Permit ELECTRICAL PERMIT CI1Y OF TIGARD
RESTRICTED ENERGY
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #:
DATE ISSU cELR96 -0045
ED: 01/=9/96
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171
PARCEL: 29104DC -08700
SITE ADDRESS...: 13285 SW WOODSH I R,E LN
SUBDIVISION MORNINGSTAR ZONING :R -4.5 PD
BLOCK ..... ° ° ° ° °° LOT......... .... :024
Project Description:
A. RESIDENTIAL-- •-- - - - - -- B. COMMERCIAL - - - AUDIO & STEREO...: X 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: .. HVAC PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER..: .°
TOTAL # OF SYSTEMS: 0
A p p l i c a n t : -- - -- - - - - -- FEES
BARRY MANSOUR type amount by date recpt
11681 SW TEAL BLVD # B PRMT $ 40.00 CJS 01/29/96 96- 275427
SPCT $ 2.00 CJS 01/29/96 96- 275427
BEAVERTON OR 97007
Phone #: 579 -0911
Contractor: -•
42.00 TOTAL
REQUIRED INSPECTIONS
Elect' 1 Service
Phone #: Elect'1 Final
Reg #..
This peroit is issued subject to the regulations contained in the ,-
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 peroit will expire if work is not started
within 180 days of issuance, or if work is suspended for oore
than 180 days. Issued By
- - -- - OWNER INSTALLATION ONLY - --
The installation is being made on property I own which is not intended for
sale, lease, or re
OWNER'S S I GNATUR : ° — ,a_ DATE: I 2
-- - -
------CONTRACTOR INSTALLATION ONLY - - - -- - - --
AUTHORIZED SIGNATURE: DATE:
LICENSE NO:
Call for inspection - 639 -4175
,_ Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT # &71 ? - OD 5/S
AMA Phone (503) 639 -4171
I I FAX (503) 684 -7297 DATE ISSUED /– a 96
-- TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY C,4or /hr „7/t– PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
I? 2 85 5\kI Waxpsh ;rC Lv
A�d s RESIDENTIAL — Restricted Energy Fee $40.00
1 1 o'y � �� 2.23 (FOR ALL SYSTEMS)
City S t � f State Zip Check Type of Work Involved:
PERMITS ARE NON - TRANSFERABLE AND NON - REFUNDABLE AND EXPIRE IF WORK udio 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 Type ❑ Vacuum Systems*
❑ Other
Address
Date COMMERCIAL — Fee for each system $40.00
(SEE OAR 918 - 260 -260)
Property Owner Check Type of Work Involved;
Contractor's Board Reg. No. ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone # ❑ Clock Systems
3. OWNER APPLICATION ,- �,p� ❑ Data Telecommunication Installations
� ' u1�4135 t\ `, 9- 1 I I ❑ HVACarm Installation
Print Owne ?acne Phone No
• (0 ? 1 -� l ;� 0 a ❑ Instrumentation
1 1 ❑ Intercom and Paging Systems
Address
POLV e( +-DY C cr70 '1 ❑ 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. / J
The person signing for this permit must be the applicant or a person a. Enter Fees $
authorized to bind the applicant.
�/n�� b. 5% Surcharge (.05 x total above) $ v� .
Signat TOTAL $ 9c2. o p
Authority if other than applicant
ENERGAP.CHP
I
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. .�-�•/
San. Sewer Gas Line Appr /Sdwlk Reins.
Other. ,
Date: 112—' L 1 0 A.M. i , P.M. Entry _ .
Address: _ - 2.- ! �C.) e•- . -
Tenant: Ste: MST: 5 < ,
BUP
Con /Own: .----- / — v °I U I MEC:
PLM:
e9 c Ce — Lf lo 0 k ELC'Y 00 5
THE FOLLOWING CORRECTIONS ARE REQUIRED ELR. I C— tC
-
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11,—./2 ?‘ ct if C.,-D •4-,o( -c 7c-
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CCTfil 41 c-i -e-e..0
Inspector: 274/ C- 4..42 -e ( 8 ,_, Date: ^„-
APPROVED _ DISAPPROVED /CALL FOR REINSP. CO