Permit CITYOFTIGARD
^ i �, ; , I � lI , DEVELOPMEN SERVICES ELECTRICAL PERMIT —
RESTRICTED ENERGY
PERMIT #: ELR97 -0290
DATE ISSUED: 10/15/97
PARCEL: 1S136DB -02600
SITE ADDRESS...:112O1 SW 72ND AVE
SUBDIVISION • ZONING:C —G
BLOCK • LOT JURISDICTN: TIG
Project Description : Installing audio /stereo system, intercom paging system, and
camera observation system
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO...: AUDIO & STEREO..:X INTERCOM & PAGING.. :X
BURGLAR ALARM BOILER • LANDSCAPE/ IRRI GAT. .:
GARAGE OPENER • CLOCK • MEDICAL
HVAC . DATA /TELE COMM..: NURSE CALLS •
VACUUM SYSTEM • FIRE ALARM • OUTDOOR LANDSC LITE:
OTHER: .. HVAC • PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER.. :CAMERA ::X
TOTAL # OF SYSTEMS: 3
Owner: FEES
MCDONALDS CORPORATION type amount by date recpt
5000 SW MEADOWS ROAD, SUITE 230 PRMT $ 120.00 JD 10/15/97 97- 300073
LAKE OSWEGO OR 07035 5PCT $ 6.00 JD 10/15/97 97- 300073
Phone #: 684 -9334
Contract or:
ENTOUCH SYSTEMS INC $ 126.00 TOTAL
3732 SW MOODY
REQUIRED INSPECTIONS
PORTLAND OR 97201 Ceiling Cover Low Voltage Insp
Phone #: 624 -6500 Wall Cover Elect' 1 Final
Reg #..: 000692
This permit is issued subject to the regulations contained in the Tigard Municipal Code, 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 180
days of issuance, or if work is suspended for more than 180 days. ATTENTTION: Oregon law requires you to follow rule adopted by the
Oregon Utility Notification Center. Those rules 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_-(" °••- 987.
Issued by . C-----) Permittee Signature W 9_Bt
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: DATE:
LICENSE NO:
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY•OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: J
13125 SW HALL BLVD Date Rec'd: ! 0 -1 S-
TIGARD OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #: E L-R17 -0240
F - 503 -684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL
I r \Z D k\ \ AS Restricted Energy Fee $40.00
1 `� ` ` (FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS \ ir2--0 1 SU.) 12:401 Check Type of Work Involved:
Ci 1 /State mt. D �1 Zip Phone # El Audio and Stereo Systems
'� Cr �',2'L'j _
Name ❑ Burglar Alarm
OWNER Mailing Address ❑ Garage Door Opener*
City/State Zip I Phone # ❑ Heating, Ventilation and Air Conditioning System*
Name ❑ Vacuum Systems*
C A&LA—di , x S S ❑ Other
CONTRACTOR M ' in Address
�j 'Z,2 S W y TYPE OF WORK INVOLVED - COMMERCIAL
(Prior to issuance a C tatq �N 1 1 1 D Z _ _ Phone # Fee for each system $40.00
copy of all licenses 1R� �` 72hJ % 1.13 (SEE OAR 918- 260 -260)
are required if Oregog Cpgtri� # Ex Date
expired in C.O.T. - (fl "1 L2� 1 1 tr ig' Check Type of Work Involved:
data base). Electr -aj Contr �` ` 0 1 'U
a Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp.Da�@,
00 b V L% 51 3,4— t8 ❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT ❑ Data Telecommunication Installation
City /State I Zip I Phone # ❑
Fire Alarm Installation
This permit is issued under OAE 918 - 320 -370. This applicant agrees to
make only restricted 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. `i Intercom and Paging Systems
These have asterisks('). All others need licensing;
2. Call for inspections when installation under this permit are ready for
0 Landscape Irrigation Control'
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 — c
corrections are completed. .0 Other O 6 "LI
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.
S FEES:
U.) r
Signature \� ENTER FEES $
5% SURCHARGE (.05 X TOTAL ABOVE) $ /
•
Authority if other than Applicant TOTAL $
i:Vesele.doc 12/98 —