Permit rr. CITY OF TIGARD RESTRICTED ENERGY
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #: ELR96 -0171
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639-4171 DATE ISSUED: 05/29/96.
PARCEL: 1S134DC -00300
SITE ADDRESS...: 10865 SW WALNUT ST
SUBDIVISION ZONING :R -4.5
BLOCK LOT
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.. :X NURSE CALLS °
VACUUM SYSTEM ° FIRE ALARM OUTDOOR LANDSC LITE:
OTHER: : HVAC ° PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER..: ..
TOTAL # OF SYSTEMS: 1
Owner : -• - -- FEES
TIGARD TUALATIN type amount by date recpt
10865 SW WALNUT ST PRMT $ 40.00 CJS 05/29/96 96- 279923
SPCT $ 2.00 CJS 05/29/96'96- 2799`3
TIGARD OR 97224
Phone #:
Contract or:
OPITEC INC • $ 42.00 TOTAL
7324 SW DURHAM RD
REQUIRED INSPECTIONS
PORTLAND OR 97224 Wall Cover Elect' 1 Final
Phone #: 503- 639 -2871 Elect' 1 Service
Reg #..: 64137
This permit is issued subject to the regulations contained in the _ ! V 1‘
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permitee Signature
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 CIir r le 5 , c 4 -" ;€1
than 180 days. I ssued 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
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT # F[ %296 -61 71
ho -./ j I P FAX hone (5(03) 8 684 -7 2171 297 DATE ISSUED .5 - a 9 - 46
'' I FAX (03) 4 -7
TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY ChczP Ic's 5c1, m
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
OS L 5 Svo tJJPA-t. iiT sr
Address RESIDENTIAL — Restricted Energy Fee $40.00
GARP 6R q7�a� (FOR ALL SYSTEMS)
City State Zip Check Type of Work Involved:
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
180 DAYS. ❑ Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
Contractor OPT 1- Type ❑ Vacuum Systems*
❑ Other
Address � S W acv re o
Date S a �} - 'j ( COMMERCIAL — Fee for each system $40.00
(SEE OAR 918- 260 -260)
Property Owner TIt's12 q - ri ,/ SCtC DX -51- Check Type of Work Involved:
Contractor's Board Reg. No. 3 ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone # 1 ❑ Clock Systems
3. OWNER APPLICATION I] Data Telecommunication Installations
❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No
❑ I nstrumentation
Address ❑ 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:
❑ Protective Signaling
1 Only use electrical licensed persons to do installations where required. (Certain
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 $ zip '
authorized to bind the applicant.
b. 5% Surcharge (.05 x total above) $
Signature
TOTAL $ � Ia
Authority if other than applicant
ENERCAP.CHP
oIAJ leek- /Middle
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: I 1 ° I
Date A.M. P. . Entry:
Address: / A >t 1 0 /44 . .
Tenant: Ste: MST:
BUP:
Con /Own: D_, MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
f 7P Inspector: /� ,I Date:
PPROVED _DISAPPROVED /CALL FOR REINSP. 41100 CO