: ENGLEWOOD NO. 2 ZONING: R-4.5 —__ __ BLOCK: LOT: 103 _ JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYNE OF USE: SF WASHING MACH: 1 BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS: 'TRAPS: STORIES: W4TER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS. URINALS: GRF".SE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOVVERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft GISHWASHERS: RAIN DRAIN: ft Remarks: Move washer& dryer. Owner: FEES ----- _ — GARCIA, GREGORY A/KATHL.EEN J Description Date Amount— 11,985 SW HAZELWOOD LOOP ii'LUMBI I'rrm:t I rr 12/26/02 $72.50 TIGt*,RD, OR 9722:; I I'AX1 R° Stitt Iit\ 12/26/02 $5.80 Total $78.30 Phone . --- -- — Contractor: HAPPY JACIhS PLUMBING 7483 SE JOF,NSON CREEK PORTLAND OR 97206 REQUIRED INSPECTIONS Phone : 503-799-6947 Top-out Insp —Final Inspection Inspection Reg #: LIC '48472 PLM 3-.175PB This permit is issued subject to the regulatinns contained in the Tigard Municipal Code, State of OR. Spec?al y Codes and all other applicable laws. All work will be clone in =accordance with approved plans. 'Fhis permit will expire if work is not started within 180 days of Issuance, or if work is Suspended for more: than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon ued By: I .� 1 Permittee Siginaturr. Call(503039-4175 by 7:00 P.M. for an inspection needed the next business day L- FROM :.TACK CORMAN PLUMBING, INC. FAX NO. :5037886949 Dec. 26 2002 1O:O5AM P1 —S-29• Awl --Vw as-VU IA,► UVUVooatftru 1,411 UP 116AIW 190UUA Building Fixtures Plumbin R Permit vn CT V Dau meiyed: D? Permlc ne- cl1 A;kCity0f rigar r Sewat pennil no.: Iluildiaa permit no.: Addraar: :3125 9W Ball Blvd 1 LU 3 -"- --- Co'IV"°rd Pbone: (501) 619-4171 [�t ) U ProjacbipFl.nn.: }lxpire data: Fax' (503)598-1960 Dile Naoad B7p t Jf) Rem,pt no.: _ CITY OF TIGARD Pa Land use approval: ,111 tr DIVl I' case f!lcn-,..oma ym. 1 A 22 family dwelling or accessor;� rI Comrnotclal/industrial U Multi family t-I'Tenant imprevemttnt U Now construction rJAddiltonlaltetahnn/replacement LI Food service L;Qtht:t. lob address: 1`� ,,� � '1 ` � 1� y� � ��� � �beb�cd�tion ► . Fey ea. of�l lc D• - 6Z_`- C 1, l �11� -_ -1���- ew� n�7 4arnily dwellinpx only! Vids nu.: -- (Incladn the R.for aach utUity coopactleu) ThX Mehta lot/locount DO.: — $I°R(1)bath Lo► 111ockc Subdivision: Pic,t name: moi~ , oCIt /c,1 Dscriplocla and Ioaf _ �_ - wo,k on p [Wiser. _ Sireatilltlar Catch basin/araa drain U�esich lme%tmncb dram P"date of col,+pl-"^„/InatWeAcn: D^►'e Footing brain no. t;.it. anufnetured home utilities Business name: •�� an iele>, - -- Addrara; \ c dj . in dein eoancetc CI /� swo: M anttary sower no.,+n 6 r Phoned -'! Fax: E-Mail: CCU no.. 1 - Z Plumb.but,reg.no: -fie -_ rasa service(no.lin. ') Ciryhnatra tic.no.: / fixture or Itc.n:— I Contnctoes re erenative aitr►alula: apron alve Print[tame:; (. _ Date:1 Z ac (leer,evenet r Backwater-ter va"Tvc— nu m avatvry — Narne' Clothes washer Dlshwa% cr — {o'untr (e Stats: Zp: �_ , — - lector!SUMS_ Phone; Fax: E-mail: R steno tsnk FUtttae/sect ra Nrine tint): Fl,)or tr!lloor s t ub �.�- C7at a e t�49ospl- Didlirtq address: l 1 U. ��5 Hose i �'- _Cit r Q eta za!:Y Lt � �j._�._ _ et meker Phone: Fax: -- E-mall: Intatre tor/ aatt tht Comet installatitm/tesidentitil maha nnancc only: The actual installation Y>;ime s) will tie trade by m•or the maintenance and repair made by my reWilar oa a n(commercta amployee on the pturetty I own a per CIPS Chapter 447 ownsee ri taro: Ddte: Sump r�alsTto'-wet sllowet pan Nanta: AAAt*:e' -�Wwte--he ---— �_ (:i — State:--- ZIP: i._ Phone: -� — E-Mail: ern T _ Not all balM Wora oftW ewe!-sib.s�--a eau htdiwi d.tr►am wf .mt..: pqrTnMinimum Ever.............,.._ D tM U IMrtt"Caod explee: This [mit i sppllendon Plfln review(at %) S cipher it a pettnlc,� not ohGinm) � t,.+n ant `•- State sun-huge S within 180 days a!tr*It hot b"n (RK).... ,..memo o ear TOM- ...... ... S -, — � ��r��'— aeeepletl as compleu _ 1 AM 40 401046111 WacaM) CITY OF TIGeARD 24-Hour BUILDING Inspection Line: (503) 6309.4175 MSTINSPECTION DIVISION Business Line: (503) 639-41171 BLIP -_- Received .__ Date Requested— AM___ PM._ BUN Location ll G �/ —Suite MEC - - - Contact Person __, Ph(—) 7' 30 7'Z PLM Contractor / F � — Ph BUILDING Tenant/Owner ELC Footing �— ELC 'z .r 0030 q �— oundation Access: Ftg Drain ELR Crawl Drain _ Slab Inspection Notes: SIT Post& Beam � _- Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing - Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART L_ T FAI PLUMBING_ Post&Beam Under Slab Rough-In Water Service - - Sanitary Sewer Rain Drains Catch Basin/Manhole - Storm Drain -- - --- - ----- -- - -- - _ - Shower Pan _ Other: Final PASS PART FAIL — MECHANICAL__ Post&Beam Rough-In - — -- Gas Line Smoke Desnpers ------- ----------_------- -- --_ - ___.- — Final PASS PART FAIL - - --' ELECTRICAL Service -- Rough-In - - UG/Slab Low Voltage -- Fire Alarm PAS ' PART FAIT_ ❑ Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. E _ [� Please call for reinspection RE:___ Unable to inspect-no access Fire Supply Line ADA Date ���'� Inswactor Approach!Sidewalk � r Other :/ --✓✓ Firal ©O NOT Ih'EMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 BUILDING inspL. , Line: (503)63Q-4175 MST INSPECTION DIVISION Business Line: (50.S)639-4171 _BUP8UPReceived _--.__ Date Requested " q AM PM _ Location __ _�L�c$Z`� Suite MEC _ Contact Person Ph(— ) 7 9 7--3 U 7 2 PLM --- Contractor_ — — ------ Ph(--) — SWR _ BUILDING Tenant/Owner _ _--- __. ELC . Footing —' N ELC Foundation Access: Ftg Drain iLR Crawl Drain Slab Inspection Notes: SIT _- - - - Post& Beam ------- Shear Anchors Ext Sheath/Shear _ Int Sheath/Shear Framing Insulation Drywall Nailing — - — Firewall Fire Sprinkler — -•-- - -��� ..�-�� -- t Fire Alarm r r' Susp'd Ceiling Roof — Other: -- ----- - Final A� PASS—PART _FAIL - e ( PLUMBING_ a<����� — Post&Beam Under Slab ---- - Rough-In Water Service -- - Sanitary Sewer Rain Drains — Catch Basin/Manhole Storm Drain - — Shower Pan Other: - Final PASS PART FAIL MECHANICAL__ Post& Beam Rough-In Gas Line Smoke Dampers Final PASS PART FAIL - ELECTRICAL Service Rough-In ---___-_-- - _ UG/Slab Low Voltage Fire Alarm Final Reinspection fee of$._ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART AI SITE Please call for reinspection RE: _ Unable to inspect-no access Fire Supply Line ADA 9 r' — — Approach/Sidewalk D�- - fC `} C�� �napActr o �Q� �^ Ext Other: Other: _ J Final DO NOT REMOVE this Inspection record fro,in the job site. PASS PART FAIL CITY OF TIGARD Bl.,ill DING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-1175 Business Line: 639-4,171slip — Date Requested 1' -G l BLD _�— I.ocation— C��J r.J �(Jv ite _ _.� MEC � -�� Contact Person �.� � PLM ---Contractor — L 6t �- Ph 3 3 - z(y zc SWR BUILDING — Tenant/Owner —_` ELC _—�- Retaining Wall �— aE Footing Access: w Foundation -- — Fig Drain Crawl Drain Inspection Notes:Slab _._.Post&Beam Ext Sheath/Shear — - ----- Int Sheath/Shear Framing — _ - — --------- ---- Insulation Drywall NailingFirewall Fire Fire Sprinkler -_ -- - Fire Alarm _ Susp'd Ceiling — - — Roof — Misc: _. --- —---- —�. Final PASS PART PART FAIL — --- — ----- PLUMBING _ Post li 8earn ------_----- -- - Under Slab Top Out Water Service --- ------ Sanitary Sewer Rain Drains ---- Final PASS PART FAIL ---- MECHANICAL Post& Beam Rough In Gas Line " ----- -- - Smoke Dampers Final - - -- -- p _SARI FAIL (T tJECTRICAL_,) Service - - — Rough In UG/Slab _-- -------- Low Voltage IFir lane eG>?E'Q r /? ---- --- -- AS� P!,RT FAIL __ __---- ------- Backfill/Grading _-- -- — Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at C"y Hall, 13125 SW Flail Blvd Catch Basin Unable to inspect -no ac--ess Fire Supply Line [ ]Please call for reir pection RE: —_ [ ) p ADA Approach/Sidewalk Date � _Inspector Ext Other Fina! f PASS PART FAIL DO NOT REMOVE this inspection record from the job site. F_ A CITY OF TIGARD DEVELOPMENT SERVICES ELECTRICAL PERMIT 13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 RESTRTCTED ENERGY PERMIT #: EL R98-028:-; DATE ISSUED: 10/09/98 PARCEL: IS134BD-01500 SITE ADDRESS. . . : 11685 SW HAZELWOOD LP SUBDIVISION. . . . :ENGLEWOOD NO. 2 ZONING:R-4. 5 BLOCK. . . . . . . . . . . I_07. . . . . . . . . . . . : 103 JURISDICTN: TIG Project Description: Burglaralare A. RESIDENTIAL---------- B. COMMERCIAL.------_-._—__----.---___—__------------- AUDIO OMMERCIAL------------------------------------------- AUDIO & ST7-REO. . . : ALID10 & STEREO. . : INTERCOM & PAGING. . s BURGLAR AL.ARM. . . . .X BOILER. . . . . . . . . . : I-AND13CAPE/I RR I BAT. . : GARAGE OPENE=R. . . . . CLOCK. . . . . . . . . . . MEDICAL. . . . . . . . . . . . : DATA/TELE COMM. . NURSE CALLS . . . . . . . : VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . :* OUTDOOR LANDSC LITE: OT,AER: HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . : INSTRUMENTATION. - OTHER. . : 11. TOTAL # OF SYSTEMS: 0 Owner: FEES GARCIq, GREG & KATHY type amount by date recpt 11685 SW HAZELWOOD PRMT $ 40. 00 B 10/09/98 TIGARD OR 97223 5PCT $ 2. 00 B 10/09/98 98-3098p , Phone #: Contractor: ALLTEC SECURITY $ 42. 00 TOTAL PO BOX 55310 REQUIRED INSPECTIONS ----- PORTLAND OR 97238 -5310 Ceiling Cover Low Voltage Insp Phone #: 331-2620 Wall Cover Elect' l Final Reg #. . : 001188 This permit is issued subject to the regulations ontained in the Tigard Municipal rode, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within In days of issuaxe, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rule auipted by the Oregon 1ftjlity Notification Center. Those rules are set forth in DAR 952-M14010 through OAR 952-001-6080. You way obtain copies of these rules or direct questio ��0 OM at (503)246-19bl. -1 P r-m- ttee Gi gnat 1.ire er� ISS1.(ed r ---.f I--/, ----OWNER INSTALLATION The installation is being] made on property I own which is not intended for sale, lease, or rent. OWNER' S SIGNATURE: DATE TNSTAl.J..ATTON ONLY—- SIGNPTURE OF SUPR. ELECIN: DATE: 4 LICENSE NO ...............t +++++4........4•................................................4-+++4 Call 639-4175 by 7:00 P. M. for an inspection needed the next bijsiness day ...........++_6........4.......4......................4.........'-++++4......... Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION 13125 SW Hall Blvd. PERMIT# Tigard, OR 97223 — Phone(503)639-4171 FAX(503)684-7297 DATE ISSUED —�-- TC9 No. (503)684-2772 CITY OF TIGARD Inspection (503)63 1-4175 ISSUED 6Y �7 1• ' �/ �— PLEASE COMPLETE ALL SECTIONS RECEIVED 1. LOCATION OF INSTALLATION 4. TYPE OF WORK (� k S�� c OCTo f, 199p Address RESIDENTIAL--Restricled Energy Fee . . 54SL1111 �� Q/2 Ld D�6� (FOR At L SYSiHM"a)':: lTY D:VELUI�r� Nl City (J-- Stale Zip Check Tvn tL'l�Ikluyyl'ss1 PERMITS ARE NON.TRANSrtRARLE ANI)NON•REFUNI)A ND EXPIRE It WORK El Audio and Stereo Systei+s IS NOT STARTED WITHIN too BAYS OF ISSUANCE UR IF K IS SUSPENDED FOR 1R0 DAYS. (Burglar Alarm ❑ t,-.arage Door Opener* 2. CONTRACTOR APPLICATION ❑ Heating,Ventilation and Air Conditioning System' Conlractot A1.1tec Security Type ❑ Vacuum Systems' ❑ Other Address PO Dox 55310 - Portland, OR 97238- 3 Date —C COMMERCIAL--Fee for._acft system . . . . . . . . $AQ100 (SEE CAR 910-260.260) Property Owner JI ��/'� �/12�L a IC Teck TXpe of Work in Ived: Contractor's Board Req. No. 11'339 _ ❑ Audio and Stereo Systems ❑ Boller Controls Phone # 331-2620 ❑ Cl.ck Systems ❑ Data Telecornmunication Insta'.+tions 3. OWNER APPLICATION ❑ Fire Alarm Installation ❑ HVAC Print Owner's Name Phone No ❑ Instrumentation ❑ Intercom and Paging Systems Address ki ❑ Landscape'-ligation Control' City Stale , Zip ❑ Medical Cl Nurse Calls This permit is issued under OAR 918.320.370.Tills applicant agrees to make only restricted energy installations 1100 voll amps or less)under this permit and to do the ❑ Outdoor Landscape Lighting' Intlowinil [ Protective Signaling 1. Only use electrical!icensed persons to do Installations where required.(Certain Other residential and other Ira sactions are exempt from licensing.These have aslerisksl').All others need licensing). 2. Call for an inspection when all of the installations under this permit are ready for Inspection at 503.639.4119. ❑ Number of Systems 3. Purchase senarate Purmits 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 installations 4. Assume responsibility for assuring that all corre-ctions required by the Inspector ---------- — are d-:ne,and 5. Assume.resftonsibility for calling for a Anal Inspection when all of the 5. FEES conectinns a e tompleled. The person signing for this permit 311,15t the applicant or a person a. Enter Fees $ authorized In hind U " plkant tom- b. 5%Surcharge (.OS x total above) $ 2— .06) 01 Signature TOTAL $ Authnnly if olie.r than.lpplicant [SKRGAP.0IP