Permit •
CITY OF TIGARD
%�� ,� DEV SERVICES ELECTRICAL PERMIT -
RESTRICTED ENERGY
PERMIT #: ELR98-0263
DATE ISSUED: 09/17/98
PARCEL: 3S1 i 3AA - -01 100
SITE ADDRESS...:16580 SW 72ND AVE #8 -i1
SUBDIVISION :ROSEWOOD ACRE TRACTS ZONING:I -L
BLOCK..........: LOT °. ........ ...:00D JURISDICTN: TIG
Project Description: PacTrust Bldg #11
A. RESIDENTIAL B. COMMERCIAL - -- • _..------ __ -_.- -
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM....: MOILER..........: 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: _ _ _- -----
PACIFIC REALTY ASSOCIATES type amount by date recpt
15350 SW SEQUOIA PKWY STE 300 PRMT $ 40.00 JSD 09/17/98 95-- 309239
TIGARD OR 97224 0000 SPCT $ 2.00 JSD 09/17/98 98- 309239
Phone #:
Contract or : ----- - - - - -- -- - - - -----
HONEYWELL INC $ 42.00 TOTAL
15495 SW SEQUOIA
STE 100 -- ___- REQUIRED INSPECTIONS --- - - - - --
PORTLAND OR 97224 Ceiling Cover Low Voltage Insp
Phone #: 968 -3333 Wall Cover Elect'l Final
Reg #..: 000578
This perait 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 persit will expire if work is not started within 180
days of issuance, or if work is suspended for sore than 180 days. ATTENTION: Oregon law requires you to follow rule added by the
Oregon Utility Notification Center. Those rule are set forth in OAR 952 -001 -0010 through OAR 952- 001 -0080. You may obtain copies of
these rules or direct questions to O '.,)246 -1987.
Issued by 4111W Permittee Si.gnature / / �� / �
•
- - -- -OWNER INSTALLATION ONLY--- ---- .----- __--- - - - - -_ . ---
The installation is being made on property I on which is not intended for
sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
--------------- CONTRACTOR INSTALLATION ONLY----------- -- -- - -. -•- --------
SIGNATURE OF SUPR. ELEC' N : DATE:
LICENSE NO:
1+ ++++++++++++++++++++++++ ++ ++ + + +++++-1-+++ + ++++++++•*+++ ++ + + +
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
++++++-I--1--F ++++ +++-1 +++++++++++++++++++++++++++++++ ++++++++++++ ++++++ + ++++++ + +++•i ++
CITY OF TIGARD RECM E.fCTED ENERGY ELECTRICAL APPLICATION Rec'd by: (9 1:-)
13125 SW HALL BLVD Date Rec'd: 04/ 5g
TIGARD OR 97223 ,� PRINT OR TYPE
V - 503 - 639 -4171 X304 Sr i2 1 7 1998 Permit #:C — OW , . 3
F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd
CQ,.: , !_!.;;n B ELC "` WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
�
/ Restricted Energy Fee $40.00
/ Q e t-1 is 71 ./7 L rI? '# // (FOR ALL SYSTEMS)
JOB Street Address J Ste #
Check Type of Work Involved:
ADDRESS / G.Sg() .56.i 7anal Ave.
City /State Zip Phone # ❑ Audio and Stereo Systems
-- Pew iinnd, y
Name ' ' / �., El Burglar Alarm
/
u l i i taict / '! re.r �/ /'` m ❑ Garage Door Opener*
OWNER Mailing Address J
/5:3 C a S' /, Segii i i y � ..,.O f7 ❑ Heating, Ventilation and Air Conditioning System*
,q ty /Stet% oR i Zip° Phone #1
f G� I `77-?•25/ `77-?•25/ `77-?•25/ ❑ Vacuum Systems*
Nam
Name
kin e _ / _ ❑ Other
CONTRACTOR Mailing Addr
/55 SLcJ Seg o/ a ,� kii// #y�o TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /State Z /Phone # Fee for each system $40.00
copy of all licenses 7ni-f9nnd 40, 97.22 9 961•330-A (SEE OAR 918 - 260 -260)
are required if Oregon Contr. $rd Lic. # Exp. Date
expired in C.O.T. ( �-r j t�
7 g2y V Check Type of Work Involved:
data base). Electrical Contr. Lic. Exp. Date
.7 6 - 2 07 CL E / /i i 9Q ❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. bate
L O 9 y 1/1/ 19 ❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT ❑ 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 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. ❑ Intercom and Paging Systems
These have asterisks( *). All others need licensing;
❑ Landscape Irrigation Control*
2. Call for inspections when installation under this permit are read -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. 1 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.
a i FEES:
- W AL / c& 7 ENTER FEES $ co. 0 0
Signat h
5% SURCHARGE (.05 X TOTAL ABOVE) $ I O2 - O a
Authority if other than Applicant C7
TOTAL $ 0
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