Permit CITY OF TIGARD ELECTRICALPERMIT -
RESTRICTED ENERGY
011A DEVELOPMENT SERVICES PERMIT #: ELR1999 -00302
� I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/13/1999
SITE ADDRESS: 12376 SW QUAIL CREEK LN PARCEL: 2S103CB -09400
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 052 JURISDICTION: UR
Project Description: landscape irrigation control
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: IRRIGATION : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE HOMES PROGRASS LANDSCAPE SERVICES
4230 GALEWOOD STREET . 29895 SW KINSMAN RD
SUITE 100 WILSONVILLE, OR 97070
LAKE OSWEGO, OR 97035
Phone: 274 -5223 Phone: 682 -6076
Reg #: LIC 6136
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
5PC2 BON 12/13/199E. $4.80 99- 320369 Elect'I Service
Elect'I Final
PRM3 BON 12/13/199E $60.00 99- 320369
Total $64.80
ORIGINAL*
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 rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987. `_�
Issued by r '"— Permittee Signature /dap I1 Ui i'
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: P / DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
. 06/08/99 TUE 10:59 FAX 503 598 1960 CITY OF TIGARD e1 004
CITY OF TIGARD RECEHICTED ENERGY ELECTRICAL APPLICATION Rec'd by: !kid
13125 SW HALL BLVD Date Rec'd: )7_— 16 - 1g1q
% T1GARD OR 97223 PRINT Oil TYPE
V - 503- 639 -4171 X304 DEC 0 9 1999 Permit #: 6-L --
F - 503- 598 -1960 • INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
•
, COMMUNITY DEVELOPMENT WILL NOT BE ACCEPTED
"real _ - 1 . 4 Name cf Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
• Restricted Energy Fee .._.._. $60.00
GW-Cu- .-� t4-0- 1.Ltn.- (FOR ALL SYSTEMS)
JOB Street Address (21•0; CA- --451e
ADDRESS i /c 3 76, U Emit, Check Type of Work Involved: •
T[ t a u O I Y l Phone # ❑ Audio and Stereo Systems
Name . 0 Burglar Alarm .
Doll 6Irii SCe>f'i l
di Address ❑ Garage Door Opener
OWNER D SW GL-(cLvo(D La-r) c_ •
&I Ity /Stat e Zip pho tp # ❑ Heating, Ventilation and Air Conditioning System*
Ct'. 6cruX�O Iq7 0 3 q, 790 t'e L i ...)1z,
r" ❑ Vacuum Systems' -
Name _
LU.nd SpC pro G ling La-ricLS cape. W Other teLn a SCa10G L'Ut..rOMc y) ein 17 gG
CONTRACTOR Alger re§s I. ilA K - D TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to Issuance a Citx/State ., Zio Phone # Fee for each system $60.00
copy of all licenses W 11 I Ur )� L • I 0R 410 10 to fra --(O i (o (SEE OAR 918.260 -260)
are required if Oregon Contr. rd Lic. # ate a I` •
expired in C.O.T. • l0 I (p $ S 113pbp Check Type of Work Involved:
data base). Electrical Contr. LIC. # Exp. Date
Q Audio and Stereo Systems
C.O.T. or Metro Lic. xp. # E Date
. ❑ Boiler Corrtrcls
Owner's Name
❑ Clock Systems •
• OWNER - ' Mailing Address
APPLICANT • ❑ Data Telecomrr.unicetion Installation .
City /State I Zip I Phone # ❑
Fire Alarm Installation
This permit is issued under OAE 918-32C-370. This applicant agrees to
make only restricted energy installations (100 volt amps or less) under this ❑ HVAC
permit and to do the following: D •
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 asterlsks('). All others need licensing;
❑ Landscape Irr:gatioa Control'
2. Call for inspections when installation under this permit are ready for
Inspection at 603 - 639 -4176; ❑ Medical •
3. Purchase separate permits for all installations that are not ready for an El 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; El Protective Signaling
• 5. Assume resoonsibi:ity for calling for a final inspection when all of the
corrections are completed. ❑ Other
Permits are •ncn- transferable and non- refundable and expire if work is not
started within 180 days of issuance or :f 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 requred for all other Installations
authorized to bind the applicant. • •
FEES:
-1 _S:L.--
ENTER FEES S
Signature rk.) • y
"'C SURCHARGE (.05 X TOTAL ABOVE) $ •
Authority if other than Applicant TOTAL $ LO if Ira
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