Permit ' CITY OF TIGARD
� „ ,�,i DEVELOPMENT SERVICES ELECTRICAL PERMIT -
_!�+�- 'I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 RESTRICTED ENERGY
PERMIT #: ELR96 -0392
DATE ISSUED: 12/31/96
PARCEL: 25102CA -00925
SITE ADDRESS...: 13240 SW VILLAGE GLENN DR
SUBDIVISION....: VILLAGE GLENN ZONING : R -4. 5
BLOCK........... LOT .............:25
Project Description: INSTALL BURGLAR ALARM
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..: an
TOTAL # OF SYSTEMS: 0
Owner: FEES
ED /LOUISE KLINKENBERG type amount by date recpt
13240 SW VILLAGE GLENN DR SPCT $ 2.00 TAT 12/31/96 96- 288289
PRMT $ 40.00 TAT 12/31/96 96- 288289
TIGARD OR 97223
Phone #:
Contractor:
BRINKS HOME SECURITY 42.00 TOTAL
8059 SW CIRRUS DR
REQUIRED INSPECTIONS
BEAVERTON OR 97008 Ceiling Cover Elect'l Service
Phone #: V- 641 -0574 Wall Cover Elect'l Final
Reg #..: 44421 �Q f
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm S i gnat ur
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 182 days of issuance, or if work is suspended for Bore , J A (,UV /4-19”
than ise days. Issued By
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 for inspection - 639 -4175
. - • r - - - -
Community Development tY p RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd. / /� /7
Tigard, OR 97223 PERMIT # �L p � V
- ,3zT
/a/v11i0 � \ Phone (503) 639 -4171
sly FAX (503) 684 -7297 DATE ISSUED /� �D
�f I� TDD No. (503) 684 -2772 / �
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INST CATION 4. TYPE OF WORK
Ad City . RESIDENTIAL — Restricted Energy Fee $40.00
...- 1(//4 1 /4
I I Z2 (FOR ALL SYSTEMS)
City S to Zip Check Type of Work Involved:
: d
PERMITS ARE NON - TRANSFERABLE AND NON - REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems
IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR y
180 DAYS. Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
Contracto yp
RINKS HOME SECURL�Y ALARM
e ❑ Vacuum Systems*
Address 8059 S.W. CIRRUS DRIVE, BEAVERTON 97008 ❑ Other
Date /;--( /J COMMERCIAL— Fee for each system VILE
r --- r � �/ / � J [ ^ � (SEE OAR 918 - 260 -260)
Property Owner 4 �4_ J1,lry1 'y` Ch Y c Type of Work Involved;
Contractor's Board Reg. No. 0/1/0 21 ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone # (503) 641 -.0574 ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation .
❑ HVAC
Print Owner's Name Phone No
❑ Instrumentation
Address El Intercom and Paging Systems
❑ Landscape Irrigation Control*
City State Zip • ❑ Medical
This permit is issued under OAR 918- 320 -370. This applicant agrees to make only ❑ Nurse Calls
restricted energy installations (100 volt amps or less) under this permit and to do the ❑ Outdoor Landscape Lighting*
following:
1. Only use electrical licensed persons to do installations where required. (Certain ❑ Protective Signaling
residential and other transactions are exempt from licensing. These have ❑ Other
asterisks(*). All others need licensing).
2. Call for an inspection when all of the installations under this permit are ready
for inspection at 503-639-4175. ❑ Number of Systems
3. Purchase separate permits for all installations that are not ready for inspection
when the inspector is out to inspect under this permit. • No licenses are required. Licenses are required for all other installations.
4. Assume responsibility for assuring that all corrections required by the inspector
are done, and
5. Assume responsibility for calling for a final inspection when all of the 5. FEES
corrections are completed.
The person signing for this permit must be the applicant or a person a. Enter Fees $ ' '
authorized to bind the applicant.
b. 5% Surcharge (.05 x total above) $ ,
Signature `
TOTAL $
Authority i other than apNlican
ENERGAP.CHP
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
Q BUP
Date Requested to - 1 1 AM PM BLD
Location I ?Z � 0 1) I � ccg � &LP%\ Suite MEC
Contact Person Ph(Aq'gzc PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR I ca--0332-
Footing Access:
Foundation FPS
Ftg Drain
Slab
Crawl Drain Inspection Notes: nn 1 ��nr SGN
Post & Beamlr SIT
Ext Sheath /Shear
Int Sheath /Shear
Framing _
Insulation
Drywall Nailing
Firewall
•
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: l ��
Final .
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL •
ECT
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
PART FAIL
S E ,,,►
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach/Sidewalk
Other Date 6 C y
Inspector Ext
Final •
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.