Permit CITY OF TIGARD
,gyp q�,a, DEVELOPMENT SERVICES ELECTRICAL PERMIT —
°'� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 RESTRICTED ENERGY
PERMIT #: ELR97 -0350
DATE ISSUED: 12/09/97
PARCEL: 281O4CC -00100
SITE ADDRESS...:13713 SW TRACY PL
SUBDIVISION •HILLSHIRE ESTATES NO. 2 ZONING:R -7 PD
BLOCK • LOT :106 JURISDICTN: TIG
Pro.j ect Description : Installation of residence backflow prevention device for
landscaping.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM • BOILER LANDSCAPE/ IRRI GAT. .
GARAGE OPENER • CLOCK • MEDICAL •
HVAC • DATA /TELE COMM..: NURSE CALLS •
VACUUM SYSTEM • FIRE ALARM OUTDOOR LANDSC LITE:
OTHER:BP DEVICE ::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 DRA 12/09/97 97- 301571
TIGARD OR 97224 5PCT $ 2.00 DRA 12/09/97 97- 301571
Phone #: 590 -4700
Contractor:
CEDAR LANDSCAPE $ 42.00 TOTAL
14375 SW PATRICIA
REQUIRED INSPECTIONS
HILLSBORO OR 97 123 Low Voltage Insp
Phone #: 628 -3411 Elect'l 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 rules are set forth in OAR 952 -001 -0010 through OAR 952- 001 -0080. You may obtain copies of
these rules ire questions to OUNC at (503)246 -1987. /
Issued y � Permittee Signature�r A21
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 by:
13125 S4V HALL BLVD Date Rec'd: / 9� -9 --7-7
TIGARD OR 97223 PRINT OR TYPE
V - 503 - 639 -4171 X304 Permit #: 6- • 97- ) 36O
F - 503 - 684 -7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED - RESIDENTIAL
Restricted Energy Fee $40.00
�S M7E5 jar /0,6 (FOR ALL SYSTEMS)
JOB Street Address Ste #
ADDRESS /37/3 S(,�J /�Cy RL, Check Type of Work Involved:
City/State Zip Phone # ❑ Audio and Stereo Systems
/-4 0 /Q. 9
Name me / �� El Burglar Alarm
►/( Av D wood 44 04 ❑ Garage Door Opener*
OWNER Mailing Address
City/State Zip Phone # ❑ Heating, Ventilation and Air Conditioning System*
Name ❑ Vacuum Systems*
et iOsc a S,(/C, d Other LA,vDSCAPE 7R419ATirw CD.YrROCLeiQ.
CONTRACTOR Mailing Address
/437-S' SW AirRlev.? "Ii/e TYPE OF WORK INVOLVED - COMMERCIAL
(Prior to issuance a City /State Zip Phone # Fee for each system $40.00
copy of all licenses y// j0 7./.23 4.21.39// (SEE OAR 918 - 260 -260)
are required if Oregon Contr. Brd Lic. # Exp. Date
expired in C.O.T. 56 (o -93' 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.
, / 4C FEES:
Signature ENTER FEES $ 1/9
ae
5% SURCHARGE (.05 X TOTAL ABOVE) $ 2
Authority if other than Applicant TOTAL $ 4 2—
i Vesele.doc 12/96 —
4-1 g ,7 pt_M ry iis AM
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 0 1 1 — l 0 A.M. 0 X MST: 7 7` 60 SS
Location: /37/3 SW Jl U ex Q BUP:
Tenant: Suite: Bldg: MEC:
Contractor: (-- Phone: 703- PLM: 9 7- 0 ‘22
'
Owner: Phone: ELC:
ELR: 9 7-v 35D
SIT: .
BUILDING ; LDG on't) , PLUMB I .. ELECTRICAL SITE
Site •os : eam Po Po : y. Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Ahn Crawl/Found Dr Heat Pump Low Volt
u. ov w.ii. ( rov Approved Approved
Appr /Sdwlk ► • ...roved Not Approved • . • ..roved Not Approved Not Approved
I • INAL FINAL FINAL
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q . ) / 4...........„ ' .fit .1.o�. (--,:,s-err, ( 4 0 . %_ -2 __ .� J chest, 2 .-e. "- & - : - /--7...).0 -
rVf-_
"eit — g z 6- 97
)3 -6
O Call for reinspection O Reinspection fee of $ required before next inspection 0 Unable to inspect
Inspector: :,7// Date: 4 " "C. ` 77 Page of