Permit CITY OFTIGARD
i ;� DEVELOPMENT LOPMEN R SERVICES (503)639 E ELECTRICAL PERMIT - -4171
RESTRICTED ENERGY
PERMIT #: ELR97 -0293
DATE ISSUED: 10/17/97
PARCEL: 2S1O4CD -10500
SITE ADDRESS... :13665 SW TRACY PL
SUBDIVISION °HILLSHIRE ESTATES NO. 2 ZONING:R -7 PD
BLOCK . LOT :104 JURISDICTN: TIG
Project Description:
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: 0
Owner: FEES
WINDWOOD HOMES type amount by date recpt
14076 SW BENCHVIEW TERR PRMT $ 40.00 JSD 10/17/97 97- 300160
TIGARD OR 97224 5PCT $ 2.00 JSD 10/17/97 97- 300160
Phone #: 590 -4700
Contractor:
CEDAR LANDSCAPE $ 42.00 TOTAL
14375 SW PATRICIA
REQUIRED INSPECTIONS
HILLSBORO OR 97123 Low Voltage Insp
Phone #: 628 -3411 Elect'1 Final
Reg #..: 000058
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 rule adopted by the
Oregon Utility Notification Center. Those Iles are set forth in OAR 952 -1 -0010 through OAR 952- 001- 1, '' , :' , . You may obtain copies of
these rules or direct questions toJl1NC et987.
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:
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 OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd
131.25 SW HALL BLVD Date Rec'd: o(
TIGARD OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #:
F - 503 -684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL
i/ll Restricted Energy Fee $40.00
ge fsrxres (FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS /366$- Slit %,Q/1C(/ T L, Check Type of Work Involved:
/State // Zip Phone # ❑ Audio and Stereo Systems
/ /9/iRb a 97.2
Name ❑ Burglar Alarm
OWNER Mailing Address ❑ Garage Door Opener*
City /State Zip Phone # ❑ Heating, Ventilation and Air Conditioning System'
Name ❑ Vacuum Systems*
CEA1R 1A4/1>sore Other — 2 - 2.¢1/1rioN C
CONTRACTOR Mailing Address
/4375 Su/ P67X/Cpq At/E TYPE OF WORK INVOLVED - COMMERCIAL
(Prior to issuance a City /State Zip Phone # Fee for each system $40.00
copy of all licenses WA-% Q° DA 497/23 6.2$ .3 // (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Brd Lic. # Exp. Date
expired in C.O.T. Sb'¢3 6 -9'8 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
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:
❑ 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.
Signature ENTER FEES $ 4
ono
5% SURCHARGE (.05 X TOTAL ABOVE)
00
Authority if other than Applicant TOTAL $ g2
is resele.doc 12/98 _
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