Permit CITY OF TI GARD A ELECTRICAL PERMIT -
RESTRICTED ENERGY
W; DEVELOPMENT SERVICES '� PERMIT #: ELR1999 -00276
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 *TE ISSUED: 11/22/99
SITE ADDRESS: 10624 SW 127TH CT PARCEL: 1S133AD-10700
SUBDIVISION: AMART SUMMER LAKE NO. 3 o ZONING: R -7
BLOCK: LOT: 163 0RiGitslikto, JURISDICTION: TIG
Proiect Description: Installation of protective signaling.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: PROTECTIVE : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
SALVATION ARMY, CORPORATE BOAR SONITROL PACIFIC
PO BOX 8798 1975 SW 6TH AVE
PORTLAND, OR 97208 PORTLAND, OR 97201
Phone: Phone: 223 -5822
Reg #: LIC 00053535
ELE 26370CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT DEB 11/22/99 $60.00 99- 319940 Elect'l Final
5PCT DEB 11/22/99 $4.80 99- 319940
Total $64.80
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other 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. ATTENTION: Oregon law
requires • o • , rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -01 -0010 through •AR 952-011-0080. You may obtain copies of these rules or direc questio to OUNC at (503)
246-1!87.
• Issue, by / I� ' /� /�
,/�i� Permittee Signature jih,
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd t y:
13125 SW HALL BLVD Date Recd: // - 8? -
TIGARD OR 97223 REC'El r ''r PRINT OR TYPE
V 503-639-4171 X304 Permit #: 6i-P-699 - 7k
F - 503 - 684 -7297 NOV 2 2 1 91gOMPLETE OR ILLEGIBLE APPLICATI Cust.Call'd:
WILL NOT BE ACCEPTED
Na Y P L 1 TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
"t r — kV-JP' Restricted Energy Fee WOO
(FOR ALL SYSTEMS) $66-00
JOB Street Address Ste #
ADDRESS 1(( 1.\ �ft" k 0 Check Type of Work Involved:
Zip Phon # n Audio and Stereo Systems
— n C c �aa3 . a ?� - a$a 5
Nam ll n Burglar Alarm
OWNER Mailing Address ❑ Garage Door Opener'
City /State Zip Phone # ❑ Heating, Ventilation and Air Conditioning System'
Name k ❑ Vacuum Systems*
SOO \ ( cecik -t V ` ❑ Other
CONTRACTOR ,>�{ing A? re �q Lo-- Cu j f l -Q TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a .City/State � Phone # 1, Fee for each system WPM
copy of all licenses AAA. ) y� ' 1 �C> �'3 5�rl (SEE OAR 918 - 260 -260) 0
are required if Oregon ontr, d # Exp. Date ern
expired In C.O.T. ! .. ) Check Type of Work Involved:
data base). Electrical Contr. Lk. # Exp. Date
--)-16 , 10 n Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date
0 Boiler Controls
Owner's Name
El Clock Systems
OWNER - Mailing Address
APPLICANT n Data Telecommunication Installation
City /State Zip Phone # n
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 n HVAC
permit and to do the following: I I
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;
0 Landscape Irrigation Control*
2. Call for inspections when Installation under this permit are ready for
inspection at 603- 639 -4175; 0 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 n 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.
FEES: CO
Signature ENTER FEES $ (P
5% SURCHARGE (.05 X TOTAL ABOVE) $ 1 ' b()
Authority if other than pplicant TOTAL $ (.D -T ' gO
I.\dsts \reseie.doc 7/D7
55a& -L\as
6/19/00 Activities for Case #: ELR1999 -00276
2:09:46 PM
Assigned Hold Updated 0+
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRA003 Application received 11/22/99 DEB DONE No Hold DEB 11/22/99 #P
ELRA010 Permit created 11/22/99 DEB DONE No Hold DEB 11/22/99
ELRA725 Low Voltage Inspection No Hold DEB 3/3/00
ELRA799 Elect'I Final 11/22/99 11/22!99 No Hold DEB 11/22/99
ELRA500 (F) Issue permit 11/22/99 DEB DONE No Hold DEB 11/22/99
ELRA845 Request inspection research 6/8/00 JMT DONE No Hold JMT 6/8/00
ELRA580 Expired by limitation 6/11/00 HAP DONE No Hold AKJ 6/11/00
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