Permit - '
TY OF TIGARD
ELECTRICAL PERMIT —
RESTRICTED ENERGY
^- PERMIT #: ELR96-0254
����]�|�K��W�Y DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigar Oregon 97223°8199 (503) 839-4171 DATE ISSUED: 08/15/96
PARCEL: 2S101AA-09001
SITE ADDRESS...: 12585 SW 68TH AVE
SUBDIVISION • WEST PORTLAND HEIGHTS ZONING:C—P
BLOCK ^ LOT ^29
Project Description:
_
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: FEES
ROTH OFFICE BUILDING type amount by date recpt
12585 SW 68TH AVE PRMT $ 40.00 CJS 08/15/96 96-282935
5PCT $ 2.00 CJS 08/15/96 96-282935
TIGARD OR 97223
Phone #: 639-2639
Contractor: —
SONITROL PACIFIC $ 42.069 TOTAL
1974 SW 6TH AVE
REQUIRED INSPECTIONS
PORTLAND OR 97201 Wall Cover Elect'l Final
Phone #: 503-223-5822 Elect' Service
. Reg #..: 53535
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permitee Signature
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 ponded for more '�
i91
than 18N days. Issued By
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: M���,/p�� DATE: 8-15
LICENSE NO:
Call for inspection — 639-4175
•
•
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT # ELR�-O 5y
�i��ta °��i Phone
FAX (503) 684-7297 1 ATE ISSUED �- J �J- 9 �
-- TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY Ci r/e c
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
A er c54I di
Addr� RESIDENTIAL — Restricted Energy Fee $40.00
On 972)3 (FOR ALL SYSTEMS)
City State Zip Check Type of Work Involved:
PERMITS ARE NON - TRANSFERABLE AND NON - REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems
IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
180 DAYS. ❑ Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener*
, 7eei ❑ Heating, Ventilation and Air Conditioning System*
Contractor S i'7p/, Type 2>s i/�fj ❑ Vacuum Systems*
Address /f f� �� 4i c, �%-P f j�/al// ❑ Other
//
Date ( / 6 COMMERCIAL — Fee for each system $40.00
(SEE OAR 918- 260 -260)
Property Owner l Check Type of Work Involved:
Contractor's Board Reg. No. Li�,s , 3.) ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone # -223 0'22— ❑ Clock Systems
❑ Data Telecommunication Installations
3. OWNER APPLICATION
❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No ❑ Instrumentation
Address ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
City State Zip ❑ Medical
This permit is issued under OAR 918 - 320 -370. This applicant agrees to make only ❑ Nurse Calls
restricted energy installations (100 volt amps or less) under this permit and 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).
2. Call for an inspection when all of the installations under this permit are ready ❑
for inspection at 503- 639 -4175. Number of Systems
3. Purchase separate permits 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 corrections required by the inspector
are done, and
5. Assume responsibility for calling for a final inspection when all of the 5 FEES
corrections are completed.
GO
The person signing for this permit must be the applicant or a person a. Enter Fees $
authorized to bind the a licant.
cJ
b. 5% Surcharge (.05 x total above) $
Si naturi L 0
g TOTAL $ /�
Authority if other than applicant
ENERGAP.CHP