Permit • CITY OF T I G A R D ELECTR ENERGY
RESTRICTED ICAL ENERGY
VIA DEVELOPMENT SERVICES PERMIT #: ELR1999 -00221
. -` I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 9 1 MA TE ISSUED: 9/23/99
. SITE ADDRESS: 12959 SW PACIFIC HWY PARCEL: 2S1026D -02600
SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: C -G
BLOCK: LOT: 037 JURISDICTION: TIG
Project Description: Installation of burglar alarm system.
A. RESIDENTIAL B. COMMERCIAL -
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: .. DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: BURGLAR AL X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
EMERY, ROSEMARIE TRUSTEE BRINKS HOME SECURITY
BY KIM, ROBERT + HAE LIM 8059 SW CIRRUS DR
1360 SW WOODWARD WAY BEAVERTON, OR 97008
PORTLAND, OR 97225
Phone: Phone: 641 -0574
Reg #: SUP 2650JLE
LIC 00044421
ELE 34166CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
. PRMT DEB 9/23/99 $60.00 99- 318564 Elect'I Final
5PCT DEB 9/23/99 $4.20 99- 318564
•
Total $64.20 .
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other 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 180 days. ATTENTION: Oregon law
requires • o • : rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0' -0010 throug' OAR 952- 1 -008 You may obtain copies of these rules or d' ect questions to tl NC at (503)
246 - 1':87. �iJ
Issue • • r s r/ �
f Permittee Signature / / � /
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd fi
13125 SW HALL BLVD Date Rec'd: 9 -(23 q
TIGARD QR 97223 PRINT OR TYPE
V -'503-639-4171 X304 Permit #: `GLR 1999 -Ge
F - 503 - 598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee
(9harper 4 Video E (FOR ALL SYSTEMS) $60.00
JOB Street A dress Ste #
ADDRESS I p5g S w I(J Check Type of Work Involved:
L tate ,�i� 1 1 ne #) , ❑ Audio and Stereo Systems
Nam e , o
❑ Burglar Alarm
OWNER Mailing Address ❑ Garage Door Opener'
City /State I Zip I Phone # ❑ Heating, Ventilation and Air Conditioning System'
Name 1,�, a �,�,,, , ,, ❑ Vacuum Systems*
l )rnrCJ - \ITA L ,\ I/` - ❑ Other
CONTRACTOR ,;;..- ili . • Ad ress �J
•11: al,. ('A,cnks &-. TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a VState ` l� ^ p-�/�a P # Fee for each system $60.00
copy of all licenses Rr Y l 4' XX � j -QS�4 (SEE OAR 918 - 260 -260)
are required if Oregon r. rd Li . # Exp. at e
expired in C.O.T. 16"1 Check Type of Work Involved:
data base). Electrical Co ic. #/^/, p.
CCXIX �� ��-- ❑ Audio and Stereo Systems
C.O.T. or Metro Licy4 / p.,Q,�te ❑
!! // R 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: ❑
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 � II '^n
corrections are completed. Other Q \
Permits are non - transferable and non - refundable and expire if work is not J
started within 180 days of issuance or if work is suspended for 180 days. Number of Systems
The person signing for this permit must be the applicant or a person • No licenses are required. Licenses are required for all other installations
authorized to bind the applicant.
r.--- ■TO gi
FEES:
Signature ° ENTER FEES $ CXC �
� . ,l
5% SURCHARGE (.05 X TOTAL ABOVE) $ " • D�LJ-v
Authority if other than Applicant TOTAL $ LQ 02-0
is \dsts\forms\resele.doc 3/98