Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
ei DEVELOPMENT SERVICES PERMIT #: ELR1999 -00250
III 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/26/1999
SITE ADDRESS: 12522 SW QUAIL CREEK LN PARCEL: 2S104DA -00800
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5
BLOCK: LOT: 045 JURISDICTION: UR
Project Description: Install audio and stereo system, burglar alarm, garage door opener, heating, ventilation and air
conditioning system, vacuum systems, and all encompassing.
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 ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE HOMES GARY'S VACUFLO INC
5000 SW MEADOWS LANE 9015 SE FLAVEL
LAKE OSWEGO, OR 97035 PORTLAND, OR 97266
Phone: 274 -5223 Phone: 775 -2042 ORIGINAL
Reg #: LIC 069047
ELE 26- 728CLE
FEES Required Inspections
Type By Date Amount Receipt Elect'l Service
PRM3 KJP 10/26/1995 $60.00 99- 319344 Elect'I Final
5PC2 KJP 10/26/199E $4.80 99- 319344
Total $64.80
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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 throug AR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
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Issued by 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:
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CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: 7l, / a- DATE: /0/ /q?
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
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E0 ' d 11:1.LO.L
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLIC: ON Recd by_
13125 SW HALL BLVD / Date Rec'd:_ 0/161il
TIGARD OR 97223 PRINT OR TYPE '(
v - S03- 639 -4171 X304 Permit* h-g /94'
F - 503 -598 -1960 INCOMPLETE OR ILLEGIBLE APPLIC • ONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
/1507 a (FOR Restricted
ALL Energy Fee $60.00
(FOR ALL SYSTEMS)
JOB
let Addres J Ste*
ADDRESS d i� � �/ M
Check Type of Work Involved:
�� Zip Phone # Audio and Stereo Systems
f
N me ��/( Burglar Alarm
il tar, m Ole 15 5 �T rr � e. ILo vn e. f ny Garage Door Opener"
OWNER Mailing Address /
SO(10 St.,-) YY12.a if-OW La .n-g-- Heating, Ventilation and Air Conditioning System'
City /State Zip I Phone #
N ame Oswe 0 L. ct7o 3S V m S ste
Tile_ cuu // T Lm 4 ss� n .
C- . a r y r s U ._ Othe
CONTRACTOR ling i( • • ress
"i ■ TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a r - one Fee for each system $60.00
copy of all licenses , _- 4 1 / (SEE OAR 918.260 -260)
are required If Oregon Con . Brd Lic. # En Da e
expired in C.O.T. / 90 9 Qp %� Check Type of Work Involved:
data base). Ele�tgalo Lic. #
y�f .7 0 p a Audio and Stereo Systems
C.O.T. or Metro ic. # C LE E I1o'7D 2 4 72 2 , ' a� ❑ Boiler Controls
Owner's Name
0 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:
• 0 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 perrnit.are ready for
inspection at 503-836 -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 - refundable and expire if work is not
• 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. ,,p � •
" : B il • S FEES. o ( ! _ ) 2 •
5 0 �r0
o
Signature — ENTER FEE D � $ ,
If% SURCHARGE ( X TOTAL ABOVE) S •
Authority if other than Applicant TOTAL S / •
i AdstsVorrnsvresele.doc 9/98
ZO'd ET:60 6662- 9? -.DO
01/05/2000 Activities for Case #: ELR1999 -00250
11:53:12 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRA003 Application received 10/26/1999 KJP RECD No Hold KJP 10/26/1999
ELRA010 Permit created 10/26/1999 KJP DONE No Hold KJP 10/26/1999
ELRA730 Elect'I Service 10/26/1999 10/26/1999 No Had KJP 10/26/1999
ELRA799 Elect'l Final 10/26/1999 10/26/1999 No Hold JMT - 12/21/1999 12/21/99 message to Ben. Was
this inspected at time of
electrical final? Hold on C/O
until final. Jeanne
ELRA500 (F) Issue permit 10/26/1999 KJP DONE No Hold KJP 10/26/1999
ELRA799 Elect'I Final 12/28/1999 12/28/1999 12/13/1999 GS PASS No Hold GES 12/28/1999
ELRA800 Case finaled 01/05/2000 JMT DONE No Hold JMT 01/05/2000
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