Permit DEVELOPMENT SERVICES ~�°�="�.���. nmnm�.� " =*m~""�"~�=~=v ELECTRICAL PERMIT —
Ali- 11L 13125 SW Hall Blvd., - — ��-- '' . RESTRICTED ENERGY
''PERMIT ' ELR96-0368
' DATE ISSUED1.. 12/12/96 .'
.'
PARCEL�'2S110DC-90091
SITE ADDRESS...: 15655 SW 114TH CT #11
SUBDIVISION - FOUNTAINS AT SUMMERFIELD CONDO ZONING:R-25
BLOCK ^ LOT.............:9
Project Description: INSTALL BURGLAR ALARM
A. RESIDENTIAL, —
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM. r �.� :X�� /. ��` BQILER�'.�.��. .��.. .:�� ` � ^' ' LANDSCAPE/IRRIGAT. . :
GARAGE OPE■ER....: CLOCK...........: MEDICAL............:
• ".^ HU AC. +~, , ,��, a � . � : ��/� � �� • 'DATA/TELE COMM��:��� z� 'NURSE CALLS,. :�. .'. .
VACUUM SYSTEM....: FIRE ALARM......: OUTDOOR LANDSC LITE:
8THER:14" �'^.��` , .t`��.�. :��������'���''HUAC�� .'..`...,�� ;�;'�r� � • ',PROTECTIVE , SIGNAL. •
INSTRUMENTATION.: OTHER..: ::
...TOTAL'# OF SYSTEMS: 0
Owner: — — FEES
DOMGORGEN IRMGARD'•• • ' type amount ` by date • recpt
15655 SW 114TH CT PRMT $ 40.00 TAT 12/12/96 96-287639
5PCT.$ . 2^'00' TAT 12/12/96
TIGARD OR 97224
Phone. #:
Contractor:'.
PHILLIPS ELECTRONICS $ 42.00 TOTAL
1110' NW FLANDERS '
REQUIRED INSPECTIONS
PORTLAND OR 97209 Ceiling Cover Elect'l Service
Phone #: 503-227-0571 Wall Cover Elect'l Final
Reg #..: 000433
This permit is. subject to the regulations contained in the. i42
Tigard Municipal Code; State .of Ake..SpecialtyCodes^'and.aD,othoc • ''' „Permit- i nature o.
applicable laws. All work will be done in accordance with )
approved, plans. ' This^pormit.w8J./expiro' if work .is.not,started •' , / • )
wtth�n.18&days*uf'iemmee,''oribwunk'is suspended for'mone"+.'.` ' AddilL. ' , A*^°
' t6an^18N'6ays:'• � • • r • +, ` ` ,•� . ``' '�'�.''I���� d� •
OWNER INSTALLATION ONLY ~ —
The installation-is being made on:,property J[' own which is not intended' for
sale, lease, or rent.
OWNER' S' SIGNATURE: ' • . ' .' .. . ' ' � DATE t•
CONTRACTOR NSTALLATION ONLY----------
•
SIGNATURE.. OFvSUPR, ELEC7N,c_' `~ � _ DATE:
LICENSE NO:
� .^ .` , • Call for inspect 639-4175_.
' ' _ ' - - _-_
•
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd. PERMIT # �. 96— V3V �r FAX (503) '� FAX 6847
DATE ISSUED
Tigard, OR 97223 297 //9 /9
A c ■ 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
1 56ss 5_• 11a -' c_ • \\
Address RESIDENTIAL — Restricted Energy Fee $40.00
I ` C - V,r c ) Q(`ec r, 9 -7 72 9 (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* -
IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR .
180 DAYS. ' Burglar Alarm
2. CONTRACTOR APPLICATION CI Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
Contractor P�i � � ; 5 L 1 LeC Typ ��., vc1 ‘)R, ❑ Vacuum Systems*
Y�� ❑ Other
Address ' ( kU t��,., ` �5 O!�•
i
Date 1 I / 21 A C COMMERCIAL — Fee for each system $40.00
7� (SEE OAR 918 - 260 - 260)
Property Owner �JOn y,r . 9-en1 - in. ,d,,, Check Type of Work Involved:
Contractor's Board Reg. No. `f 3 3 L ❑ Audio and Stereo Systems*
❑ Boiler Controls
Phone# ZZ '7 - c2 7 ( ❑ Clock Systems
3. OWNER APPLICATION ❑ 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 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.
❑ 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 corrections 5. FEES
are completed.
The person signing for this permit must be the applicant or a person a. Enter Fees $ U • O V
authorized to bind the applicant.
b. 5% Surcharge (.05 x total above) $ 7 ' 17°
---X
Signature
TOTAL $ 4l - (7C 2
Authority if other than applicant
ENERGAP.CHP