Permit OF � ELECTRICAL PERMIT — CIF
RESTRICTED ENERGY
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #: ELR96-0274
1o1ommw Hall Blvd. Tigard, Oregon m72u°81om (503) 83m4171 DATE ISSUED: 09/05/96
PARCEL: 2S113AD-01700 •
SITE ADDRESS...: 16920 SW 72ND AVE
SUBDIVISION • ROSEWOOD ACRE TRACTS ZONING:C—G
BLOCK • LOT ^30
Project Description: Data telecommunication installations.
_
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM ^ BOILER • LANDSCAPE/lRRIGAT..:
GARAGE OPENER • CLOCK • MEDICAL
HVAC ^ DATA/TELE COMM..:X NURSE CALLS •
VACUUM SYSTEM ^ FIRE ALARM • OUTDOOR LANDSC LITE:
OTHER: HVAC • PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER..:
TOTAL # OF SYSTEMS: 1
Owner: FEES
BINGHAM INVESTMENT CO type amount by date recpt
3939 SW ST HELENS RD PRMT $ 40.00 JMH 09/05/96 96-283617
5PCT $ 2.00 JMH 09/05/96 96-283617
PORTLAND OR 97210
Phone #:
Contractor:
TELEPHONE SERVICES & COMM. $ 42.00 TOTAL
18438 SE PINE
REQUIRED INSPECTIONS
PORTLAND OR 97223 Wall Cover Elect'l Final
Phone #: 503-665-4900 Elect'l Service
Reg #..: 74870
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other P mitee 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 for more
than 180 days. ued By
�
OWNER INSTALLATI~' ONLY-----
The installation is being made on property I on which is not intended for
sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
' —
—CONTRA OR INSTAL TION ONLY
SIGNATURE OF SUPR. ELEC' N ww��~� %��E: ?7'0Fgr
'
LICENSE NO:
Call for inspection — 639-4175
=ti.. Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT #
A�,n�tiipl Phone (503) 639 DATE ISSUED
,-44 J - 1 I FAX (503) 684-7297
� TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
/4 sal 7an-bt
Address R RESIDENTIAL - Restricted Energy Fee $40.00
-Tigard ci (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
15 NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
180 DAYS. ❑ Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener*
�t°lt° U112 Senn t7H S ❑ Heating, Ventilation and Air Conditioning System*
Contra or Type }�7 ❑ Vacuum Systems*
Address /g '3V SE PU2— �JU *Rand a pe. c3 ❑ Other
Date q- -/ 9l COMMERCIAL — Fee for each system $4o.00
� � � �, �� (SEE OAR 918 - 260 -260)
Property Owner Check Type of Work Involved;
Contractor's Board Reg. No. 'a 1 ! 7 7� ❑ Audio and Stereo Systems
( �(� �j ❑ Boiler Controls
Phone # ( ( L 2 ' — I t 0 0 ❑ ock Systems
mod/ Data Telecommunication Installations
3. OWNER APPLICATION
j Lv"' �F �3 5 JLL C
og& Fire Alarm Installation
/ ❑ HVAC
Print Owner's Name Phone No ❑ Instrumentation
Address El 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. ❑ 1 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. t �, `f/"�/I D O
The person signing for this • ermit must be the applicant or a person a. Enter Fees $ 1H
authori -d to bind the a' pl . nt.
/ b. 5% Surcharge (.05 x total above) $ 1- ' 01)
Sign. ure TOTAL $ `(v 1
Authority if other than applicant
ENERGAP.CHP