Permit 1/
CITY OF TIGARD RESTRICTED ENERGY
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #: ELR95 -0223
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 DATE ISSUED: 11/27/95
PARCEL: 2S104BA -07700
SITE ADDRESS...: 13920 SW LIDEN DR
SUBDIVISION • CASTLE HILL #2 ZONING:R -12 PD
BLOCK • LOT •112
Project Description: All encompassing residential restricted energy permit
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO...:X AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM °X BOILER • LANDSCAPE /IRRIGAT..:
GARAGE OPENER •X CLOCK • MEDICAL
HVAC °X DATA /TELE COMM..: NURSE CALLS •
VACUUM SYSTEM -X FIRE ALARM • OUTDOOR LANDSC LITE:
OTHER:ALL .• HVAC • PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER..: ..
TOTAL # OF SYSTEMS: 0
Applicant: FEES - - - --
MICHAEL CARMIENCKE type amount by date recpt
461 NE 5TH AVE PRMT $ 40.00 JSD 11/27/95 95- 273230
5PCT $ 2.00 JSD 11/27/95 95- 273230
HILLSBORO OR 97124
Phone #:
Contractor: -•
CONTRACTOR NOT ON FILE $ 42.00 TOTAL
GIN N ER
REQUIRED INSPECTIONS
• Ceiling Cover Elect'1 Service
Phone #: Wall Cover Elect' 1 Final
Reg #..
This permit is issued subject to the regulations contained in the _ 7/4 4 4 64 %tu.i_
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t e e Signature
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 190 days of issuance, or if work is suspended for more
than 190 days. I s Lied 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
i.. Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd. C' ° -
Tigard, OR 97223 PERMIT # (�
A l ,I Phone (503) 639 -4171 684-7297
-�I I ;- I TDD No5 684-2772 DATE ISSUED ' ( -- 7 -97 /
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
1 39 Z 5'/A.) G /J- EA/ R
Address RESIDENTIAL — Restricted Energy Fee • I / I
Tj ‘9/t-/ 0/2 q 7 (FOR ALL SYSTEMS)
City State ! Zip Check Type of Work Involved:
A VP
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
2. CONTRACTOR APPLICATION ❑ Garage Door Opener* "�
❑ Heating, Ventilation and Air Conditi s ing Syst: *
Contractor Type ❑ Vacuum Systems*
❑ Other
Address — '
Date COMMERCIAL — Fee for each system $40.00
(SEE OAR 918 - 260 -260)
Property Owner Check Type of Work Involved;
Contractor's Board Reg. No. ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone # ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
f }1 l' (-II /4-Q,I ` n il-R 'yi i l ck7 _ /4 '/ I937 ❑ HVAC
Print Owner's Name Phone No
y(o I NF S -41 i4-VE ❑ Instrumentation
Addr ss ❑ Intercom and Paging Systems
tl P.', /20 n2 97/ v-/ ❑ 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 El Outdoor Landscape Lighting*
following:
❑ Protective Signaling
1. Only use electrical licensed 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
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 $
authorized to bind e applicant.
Is �74- /, 4.4,,„,;,-,..i 4.4,,„,;,-,..i b. 5% Surcharge (.05 x total above) $
gnature -
TOTAL $
Authority if other than applicant
ENERGAP.CHP
CITY OF TIGARD BUILDING INSPECTION NOTICE •
Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4171
Inspection:
Footing Susp. Ceiling Sprink. Rough -in Appr /Sdwlk
Foundation Plbg. Underslab Mech. Rough -in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough -in FINAL:
Post/Beam Mech. San. Sewer Gas Line 18,.
Plbg. Underfloor Rain Drain Framing
Alarm Water Line Insulation i f
Underflr. Insul. Shear Wall Gyp. Bd.f
Date Requested: 2- l2 -819 Time: AM PM
Address: / 3 7 ZO
Builder: Per 4 L S -- d 3 ( 0
THE FOLLOWING CORRECTIONS ARE REQUIRED: EA `75— 0
J) 5 (T90 -00
CI?/- 7z9 7 ;..
•
Inspector: , Date: 2-- zAr- ?
APPROVED DISAPPROVED XPPROVED SUBJECT TO ABOVE
_Call For Reinsp.