Permit (3) qj
CITY �� ELECTRICAL PERMIT -
A RESTRICTED ENERGY
I� DEVELOPMENT SERVICES PERMIT #: ELR1999 -00150
r - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/17/99
SITE ADDRESS: 09380 SW TIGARD ST PARCEL: 2S102A6 -01902
SUBDIVISION: NO.TIGARDVILLE ADDITION AMEND. ZONING: I -P
BLOCK: LOT: 055 JURISDICTION: TIG
Project Description: Protective signaling
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: • BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
ATLAS LAND COMPANY PHILLIPS ELECTRONICS
9380 SW TIGARD ST (DBA FOR MASTER ALARM L.L.C.)
TIGARD, OR 97223 1110 NW FLANDERS
PORTLAND, OR 97209
Phone: • Phone: 222 -5083
Reg #: LIC 00125364
SUP 329JLE
ELE 26213CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT BON 6/17/99 $60.00 99- 316183 Elect'I Final
5PCT BON 6/17/99 $3.00 99- 316183
Total $63.00
ORIGINAL
This Permit is issued subject to the regulations contained in the Tigard 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 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 Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by . Ka a /Jtk t— Permittee Signature 01/1_, A li /� — h,,,,Low
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: i! v Pc- DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
1 r .,(4 -'1
�,I ° � OP►TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: (f , (`5 i
■ 13125 SW HALL BLVD t k Date Rec'd: PO
'
TIGARD OR 97223' PRINT OR TYPE p^
V - 503- 639 -4171 X304, �� Permit #: g1 -!`°i `-z.I - --(,rl `o
-F - 503- 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee $40.00
No(/ I Sr G. I6 1.A.vr4_5' . (FOR ALL SYSTEMS)
JOB Street Address }\ Ste # Check Type of Work Involved:
ADDRESS CI L.) 5u T + CnI�U 5■
- - City /State Z ph ee ❑ Audio and Stereo Systems
'fi •,,A �1z3 (��
Name ❑ Burglar Alarm
OWNER Mailing Address Q Garage Door Opener*
City /State Zip Phone # ❑ Heating, Ventilation and Air Conditioning System'
Name El Vacuum Systems'
. - . ?1 1 ', ?S (ricC-+cdnrC S.," , • ❑ Other - • - - - -
CONTRACTOR Mailing Address 1
7110 N lti' Fo r•s TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a Ci /Sta t a Zip Phone # Fee for each system .$40:00 - -
copy of all licenses ro{ } r _ qlZ 1 3 27 ?- . ‘?`'AS (SEE OAR 918 - 260 -260) • r
are required if Oregon Contr. Brd Lic. # E ate
expired in C.O.T. 7 .�� G /ori Cf9 Check Type of Work Involved:
data base). Electrical Contr. Lic. # Ex to
2 6 - Z 1 j - C- L.. /t) I ' t -- ❑ Audio and Stereo Systems
C.O.T. orMetro j2# � Dat ❑
o I j JJ�G '' Boiler Controls
Owner's Name
• ❑ Clock Systems
OWNER - Mailing Address
APPLICANT ' . E Data Telecommunication Installation
City / State Zip Phone # ❑
Fire Alarm Installation
This permit is'issued under OAE 918 - 320 -370. This applicant agrees to
make only'r�estricted energy installations (100 volt amps or less) under this -❑ HVAC
permit and to do the following: •
❑ Instrumentation
1. Only use electrical licensed persons to do installations where required.
Certain residential and other transactions are exempt from licensing. ❑ Intercom and Paging Systems
These have asterisks(•). All others need licensing;
❑ Landscape Irrigation Control*
27 r inspections when installation under this permit are ready for
inspection at 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 corrections required by the Outdoor Landscape Lighting*
inspector are done, and; -
" ®- Protective Signaling
5. Assume responsibility for calling for a final inspection when all of the
corrections are completed. ❑ Other
Permits are non - transferable and non - refundable and expire if work is not
started within 180 days of issuance or if work is suspended for 180 days. Number of Systems
The person signing for this permit must be the applicant or a person • No licenses are required. Licenses are required for all other installations
authorized to bind the applicant.
FEES: , ' L
ENTER FEES $ 4.' C/
Signature •
—7.-----C' v ' � � •
5% SURCHARGE (.05 X TOTAL ABOVE) $
Authority if other than Applicant TOTAL $ ` � 0- Fi
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