Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
hii DEVELOPMENT H BMEN S ERV 2 3T DATE SSU 5/19/99 ELR1999-00127
SITE ADDRESS: 15745 SW SERENA CT PARCEL: 2S111CD -07500
SUBDIVISION: KERWOOD ESTATES ZONING: R -4.5
BLOCK: LOT: 012 JURISDICTION: TIG
Project Description: Installation of timing device for 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: 1
Owner: Contractor:
PATRICK & NAVE OWNER
15745 SW SERENA CT
TIGARD, OR 97224
Phone: Phone:
Reg #:
FEES Required Inspections
Type By Date Amount Receipt Elect'l Service
PRMT DRA 5/19/99 $40.00 99- 315523 Elect Final
5PCT DRA 5/19/99 $2.00 99- 315523
Total $42.00
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 ou to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-0i 1 -00 i hrough OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 1987.
Iss d by , .� , -- �.00�J��1 Permittee Signature
OWNER INSTALLATION ONLY
The installation is being made operty I own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: DATE: ,S' /s-99
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 OR TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd�ly: ti. 2 J
13125 SW HALL BLVD Date Rec'd: J 1 9 - 9 7
TIGARD OR 97223 PRINT OR TYPE C �p
V - 503 - 639 -4171 X304 Permit #: G iLl k 9 cJ 10a1)
F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
�} - ` Restricted Energy Fee $40.00 'Lk PA' PCX. ,.J Q'iO3., 0 N4, (FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS 15 5 s,3 st dp, a Check Type of Work Involved:
City/State n Zip„ Phone # ❑ Audio and Stereo Systems
Name Ail- D-0/4 ❑ Burglar Alarm
OWNER Mailing Addres ❑ Garage Door Opener*
SA ❑ Heating, Ventilation and Air Conditioning System*
City /State Zip Phone #
Name ,/� _ ❑ Vacuum Systems* /�,,
S 1��N AIY /`-' EI'v Other i R --I - &A 7 ) 0.c
CONTRACTOR Mailing Addres
TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a City /State Zip Phone # Fee for each system $40.00
copy of all licenses (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Brd Lic. # Exp. Date
expired in C.O.T. Check Type of Work Involved:
data base). Electrical Contr. Lic. # Exp. Date ❑
Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date
❑ Boiler Controls
O ner Name
�I, er \� ❑ 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
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. (�
- \.`_lC1 FEES: p0
Signature ENTER FEES $ V i
CLJ
5% SURCHARGE (.05 X TOTAL ABOVE) $ U " I
Authority if other than Applicant TOTAL $
i:\dsts \resele.doc 7/97 —