Permit ~.�'
ELECTRICAL PERMIT —
r4. CITY OF TIGARD RESTRICTED ENERGY
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #: ELR96-0177
13125 SW Hall Blvd. Tigard, Oregon 9722308199 (503) 639-*171 DATE ISSUED: 05/29/96
PARCEL: 1S135AB-00100
SITE ADDRESS..,: 10255 SW 90TH AVE
SUBDIVISION ^ TOWN OF METZGER ZONING:R-4.5
BLOCK..........: LOT ^5
Project Description:
_
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 LANDGC LITE:
OTHER: :: HVAC • PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER..:
TOTAL # OF SYSTEMS: 1
Owner: '----- — FEES • ----
METZERG ELEMENTARY type ' amount by date recpt
10255 SW 90TH AVE PRMT $ 40.00 CJS 05/29/96 96-279937
5PCT $ 2.00 CJS 05/29/96 96-279937
TIGARD OR 97223
Phone #:
Contractor: — •
OPITEC INC $ 42.00 TOTAL
7324 SW DURHAM RD
REQUIRED INSPECTIONS
PORTLAND OR 97224 Wall Cover Elect'l Final
Phone #: 503-639-2871 Elect'l Service
Reg #..: 64137
�
This permit is issued subject to the regulations contained in the `� 01
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permitee Signature
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 ����"�,/e-
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,
— Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT #L RQ6 -C) 1 77
���,,,����I�P ��
Phone
FAX (503) 684-7297 1 DATE ISSUED S - .9 - 4G
TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY Chczries Scftm%cet
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION _s y ' C J 4. TYPE OF WORK
1 0715 S 51A) 10 111-
Address RESIDENTIAL — Restricted Energy Fee $40.00
T Ano OT>, 1-1 y (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
❑ Garage Door Opener*
2. CONTRACTOR APPLICATION ❑ Heating, Ventilation and Air Conditioning System*
Contractor O TLC. Type ❑ Vacuum Systems*
❑ Other
Address - 73) - t - I SW AtI N
Date `)f - C , COMMERCIAL — Fee for each system $40.00
(SEE OAR 918 - 260 -260)
Property Owner 1 rAvA ltO - Check Type of Work Involved:
Contractor's Board Reg. No. 3 GU ❑ Audio and Stereo Systems
/ ❑ Boiler Controls
Phone # 7 I ❑ 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 5. FEES
corrections are completed.
The person signing for this permit must be the applicant or a person a. Enter Fees $ 90 '
authorized to bind the applicant.
b. 5% Surcharge (.05 x total above) $ ®�
Signature
TOTAL $ L. '00
Authority if other than applicant
ENERGAP.CHP
5/12/99 Activities for Case #: ELR96 -00177
9:46:49 AM .
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRC001 Application Received 5/29/96 CJS RECD CJS 5/29/96
ELRC003 Permit Created 5/29/96 CJS PEND CJS 5/29/96
ELRC720 Wall Cover 5/29/96 • CJS 5/29/96
ELRC730 Elect'I Service 5/29/96 • CJS 5/29/96
ELRC799 Elect'I Final 5/29/96 • 3/4/97 MJR PASS MJR 3/6/97
ELRC500 (F) Issue permit 5/29/96 CJS PASS CJS 5/29/96
ELRC510 (F) Reprint permit 2/27/97 B PASS DST 2/27/97
. ELRC800 Case finaled 3/4/97 MJR PASS MJR 3/6/97
•
Page 1 of 1