Permit C ITY OF TI
'NIA � • � �� -
�,��i DEVELOPMENT SERVICES ELECT r�1cAL ��E r .._
13125 SW H all Blvd., Tigard, OR 97223 (5046394171 , • RE S T- R -1 ENE R G Y .
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3 1O 5. I --- 7 " I I'rt'1 " ' ,
i T C n DDt�n E S�+ L F?nl- L1.3�1. -_ C R 88
SLl 1DI V:ISI i � GI`1. . e+ A' iTION .�L_AT. 1- 4 1 ZGt�IiI�Is�.. T =i • ' t?LOCH,: . - . • . -LQ -� p sy.;i. „Ju k ISD';. C;T'h.s _ -, • •
'•f-tro ] ee:t - De ?' inn ) Install protrrct1'e signaling to, - ari exiStlig co oe�'cial • - - r _
ih11'ldIirg.
A. RESI''DENTI` L.• • .. 6. COMMERCIAL. -- — • AUDIO' : 8,. STEREO... AUDIO •,,&- STERED.,o ^ Ie,1 EF4L:DINN •& r .133:- JG. ,.. r4 '
• BURSLf'R (LA.RM.' . . L •3OIL.EI .; • .. . ' . 1:::C•iNDSCA�'E/ 1 -I GAT . d ' •
GARAGE•_ -OP!ENER..... - CLOCt!.;... . • , - ._ =iEI)': ,. .. , g
- HVRRCe,'... a -..... • ' - .'DATA / TELE COMM .... 1:1L'RSE' crl _L.a.,. . a •
. VACI_IJI _ '3YSTEr* .' . E, I RE ALARM. . -. ; - . OUTDOOR L ANDS° (L ITE,i
OTHER - , '" ' . . - ▪ . . - _ p ROIL T VE S'I,CI�I�' 9_0 . •
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TOTAL. #' or _ S,YEiTEI +ES .g' _
GlNr3Pr . - - -- °- - -- -.— - - - - -^ —. - -- .._....------ - - - - -- -- - - ,FEES - -_— — __ -- - - --
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j.'3775 ' SW.? � AVE - . -� PRIM �j' G 1I! i5.l.`37•. t.....:�1�1IL1
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,par.3'TLAi$ OR 97201, . ' PCT . $ '<,•i4!r CEO - i;,i'' /97 9‘7- 16 •
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, SON I`TROL-'I'Gi =IFI L ; t . Li•"'. �si�• TOTAL AL - , . .
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974- • Ste. ETH ;AVE:
' REQUIRED i'NSPEC'i f ONS
' '' - Lost V'oI. taoe Inep - -' '• . •
Pre one -' 44 22..3-5B -. E1_er ..s t ' 1. .'r .i.
7 n al - . •
Re . - ${; a 121: 21 5;1 ti I - - -
• Th . is, peewit is is,sued.. ?subject t e ations contained .in the Tigard Municipal Node, State of OP' Specialty Code's and all ,other° . '
applicable ,iaws. All uOr'k 'Wil=l be done in, accordance bd iah : appr"'oaed pilaus.. ThiS• per nit will, expire. work 'i5' nua .tarteo within 160
- gays of issuance, or if work,.is suspended for pore, thart,fq . RTTE;'1TdGN..: t7 - neon' lq:4 r'equir'e yuu, to. foliofi'rule adopted by the
uiegon Utility Ncti'fication.Cent. Er, Those rules are-set forth in 3 R•9 2- 4i -2010 through GAR 2 -04)1 J8 You nay obtain co'31e of '
these riiie5 .or direct questions t Oth4C,et - (5 3):24Er 98+f ♦"
is•sk..ted Liv is �� // _ Per rYlittee Sic?ra tt'cr;:o
- -- - -- -- - - .-,- . - - .•----- ulnNEP, :`Iias'- 1 ON ONLY--- .,... " -- - - - - . ---- - - -• - - -- --
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� , lease or -r,.erit. _ -j
OWNER' S S 1 G NATURE . . DATE
- - • - -- °CONI C T OR'�' I NS1"Fil_LAT I i3N ONLY- :_: - - - ._- •--=---- __•- G ..- .__- ._._._
.
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C. 1,,12 39'-'A17'�5 bv ., 7v,CI I ...M. ;1 ,an,'..1w -_�e a ni ,nee_of:C1.` he n ' xt:` .ht_lainess 'CA'n;
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Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT # G 2 f-7 --6313
. A,
III Phone (503) 639-4171
mdi FAX (503) 684 297 DATE ISSUED
- TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF IN,STALLA ION 4. TYPE OF WORK
j o?- 2 v id AitelziK
Add r� n � �� ���� RESIDENTIAL — Restricted Energy Fee $40.00
(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*
Contrac • i, S /L a Y • • ❑ Vacuum Systems*
l f y C � . ❑ Other
Address / � ■ U
L� !�
�j
Date /e -eR � - ! < COMMERCIAL — Fee for each system $40.00
(SEE OAR 918 -260 -260)
Property Owner � • Check Type of Work Involved:
Contractor's Board Reg. No. ` 1.3 < q.� ❑ Audio and Stereo Systems*
p( � J -,5--e,,..0 .. ❑ Clock Systems
Phone #
❑ Clock Systems
•
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No
❑ Instrumentation
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: t—P-Fotective 1. Only use electrical licensed persons to do installations where required. (Certain
tective 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 corrections 5. FEES
are completed. /_U
The person signing for this permit must be the applicant or a person a. Enter Fees
$ `
authorized bind the applicant.
7 1 � b. 5% Surcharge (.05 x total above) $ O .,... , et)
Sig... re
TOTAL $ ,
Authority if other than applicant
ENERGAP.CHP
■
RECEIVED
OCT 2 7 1997
COMMUNITY UEVELUr'MErVT
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