Permit CITY OF TIGARD
, r � i , f ,�, DEVELOPMET SERVICES ELECTRICAL PERMIT —
13125 SW Hall Blvd., Tigard, ( ) RESTRICTED ENERGY
PERMIT #: EL R97 -0307
DATE ISSUED: 10/29/97
PARCEL: ES104CA- -02900
SITE ADDRESS... :13520 SW LAUREN LN
SUBDIVISION.... :HILLSHIRE ZONING :R - -7 PD
BLOCK..........: LOT........e....:029 JURISDICTN: TI6
Project De scr i pt i on Add burglar alarn to an existing single fanily dwelling.
A. RESIDENTIAL - - -- -- Be COMMERCIAL - - -- -
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM.... :X BOILER..........: LANDSCAPE/IRRIGAT.n:
GARAGE OPENER.:,... CLOCK............ MEDI CAL. va.n.azp.a..
HVAC....o..n,....Q DATA /TELE COMM. .. NURSE CALLS. .o,a...
VACUUM SYSTEM.... FIRE ALARMaa.aae: OUTDOOR LANDSC LITEe
OTHER: a. HVACva...vo.aa..: PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER.. nn
TOTAL ## OF SYSTEMS: 0
Owner: _ _ --
JULIE ZIMMERMAN type amount by date recpt
13520 SW LAUREN LANE PRMT $ 40.00 GEO 10/29/97 97-300491
TIGARD OR 97223 5PC? $ 2.00 GEO 10/29/97 97- 300491
Phone #:
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Contractor: _ -_____ _______ _- -_. --------------------
ADT SECURITY ALARMS 42.00 TOTAL
703 NE HANCOCK •
REQUIRED INSPECTIONS -----
PORTLAND OR 97212 Low Voltage Insp
Phone #: 284 -3265 Elect' 1 Final
Reg #.. : 0 0 0 5 9 9
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore, Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This pewit will expire if work is not started within 180
days of issuance, or if work is suspended for sore than 180 days. ATTENTION. Oregon law requires you to follow rule adopted by the
Oregon Utility Notification Center. Those rules are set forth in OR 558 -00i -0010 through OAR 352 - 001- ' r80. You say obtain copies of
these rules or direct nestions o Oi�"C at2 246-1387.
Issued by / fir/ Permittee Signature
- OWNER INSTALLATION ONLY_.___
The installation is being made on property I own which is not intended for
sale, lease, •rent.
OWNER'S SIGNATURE: _ DATE:
- - - -- CONTRACTOR INSTALLATION ONLY _________. ---
SIGNATURE OF SUPR. ELEC' N: DATE:
L I CENSE NO: ___..
+++-h++++ +++ +-f°-i ++-i- --t + +'--h ++ ++++ +++ + ++ + -i ++ :•• +++ ++ + +++ + + ++ + +-1 + ++ +---h --l--l--!^ -[ +++++++++++-1-1-
Call 639-4175 by 7 :00 P.M. for an inspection needed the next business day
++ + +++ + + + +++ + + ++ + + + + + + + + + + + + + + +-F ++++ + + + ++ + + + + + + + + + ++ + + + + + + ++ + + + + +-i + + + + + + + + + + + +++
CJTY OF-TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
13125 SW HALL BLVD F1 , / Date Rec'd:
TIGARD OR 97223 1 `1 „ 0 �1 PRINT OR TYPE
V - 503 - 639 -4171 X304 l U/ 5 7 � ' Permit #: eG -gq 7'634
F - 503 - 684 -7297 / INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL
Restricted Energy Fee $40.00
(FOR ALL SYSTEMS)
JOB Street Address St #
ADDRESS S f [A� � , "�,�� Check Type of Work Involved:
4
1 St t Phone # ❑ Audio and Stereo Systems
Name X Burglar Alarm
i ui- Le 2/ #1/11€12H, 1] ry ❑ Garage Door Opener*
OWNER Mailing Address
City
y/ / gA State I Zip I Phone # ❑ Heating, Ventilation and Air Conditioning System*
Name ❑ Vacuum Systems*
ADT SECURITY SYSTEMS ❑ Other
CONTRACTOR Mailing A. .rd;. la H*
,.�, 2 TYPE OF WORK INVOLVED - COMMERCIAL
(Prior to issuance a City /Sae
hog I f , " . ,',.:41• Phone # Fee for each system $40.00
copy of all licenses (SEE OAR 918 - 260 -260)
are required if Oregcl Con r Lic. # t
- expired in C.O.T. 5'' / Check Type of Work Involved:
data base). Electrical CQntr.J # E Q ❑
� `�'� ` J (1" Audio and Stereo Systems
C.O.T. or Metro Lic. # E . Date
❑ Boiler Controls
Owner's Name -
❑ Clock Systems
OWNER - Mailing Address
APPLICANT ❑ Data Telecommunication Installation
City /State Zip Phone # ❑
Fire Alarm Installation
This permit is issued under OAE 918 - 320 -370. This applicant agrees to
make only restricted energy installations (100 volt amps or less) under this ❑ HVAC
permit and to do the following:
El Instrumentation
1. Only use electrical licensed persons to do installations where required.
Certain residential and other transactions are exempt from licensing. ❑ Intercom and Paging Systems
These have asterisks( *). All others need licensing;
❑ Landscape Irrigation Control*
2. Call for inspections when installation under this permit are ready for
inspection at 503 - 639 -4175; ❑ Medical
3. Purchase separate permits for all installations that are not ready for an ❑ Nurse Calls
inspection when the inspector is out to inspect under this permit;
4. Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting*
inspector are done, and;
❑ Protective Signaling
5. Assume responsibility for calling for a final inspection when all of the
corrections are completed. ❑ Other
Permits are non - transferable and non- -fundable and expire if work is not
started within 180 days of issuance • ork is suspended for 180 days. Number of Systems
The person signing forth' ..ermit st be the applicant or a person * No licenses are required. Licenses are required for all other installations
authorized to bind the applicant. Q� /
1 (J 31` —FEES: — —
Sig ure ENTER FEES $ .9 6 ATV
5% SURCHARGE (.05 X TOTAL ABOVE) $ oZ
Authority if other than Applicant TOTAL $ 7`"'
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CITY OF TIGARD BUILDING INSPECTION DIVISION �� ��
24 Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 /
Date Requested: -� p� 5-5-9? A.M. P.M. MST:
Location: 13 510 (5-1.0 ( a.,1/ 1p .40. Y BUP:
Tenant: Suite: / - Bldg: MEC:
Contractor: Cg ..01-4\-(2 Phone: _, , 1 ' Ip 5 25 PLM:
Owner: Phone: ELC:
nail y_ � 4 11 c ,op 9' 7 - 0 30 - T
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL 7 LECTRICAL SITE
Site Post/Beam 'Post/Beam Post/Beam v ce Sewer /Storm
Footing Roof UndFUSlab 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. ,� //ff
Masonry Ceiling Rain Drain A/C UG S s . �!�:XGt/l
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump .w Vol l
Approved Approved Approved , " e• Approved
Appr /Sdwlk Not Approved Not Approved Not Approved 1 of A. 'roved � Not Approved
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FINAL FINAL FINAL r • - �' FINAL
9 -
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El Call for reinspectio • A O-Reinspecti .1 fee of $ required before next. inspection CI-Unable to inspect
Inspector: _ . l ri AP Date: 5 /,S /Y� Page of
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