Permit ��
^°
FW OF T ELECTRICAL PERMIT —
COMMUNITY DEVELOPMENT DEPARTMENT RESTRICTED ENERGY
1o1usmw Hall Blvd. Tigard, Oregon wr22o°o1w» (503) 639-4171 PERMIT #: ELR96-0176
DATE ISSUED: 05/29/96
PARCEL: 2S102CB-00100
SITE ADDRESS...: 12850 SW GRANT ST
SUBDIVISION ^ NORTH TIGARDVILLE ADDITION ZONING:R-12
BLOCK...... . .. . : LOT...... ^41
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 LANDSC LITE:
OTHER: :: HVAC • PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER..: ::
TOTAL # OF SYSTEMS: 1
Owner: -- — ----- FEES ---
TIGARD TUALATIN SCHOOL DIST. type amount by date recpt
13137 SW PACIFIC HWY. PRMT $ 40.00 CJS 05/29/96 96-279934
5PCT $ 2.00 CJS 05/29/96 96-279934
TIGARD OR 97223
Phone #: 503-620-1620
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
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permitee Signatu e
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 « A
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
s, Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION A 13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT # E .R9f, -o 1 76
i�� ,r�r'e9MlrHpNJ'�' \ Phone (503) 639 -4171
- i j _�f it FAX (503) 684 -7297 DATE ISSUED 5 - a 9- 96
`- TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY Cli r /es S c }t, %-d/
LEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 'fzZ 4. TYPE OF WORK
1.. .5 &v-tsrir S r
Address RESIDENTIAL — Restricted Energy Fee $40.00
ti q-- -/.1').,i (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?>- Type ❑ Vacuum Systems*
❑ Other
Address 7 -. 5 � - 1 -1 SLv' Ov,rlkp}s - `R-p
Date Lj -1-g.- q ‘, COMMERCIAL — Fee for each system $40.00
(SEE OAR 918 - 260 -260)
Property Owner T 6 I -Tin , .St 5 '. -C L r Check Type of Work Involved:
Contractor's Board Reg. No. 3y_ a•fs6 CL.[r ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone # ❑ Clock Systems
3. OWNER APPLICATION I 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 $ 1 10 cc '
authorized to bind the applicant.
b. 5% Surcharge (.05 x total above) $ a.. c"U
Signature
TOTAL $ 4a '
Authority if other than applicant
ENERGAP.CHP