Permit . .
CITY OF TIG.ARD
DEVELOPMENT ������U������
��~~� =~m~~~n nmn��n� n SERVICES
I3I25SWHaII Blvd., Tigard OR 97223 (503) 639-4171 ELECTRICAL PERMIT -
RESTRICTED ENERGY
PERMIT #0:-/ELR96-0364-'
DATE ISSUED: .42/06/9G���. �
PARCEL�^1G125CD-05700 ^ '
SITE ADDRESS...: 09990 SW LANDAU PL
SUBDIVISION....: MLP90-0015 ZONING:R-4.5
BLOCK..........: LOT ..... ........:001
Project Description: install, burglar alarm ' �
� � ' '_�____'-__ - ^� ' _
A. RESIDENTIAL , '� .�' a.... COMMERCIAL. . , , 7
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGIN8..:
BURGLAR.'ALARM� LANDSCAPE/IRRIGAT..
GARAGE OPENER....: CLOCK ..: MEDICAL............:
'HVA8�... . ./� �. ����.'� r, �y.,�. �:�,�,���°�� '.'NUFKSE -CALLS~.. :` .
VACUUM SYSTEM....: FIRE ALARM— . OUTDOOR LANDSC LITE: ' '
OTHER HVAC. , � v� • 1PROTECTIVE'SJGNAL. :
INSTRUMENTATION.: OTHER..: ::
' . '^'••% TOTAL # OF SYSTEMS: 0
Owner: - ---- FEES
BOB FOSTER . . type . amount by-- date , recpt
9990 SW LANDAU PRMT $ 40.00 TAT 12/02/96 96-287090
.' • 5PCT $ , 2.00', TAT 12/02/96 96-287090
TIGARD OR 97223
Phone #:
.
.Contract .r
PHILLIPS ELECTRONICS $ 42.00 TOTAL
1 110 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 iSsued subject, tothereoulationscontained. \-4
Tigard , Municipalagode v .rStatef.of 8r� o�pn /�' � per ignatu `..
applicable laws. All work will be done in accordance with
, /
approved ��\��wil�p�i��_����/s��� � �
`' wwith - - issuanoe��r��f�wo�ki�s.«usoendodfor'moro,�����` k / r -~ �� ` . .��� v ! � n • • '
~ ��.''=� � �'�� � s JecL `.,
------- OWNER INSTALLATION ONLY---- - ��---� . -
The insta,llat made on property ^own which is not intended for
sale, lease, or rent.
OWNER'S SIGNATURE ' DATE:
CONTRACTOR INSTALLATION ONLY -----
•
.-SIGNATURE, .SUPR. . ` ` DATE:
LICENSE NO:
. ' ' � . Ca3l�fo��
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd. / r4-96 _ V` tC/ ' O/
Tigard, OR 97223 PERMIT # Gl� t
�
j)�I4I��k���� P FA X X (503) 6 8 684 -7 2171 297 DATE ISSUED / �/ ;/9
....�� I I � FAX (03) �i -7
- TDD No. (503y684-2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY "l r
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
Q9 ct) G,4--ti(2 A-v
Add RESIDENTIAL — Restricted Energy Fee $40.00
k""" / U k t 9, 7-1-i, 3, (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
Z: C01�Pt1�ACTOA '"AP'PLTCA'"T'fiON�`�
❑ Heating, Ventilation and Air Conditioning System*
Contractor Type z.,„,,, "" ❑ Vacuum Systems*
Address (1( 0 i _) W E r—` ❑ Other ,,
Date COMMERCIAL — Fee for each system $40.00
/� U'�FG S �� 2 (SEE OAR 918-260-260)
Property Owner (1I�„)I Check Type of Work Involved:
Contractor's Board Reg. No. L ❑ Audio and Stereo Systems
/ ❑ Boiler Controls
Z
Phone # L _.-av `c ❑ Clock Systems
3. OWNER APPLICATION . ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
Print Owner's Name POOR QUALITY ORIGINAL El HVAC `
BEST REPRODIR�14�1 ❑ Instrumentation i. -
Address ❑ Intercom and Paging Systems
❑ Landscapes Irrigation Control* %.
City State Zip ❑ Medical .
This permit is issued under OAR 918 - 320 -370. This applicant agrees to make only ❑ Nurse Cahn. �" r
restricted energy installations {100 molt amps or less) under this permit and to do the ❑ -_. Landscape Lighting*
following:
k Protective
1. Only use electrical lit�ensed persons to do installations where required. (Certain +' ,.
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 a*
for inspection at 503 -639 -4175. ❑ Number of S Ste
3. Purchase separate permits for all installations that are not ready for inspection y
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
t 5. Assume responsibility for calling for a final inspection when all of the 5. FEES
corrections are completed.
LL
// //
The person signing for this permit must be the applicant or a person a. Enter Fees $ T om.
authorized to bind - the applicant. �C CCU
✓ /1. b. 5% Surcharge (.05 x total above) $
Signature 54 C:O
TOTAL $
Authority if other than applicant
ENERGAP.CHP
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 - k --- Date. Requested: q ' O - 1 7 A.M. P.M MST:
AP
Location: FI r. (11 A A . _ / BUP:
Tenant: Suite: Bldg: MEC: -
Contractor: A, W/ !, / _ _ i • one: . 7 -0 5 7 ! PLM:
Owner: 4.15Witi � Phone: ELC: �r�
ELR: 76 '-" 3 6 /
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL /ELECTRIC SITE
Site Post/Beam ' Post/Beam Post/Beam rvice Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing, Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump •w Vo t
Approved Approved Approved r Approved
Appr /Sdwlk Not Approved Not Approved Not Approved . rti_ ..roved Not Approved
- FINAL FINAL FINAL FINAL FINAL
(2 L— L / S /) ,' C) c57i /Oil I.7 —
•
C CI .
- - O Call-for reinspects• i � C- Reinspection- fee of-$— - required- before ne in ction- - - CI-Unable to inspect
Inspector: Date: 7 ? Page of