Permit u u I
ITY OF TIGARD ELECTRICAL PERMIT —
•" COMMUNITY DEVELOPMENT DEPARTMENT PERMIT ERM ENERGY
PERMIT 4* #: ELR96 -0206
13125 SW Hall Bbd. Tigard, Oregon 97223.8199 (503) 839 - 4171 DATE ISSUED: 09 / 12 / 96
PARCEL: 2S113AD -01700 •
SITE ADDRESS...: 16920 SW 72ND AVE
SUBDIVISION • ROSEWOOD ACRE TRACTS ZONING:C —G
BLOCK • LOT • 30
Project Description: Backflow
A. RESIDENTIAL —•— B. COMMERCIAL
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM BOILER • LANDSCAPE /IRRIGAT..:X
GARAGE OPENER • CLOCK • MEDICAL
HVAC • DATA /TELE COMM..: NURSE CALLS °
VACUUM SYSTEM • FIRE ALARM • OUTDOOR LANDSC LITE:
OTHER: . . HVAC • PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER..: ..
TOTAL # OF SYSTEMS: 1
Owner: FEES
BINGHAM PROPERTIES type amount by date recpt
3939 NW ST HELENS RD PRMT $ 40.00 TAT 09/12/96 96- 283896
5PCT $ 2.00 TAT 09/12/96 96- 283896
PORTLAND OR 97229
Phone #: 224 -2676
Contractor: -----
DENNIS'7 DEES LANDSCAPING $ 42.00 TOTAL
7355 SE JOHNSON CK BLVD
REQUIRED INSPECTIONS
PORTLAND OR 97206 -9329 Elect' 1 Service __ _
Phone #: 503 - 777 -7777 Elect' 1 Final
Reg #..: 5009
This permit is issued subject to the regulations contained in the ` ,
�:J4w
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t eg S i gnat '-�
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 _ AL. /,
than 180 days. I ued 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 : U. DATE:
LICENSE NO: _________ . ---
Call for inspection — 639 -4175
•
04/05/96 15:53 8503 684 7297 CITY OF TIGARD Z002/002
, ,,_.,ii
x
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 5W Nall Blvd.
� 96 .0,700 6
Tigard, OR 97223 23 PERMIT #
,:� ;i' il ,, 1 I , I Phone (503)
(0) 639-4171
4 -7 a /. {9/
,-s-■i FAX (503) 684 -7297 DATE ISSUED ! / ` �0
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
_Address RESIDENTIAL — Restricted Energy Fee _QQ.Q
/C; Li Cl 7 !d L (FOR ALL SYSTEMS)
Ci State zip Check Type al Work Involved:
PERMITS ARE NON - TRANSFERABLE AND NON - REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems
IS NOT STARTED WITHIN lee DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
160 DAYS. ❑ Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener*
b en n i c 1 ► GS LCLinclsca -hu - 9 ❑ Heating, Ventilation and Air Conditioning System'
Contractor Type _ ❑ Vacuum Systems'
��" /�� rl"lail61 ❑ Other
Address - 1 L (' �J- S nn 1J �U (Y4���''1 (, reC k UI v . D�., Gl i 64p
Date ' ` I l.-� v l O COMMERCIAL — Fee for each system 140.00
n II I , j /l (SEE OAR 918- 260 -260)
Property Owner 8L-!'14a -m_ (JUn,�) I 4 ( ! U r7 S.heck T of Work Involved•
Li
Contractor's Board Reg. No. 00 ❑ Audio and Stereo Systems
1 ❑ Boiler Controls
�
Phone # ) 1 1 " / - 7 1 1 ❑ Clock Systems
3. OWNER APPLICATION CI Data Telecommunication Installations
❑ 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 916. 320.370. This applicant agrees ro make only ❑ Nurse Cells
restricted energy installations (100 volt amps or less) under this permit and to do the ❑ Outdoor Landscape Lighting'
Wowing:
0
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.
0 0 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 installaUom.
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 or the 5. FEES
corrections are completed. // //\\
The person signing for this permit must be the applicant or a person a. Enter Fees $ L - !�( 1
authorized to bind the applicant.
I / b. 5% Surcharge (05 x total above) $ 2
Signature _
TOTAL $
Authority if other than applicant