Permit A,. CITY OFTIGARD
�� , „0.,i,6ti DEVELOPMENT SERVICES ELECTRICAL PERMIT —
='��� 13125 SW Hall Blvd., Tigard, OR 97223 503 639 -4171 RESTRICTED ENERGY
PERMIT # ELR98- 005&
DATE ISSUED: 03/04/98
� ®
470 PARCEL: 2S111CB- 00700
SITE ADDRESS«,. :14860 SW 103RD AVE
SUBDIVISION,. -o :DEL MONTE SUBDIVISION ZONING:R-3.5
BLOCK..........: LOToa- ....,...., :006 JURISDICTN: TIG
Project Description: Add burglar alara to an existing single faoily dwelling.
A. RESIDENTIAL - -•- B. COMMERCIAL -- -- - - --
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM. -., :X BOILER..........: LANDSCAPE /IRRIGAT -.:
GARAGE OPENER.. - -e CLOCK...........: MEDICAL...- o- -n -o.ti
HVAC-- sop-- tl - - - -e - DATA /TELE COMM..: NURSE CALLS........:
VACUUM SYSTEM....: FIRE ALARM......: OUTDOOR LANDSC LITE:
OTHER: o- NVAC >--- sooso - -es PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER -n: DO
DM
TOTAL # OF SYSTEMS: 0
Owner: ---- ---------------- FEES - - -- - -- _-
ERIC MEEUWSEN type amount by date recpt
14860 SW 103RD AVE PRMT $ 40.00 GEO 03/04/98 98- 303826
TIGARD OR 97224 5PCT $ 2.00 GEO 03/04/98 98-303826
Phone #:
Contractor: --- _. _ -_ . _._. _. - - -- -- ---- ..-- ... - --
HONEYWELL INC $ 42.00 TOTAL
15495 SW SEQUOIA
STE 1 00 REQUIRED INSPECTIONS ---
PORTLAND OR 97224 Low Voltage Insp __
Phone #: 968 -3333 Elect'i Final
Reg #..: 000578
This peroit is issued subject to the regulations contained in the Tigard {1unicipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This peroit will expire if work is not started within 180
days of issuance, or if work is suspended for core than 180 days. ATTENTION: Oregon law requires you to follow rule adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -080. You nay obtain copies of
these rules or direct questions to CV' at .{F )246 -1987. --
/ .
1
Issued by Permittee Signature_ . _ __..._._.
----------- 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: 3 - V- c
LICENSE NO:
++++++++++++++++++++++++++++++-t-+++++++++++++++++++++++++++++++++++++++++++++-1-++'-
Cal l 639-4175 by 7:00 P.M. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + ++ ++-4- + + + + +F + +-+-
_, - e
pi» v-& (4.'P v Std
I..
CITY OF T4GARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
13125 SW HALL BLVD Date Rec'd:
TIGARD OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X304 ss Permit #: 955 K
F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL
E L yyl � 5e n Restricted Energy Fee $40.00
G r I '' (FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS / L ( S (o O ...SW 103 rd.' Ave, Check Type of Work Involved:
CJy /State Zip Phone # El Audio and Stereo Systems
/ I gard, `/7:2 96W -I`Ik5
NarrZ El Burglar Alarm
OWNER Mailing Address ❑ Garage Door Opener*
City /State I Zip I Phone # ❑ Heating, Ventilation and Air Conditioning System*
Name ❑ Vacuum Systems*
1-b n ty 14 fe jt, ❑ Other
CONTRACTOR Mailing Addres
f5yT,5 Su t Se t oy TYPE OF WORK INVOLVED - COMMERCIAL
(Prior to issuance a City /St to Z Phone #•! Fee for each system $40.00
copy of all licenses 7'r 'Ha 0 cL OR 7. aY 96 ?"330C (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Bra Lic. # Exp. Date
expired in C.O.T. 0.5 7 R a.y f`. /9 Check Type of Work Involved:
data base). Electrical Contr. Lic. # xp. Efate
,;26o - .207 CLE 1 el l / ❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. _ ate
G 0 9 `/ / y 99 ❑ 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 El 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 ready 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. 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.
p FEES:
ltinite...e. t SigPatur FEES $ y O n Si, atur
5% SURCHARGE (.05 X TOTAL ABOVE) $ 0? n a
�'""j .�n1m ) (Ls; 4.7`7, '
Authority if other than Applicant TOTAL $ / 2 , op
i:\resele.doc 12/96 —
6/16/00 Activities for Case #: ELR98 -00068
3:18:15 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRA003 Application received 3/4/98 GEO RECD GEO 3/4/98
ELRA010 Permit created 3/4/98 GEO DONE GEO 3/4/98
ELRA725 Low Voltage Inspection 3/4/98 3/4/98 GEO 3/4/98
ELRA799 Elect'I Final 3/4/98 GEO 3/4/98
ELRA500 (F) Issue permit 3/4/98 GEO PASS GEO 3/4/98
ELRA920 Miscellaneous action 2/22/00 JMT DONE No Hold JMT 2/22/00 research inspection request
ELRA580 Expired by limitation 6/7/00 HAP DONE No Hold AKJ 6/7/00
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