Permit ' ELECTRICAL PERMIT -
R ESTRICTED ENERGY
. CITY OF TIGARD ��1�A DEVELOPMENT SERVICES PERMIT #: ELR1999 -00259
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/02/1999
SITE ADDRESS: 11045 SW SUMMER LAKE DR PARCEL: 1S133DA -02000
SUBDIVISION: AMART SUMMERLAKE ZONING: R -7
BLOCK: LOT: 042 JURISDICTION: TIG
Project Description: Install burglar alarm in single family dwelling. Job# 3861 -HB
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: X 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: .
. TOTAL # OF SYSTEMS:
Owner: Contractor:
WAYNE MCCROSKEY ALLTEC SECURITY
11045 SW SUMMER LAKE DR PO BOX 55310
TIGARD, OR 97223 PORTLAND, OR 97238 -5310
Phone: 503 - 579 -4713 Phone: 331 -2620 O R I G I NA L
Reg #: LIC 001188
ELE 26307CLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT KJP 11/02/199c $60.00 99- 319490 Elect'I Final
5PCT KJP 11/02/199c. $4.80 99- 319490
Total $64.80
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 thro g R 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
87.
Issued ssued by Permittee Signature - Ill G 4.... €4.1
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: / / /Z� /if
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
J6b4- 3R01 - f
CITY OF TIGARD RECggPtICTED ENERGY ELECTRICAL APPLICATION Rec'd by:
13125 ,SW HALL BLVD Date Rec'd:
TIGARD OR 97223 NOV 0 2 1999 PRINT OR TYPE G�
V - 503 - 639 -4171 X304 Permit #:EL 9411 q 9 - ooq 59
F - 503 - 598 -1960 COMMUNITY DEVEIINCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee $60.00
(FOR ALL SYSTEMS)
JOB Street Address f _SSt #
(Q
ADDRESS I' b f5 S ISJ nylAr1 er fit, T J , C heck Type of Work Involved:
Tc, l d 2 7 �p_ j23 ` 3 3 - 7 / -
Na � Audio and Stereo Systems
rte !� f §t Burglar Alarm
Wakipt\g. Ki C Z CA QS 1C
OWNER re d5sw swot M Ie .
❑ Garage Door Opener•
City /State ,1 �I i ' —ho # 1:11 Heating, Ventilation and Air Conditioning System'
N u + � 611...._ I �' �� _ 713 Vacuum Systems'
14 C "� I:=1 Other
CONTRACTOR lin Add ss 111111
(�r3 s /z) TYPE OF WORK INVOLVED - COMMERCIAL ONLY
(Prior to issuance a Ritylapte A . for each system $60.00
copy of all licenses a f Q 1 L 4 127 j � Ma-7 i /laSEE OAR 918- 260 -260)
are required if Oregon Co tr. Brd . #
expired in C.O.T. I I Wk ,?j c 3t jo0 a� Check Type of Work Involved:
data base). Electrical ic. # Date 2. (O ( I i i /) 0 0 L ❑ Audio and Stereo Systems
C.O.T. or Metro Lic. # Exp. Date
❑ 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:
pi 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.
FEES:
Signature _ EN ER FEES $
,00 ,61)
%SURCHARGE (.05 X TOTAL ABOVE) $ 4f ?O
Authority if other than Applicant TOTAL $ 'I' f
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