Permit CITY OF TIGARD
DEVELOPMENT �����Ud����
���� ��"�" nmo�n� x SERVICES
ELECTRICAL PERMIT
7 1.1. 13125 SW Hall Blvd., ���y /�
' Tigard, ' ' RESTRICTED ENERGY
PERMIT #: ELR97-0085
DATE ISSUED: 03/21/97
PARCEL: 2G113AB-00800
SITE ADDRESS...: 15995 SW 74TH AVE
SUBDIVISION....: ZONING:I—P
BLOCK..........: LOT.............:
Project Description: Installing data telecommunications system
_______________________ _ ____________ ___
A. RESIDENTIAL--------- B. COMMERCIAL-- ------------ —
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM....: BOILER..........: LANDSCAPE/IRRIGAT.. :
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 --- --
JOHN DUNCAN type amount by date recpt
16055 SW 74TH AVENUE PRMT $ 40.00 B 03/21/97 97-292086
5PCT $ 2.00 B 03/21/97 97-292086
TIGARD OR 97223
Phone #: 684-0044
Contractor: ------- ---------- --- — -----------------
WESTERN TELEPHONE CORPORATION $ 42.00 TOTAL
7600 SW BRIDGEPORT RD
------- REQUIRED INSPECTIONS -------
DURHAM OR 97224 Ceiling Cover Elect'l Service
Phone #: 503-624-7600 Wall Cover Elect'l Final
Reg #..: 000699
This permit is issued subject to the regulations contained in the ~°r'
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perin. tee Signature
applicable lam. 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 y
than 180 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: DATE:
LICENSE NO:
Call for inspection — 639-4175
— - _ - ,- . - — tEJ I/uy: IJ UL
•
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 5W Hall Blvd_ E
Tigard, OR 97223 PERMIT # 1 — 00
, I ; 1 Phone (503) 639 - 4171
r. 4 f { TDD ( 6 2772 DATE ISSUED 1-q---) 2 (-� _
CITY OF TIGARD Inspection (503).639-4175 ISSUED BY j . MaelAr �. •
` PLEASE COMPLETE ALL SECTIONS
• 1. LOCATION OF INSTALLATION 4. TYPE OF WORK
__Z_3_9__g__6____,_S_W_2Y_d/ZZ_
Address-- _ RESIDENTIAL — Restricted Energy Fee $40,00
li i ae 9 / ) (FOR ALL SYSTEMS)
City �l State Zip Check Type of 1.k Involved;
PERMITS ARE NON- TRANSFERAULE AND NON - REFUNDABLE AND EXPIRE IF WORK
15 NOT STARTED WITHIN 1 130 DAYS OF ISSUANCE OR IF WQKK I5 SUSPENDED FOR 0 Audio and Stereo Systemsjte
184 DAYS. ❑ Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener
❑ Heating, Ventilation and Air Conditioning System*
Contractor _I i ,E' ;/ t ;ype ❑ Vacuum Systems`
Address 1__'-- in - 4140A j ❑ Other
Date ,3/2 9 2 COMMERCIAL — Fee for each system 240
(SEE OAR 918- 260.260)
Property Owner j ... �< .
Check Type of Work Involvest
Contractor's Board Reg. No, , ,_- ❑ Audio and Stereo Systems
/ ❑ Boiler Controls
Phone # (' - - '26 06 ❑ Clock Systems
3. OWNER APPLICATION 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 permir is issued under OAR 918- 320 -370. This applicant agrees ro make only ❑ Nurse Calls
restricted energy installations (100 volt amps or less) under this permit and to do the ❑ Outdoor Landscape Lighting'
following;
0
1. Only use electrical licensed persons to do installations where required. (Certain Protective Signaling
residential and other transactiotls an] exempt from licensing. These have ❑ Other
asterisks(i. All others need licensing).
2. Call for an inspection when all of the installations under this permit are ready
for inspection at 503-6394175.
❑ / Number of Systems
3. Purchase separate permits for all installations that are (IOC 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,
The person signing for this permit must be the applicant or a person a. Enter Fees $ l / � D, 00
authorized to bind the applicant.
b. 5% Surcharge (.05 x total above) $ o2r 00
Signature
TOTAL $ y�, f
Authority if other than applicant
ENERCAP.Ci -IP
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 7-- -- s A.M. P.M. MST:
Location: / c 7g n BUP: 2
:7 Tenant: � p C1n Suite: Bldg: MEC:
Contractor: Phone: PLM:
Owner: Phone: ELC: _
ELR: 7 75
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling. Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump ,,..,-- Volt> .t.--.1 7
Approved Approved Approved A prov Approved
Appr /Sdwlk Not Approved Not Approved Not Approved ... ved Not Approved
FINAL FINAL FINAL 311 FINAL
•
C -- )
O Call for reinspection nspec 'on - - of $ required before next inspection 0 Unable to inspect
�/
Inspector• t d e ( 0 Re i i Date: / . Page (of 4_
____ _ _
;., _ .