Permit •
^-' CITY OF � ELECTRICAL PERMIT -
COMMUNITY DEVELOPMENT DEPARTMENT RESTRICTED ENERGY
1o1osSw Hall Blvd. Tigard, Oregon w72o"o1wm (5o3)w39-41n PERMIT #: ELR95-0150
DATE ISSUED: 06/12/96
PARCEL: 2S1@9BA-HS254
SITE ADDRESS...: 13900 SW LEAH TERR
SUBDIVISION ^ HILLSHIRE SUMMIT NO. 2 ZONING:R-7 PD
BLOCK..........: LOT ^054
Project Description: It's a monument at NE corner of benchview/buIl mt rd.
A. RESIDENTIAL B. COMMERCIAL -
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM....: BOILER..........: LANDSCAPE/IRRIGAT..:X
GARAGE OPENER ^ CLOCK ^ MEDICAL
HVAC ..... ........: DATA/TELE COMM..: NURSE CALLS
VACUUM SYSTEM ^ FIRE ALARM ^ OUTDOOR LANDSC LITE:
OTHER: :: HVAC ^ PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER..: ::
TOTAL # OF SYSTEMS: 1
Owner: FEES
CEDAR LANDSCAPE type amount by date recpt
14375 SW PATRICIA PRMT $ 40.00 JIM 09/29/95 95-271116
5PCT $ 2.00 JIM 09/29/95 95-271116
HILLSBORO OR 97123
Phone #: 503-628-3411
Contractor: - - - -------
CEDAR LANDSCAPE $ 42.00 TOTAL
14375 SW PATRICIA
REQUIRED INSPECTIONS
HILLSBORO OR 97123 Ceiling Cover Elect'l Service
Phone #: 503-628-3411 Wall Cover Elect'l Final
Reg #..: 5843
This permit is issued subject to the regulations contained in the
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
than 1&0 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
P ERMIT # E-
-- `-a i. 0
• 13125 SW Hall Blvd.
Tigard, OR 97223
- /f ' 9 ,, 0
_t ill Phone (503) 639 -4171 CJ
I FAX (503) 684 -7297 DATE ISSUED
.^^'� - --.. TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY
5 1 ) 3( _ 0) P LEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
M000kkeir @ 5W euet) POLL rrowfrM,J 1
Address RESIDENTIAL — Restricted Energy Fee $40.00
Ti G- C92. °I ?22} (FOR ALL SYSTEMS)
City State Zip Check Type of Work Involved:
-
PERMITS ARE IS NOT STARTED WITHIN S
18 DAYS OF I ISSUANCE OR IF WORK AND
SUSPENDED FOR
OR ❑ Audio and Stereo Systems*
180 DAYS. ❑ Burglar Alarm
❑ Garage Door Opener*
2. CONTRACTOR APPLICATION
❑ Heating, Ventilation and Air Conditioning System*
Contractor D/37L Type ❑ Vacuum Systems*
1,47s-- Su, CI Other
Address
{�r7r,�r I yI ►L �S��l
Date COMMERCIAL — Fee for each system $40.00
(SEE OAR 918- 260 -260)
Property Owner Si )t.22a eikA1' -fC pew -me,sT
Check Type of Work Involved:
Contractor's Board Reg. No. 5 43 ❑ Audio and Stereo Systems*
` -
CI Boiler Controls
Phone# EL5 34 t ( ❑ Clock Systems
3. OWNER APPLICATION CI 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 El 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 CI 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. ❑ I l 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.
I The person signing for this permit must be the applicant or a person a. Enter Fees $
authorized to bind the applicant.
b. 5% Surcharge (.05 x total above) $ 2=
- - Signature
TOTAL $ � ' 'Z b - .
Authority if other than applicant
(2 ( 0:::? c ,— ........ ...... / /1 (ic,
ENERGAP.CHP