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132' l SW Clearview Way
CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
13125 SW He!)Blvd., Tigard,OR 97223 (503)639.4171 RESTRICTED ENERGY
PERMIT #: ELR96-0389
DATE ISSUED: 12/21 /96
PARCEL: 2SI04DC-03200
SITE ADDRESS. . . : 13221 SW CLE?RVIEW WAY
SUBDIVISION. . . . : BENCH VIEW ESTA'F'L—;S ZONINIG:R-4. 5
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . .
Project Description: INSTALL SURULAR ALARM
A. RESIDENTIAL------------ B. COMMERCIAL---------------- ---------------------------
AUDIO & STEREO. . . : AUDIO & STEREO_ : INTERCOM & PAGING. . :
BURGLAR ALARM. . . . % X BOILER. . . . . . . . . . : L.ANDSCAPE/IRRIGAT. . :
GARA 'F OPENER. . . . : ':LOCK_ . . . . . . . . . : MEDICAL. . . . . . . . . . . . .
HVAC. . . . . . . . . . . . . : LATA/TELE COMM. . : NURSE CALLS. . . . . . . . :
VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR 1...ANDSC LITE:
OTHER: HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . s
INSTRUMENTATION. : OTHER. . - I ".
TL.TA1_ # OF SYSTEMS: 0
FEES
ENERGY HOMES INC type amount by date reept
10211 SW BARnUR PRMT $ 40. 00 TAT 12/31 /96 96-28828E
SPCT $ 2. 00 TAT 12/31/96, 96--28828r
P,r',9TLnNID OK 71-72.19
Phone #: 244-33t;;`5
Contractor-:
PRINKS HOME SECURITY 42. 00 TOTAL
8099 coW CIRRUS DR
---- --- REQUIRED INSPECTIONS
BEAVERTON OR 97008 Ceiling Cover Elect' I Sorvic—
Phone 41 V--641-0574 Wall, Cover Elect' l Final
Reg #. . : 444PI
lhis permit is issued subject to the regulations contained in the
Tilard Municipal Code, State of Ore. Specialty Codes and all other Pily-niit-e7 Signature
applicable laws. All work will be done in acr-dance with
approved plans. this permit will expire if work is not started
within IN days of issuance, or if worP is suspended '-ir more
than IN days. Issued B
OWNER IWSTPLLqTILN ONLY
The installat _r is being made on property I own which is not intended for-
sale, lease, or rent.
OWNER' S SIGNATURE: DATE:
INSTA..LATION
STGNATLJR—"' Or SUPR. ELECT' N: DATE:
I ( ENSF NO:
Call f a t- i n s pect i on -- 639-4175
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 PERN(Ii
Phone(503)639-4171
FAX(503)684-7297 DATE ISSUED
TDD No. (503)684-2772
CITY OF TIGARD Inspection (503)639-4175 ISSUED BY _
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
Ad ress RESIDENTIAL.—Restricted EneFee. . . . . . . . . 140.00
` ?�� (I OR ALL SYSTL`Mmr�yy S)
Ci State Zip S�heck Type of Work I,nvo yed:
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. kBurglar Alarm
❑ Garage Door Opener*
2. CONTRAC-FOR APP'-ICATION ❑
�RINKS HOME SECURT Heating,Ventilation and Ai, Conditioning System'
ContractOa ALA_M
❑ Vacuum Systems'
Address 8059 S.W. CIRRUS DRIVE, BEAVERTON 97008 U Other- _
Date,��- e COMMERCIAL—Fee for each system . . . . . . . . . x.00
(SFE OAR 918-260-260)
Property Owner _ Check Tine of Work Involved;
Ct,ntract,,'s Board Reg. No. � ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone # (503) 641-0574
7 Clock Systems
3. OWNER APPLICATION ❑ Data Telecommonlcatlon Installations
[j 1:1-AI,;;,,installation
❑ HVAC
Print Owner's Name Phone No
❑ Instrumentation
Address ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control'
City State Zip ❑ Medica'
This permit is issued tinder OAR 918.310.370.This applicant agrees to make only ❑ Nurse.Calls
restricted energy installations(100 volt amps or less)under this permit and tv do the ❑ Outdoor Landscape Lighting'
folk»ving:
1. Only use electrical licensed person,to do installations where required.(Certain ❑ Protective Signaling
residential an(lother transactinns 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 503.6394175. ❑ Number of Systems
3. Pue,hw,ep-rate pemdts for all Installations that are not ready for Inspection
when the Inspes:tor is out to inspect under this permit. •No Ilcenm are required. Licenses are required for all other Installations.
4. Assume responsibility for assuring that all corrections required by the Inspector
are done,and
S. Assume responsibility for calling for a final inspection when all of thn S. FEES
c•erections are completed.
Th( person signing for this permit must be the applicant or a person a. Enter Fees $
autoorized to bind the applicant.
b. 5% Surcharge(05 x total above)
Signature --�— _ � V- ]
11A; TOTAL $
Authority�i other than apNlican�
ENERWP.CHP