Permit • CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
44 ' 0 601' 1 DEVELOPMENT SERVICES PERMIT #: ELR2000 -00087
`- '�'I� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 04/25/2000
SITE ADDRESS: 12284 SW QUAIL CREEK LN PARCEL: 2S103C6 -09800
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 056 JURISDICTION: UR
Proiect Description: Audio /stereo, co -axial cable, and telephone wiring.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: X 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: CO- AX/PHON : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE HOMES MARTINDALE'S COMMUNICATION CO
4230 GALEWOOD ST 4230 SW 185TH AVE
STE 100 STE 100
LAKE OSWEGO, OR 97035 ALOHA, OR 97006
Phone: Phone: 503 - 649 -6505
Reg #: SIC 126892
FEES Required Inspections
Type By Date Amount Receipt Elect'l Service
PRM3 BON 04/25/200C $60.00 0001693 Elect'I. Final
5PC2 BON 04/25/200C $4.80 0001693
Total $64.80
ORIGIN
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 you to follow rules adopted by the Oregon Utility Notification Center. Those s are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules r dire t questions to OUNC at (503)
246 -1987. J� Q ` �"
Issued by � I t�IlfLltiVv 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
04/25/00 TUE 09:40 FAX 503 598 1960 CITY OF TIGARD . LA —x Iill002
•
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
' 13125 SIN HALL BLVD Date Rec'd:
TIGARD OR 97223 PRINT OR TYPE
V - 503 - 639 - 4171 X304 Permit*:
F - 503 -598 -1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS CustCall'd:
WILL NOT BE ACCEPTED
Name of Development Project , - TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
t Restricted Energy Fee $60.00
r
f a i 7• SW Qv p) L CRAM- YL (FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS Check Type of Work Involved ` ` I p „s. �/ ^, n
City /State Zip Phone # ED Audio and Stereo Systems oy: 1/7 (� _( _ ( Q t 6j .
__ _
Name l ❑ Burglar Alarm O ILO /� f�
1 IMOYte (-64 . / ' l � U ,� J S y�� 262 ,_ .
OWNER Mailing Addres ❑ Garage Door Opener - Q7�O?, si, tura
1..
tale Zi 3 - p e , El Heating, Ventilation and Air Conditioning System'
• Q OR _el Z7 -# 755
0//0/144d Name ❑ Vacuum Systems' pf /1I r1 M /�
N� COMM v G s ❑ Oth C _ ^ I U r /4-
CONTRACTOR JQailina Add ss
J' W /s), 4 v 6 SiE A TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to Issuance a ! tate p Ph rte # . Fee for each system $60.00
copy of all licenses 1 Oil- # 7 G0 1/ ,6µ4' L f -Dr (SEE OAR 918-260 -260)
are required if Oregon CRn ,Itc. # xp. Date
expired in C.O.T. / Uhl /3 /�(A
Check Type of Work Involved:
data base). Electrical Contr. Lic. # E 6ate
❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Data
❑ Boiler Controls
Owner's Name
❑ Clock Systems
•
OWNER - Mailing Address •
APPLICANT ❑ Data Telecommunication Installation
City/State ' Zip ! Phone # Q
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 tnis ❑ 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. El 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 603 - 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. El Other
Permits are non - transferable and non- refundable and expire If work Is not
started within 180 days of issuance or If work is suspended for 1 eo days. Number of Systems
The pers. signing for this permit must be the applicant or a person • Na licenses are required. Ucenses are required for ell other .natallations
authorized o bind the applicant. •
•
FEES: �) ,vr)
Signature ENTER FEES $ (PS • �'"
/ / 8% SURCHARGE (.08X TOTAL ABOVE) $ 14'W CDA f IV +S �O
Authority if other than Applicant TOTAL $ (.�
I tdstsVormsiesefe.doc 3/98 '
■
06/08/2000 Activities for Case #: ELR20O0 -00087
3:41:22 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRA003 Application received 04/25/2000 BON DONE No Hold BON 04/25/2000
ELRA010 Permit created 04/25/2000 BON DONE No Hold BON 04/25/2000
ELRA730 Elect'I Service No Hold BON 04/25/2000
ELRA799 Elect'I Final 04 /27/2000 TLP PASS No Hold AKJ 04/27/2000
ELRA500 (F) Issue permit 04 /25/2000 BON DONE No Hold BON 04/25/2000
ELRA800 Case finaled 04/27/2000 AKJ DONE No Hold AKJ 04/27/2000
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