9529 SW INEZ STREET �!
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CITY CF TIGARD
IDEVELOPMENT SERVICES FLEC1 RICAI_. PERMYr -
11125 SW Hall Blvd., Tlgar^,OR 97223 (503)639-4171 RESTRICTED r.Nr_.r<l.;Y
i PERMIT #: F-I .P96-0401
DATE ISSUED: !.2/31/96
I-IARC;EL: 25 1 1 1 BA--06900
TTE ADDRESS. . . : 0951'29 SW INEZ ST
3UBCTVISION. . . . : BUTLER TERRACE ZONING.-R-4. 5
JILOC;K.. . � , . . . . . . . L.OT. . . . . . . . . . . . :3
,r,rj.ject Description: INSTL. BURGLAR ALARM
�. RESIDENTIAL---•-----•--- B. COMME=RCIA1-.---_---_--___--____-_._--_.--.__--__--_
AUD I D 8. STEREO. . . : AUDIO R STESREO. . : T N'TERCOM 4. PAGING. . :
BURGLAR ALARM. . . . :X BOILER. . . . . . . . . . : LANDSICAPE/IRPIGA'f. . ;
C ARAGE OPENER. . . . . CLOCK. . . . .. . . . . . . . IhC.DTCAI.. . ,. . . . . . . . . . .
MVAC. . . . . . . . . . . . . : DATA/TELE COMM. . : NURSE rPLLS. . . . . . . .
VACUUM SYSTEM. . . . : F I RE AL_ARM. . . . . . : OUTDOOR I_ANDSC t i TE:
OTHER: ss HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL.. . :
INSTRUMENTATION, : OTHER— : . .
TOTAL. # OF SYSTEMS: 0
FEE __._._._._._._...._.__._..____.__..
I)ARWIN WEBB type amount by date recpt
'?52`J SW TnIrZ PRMT $ 40. 01?.. TAT 12/31/96
SPCT $ 2, 00 TAT 1.2/31/91S 96--288302
TGARD OR 97224
.'hone #: 620-2!539
FOTItraCtoro ___.__._.____----....__.__.._._..._.......____.__._.-•---__ ._-- -----____--
"n1 JTRACTOR NOT ON FILE 42. 00 'TOTAL_
----- -- REGUIRED INSPECTIONS --- --
Ceiling f`aVer° f=leet' I Sfrrvir_^e
11hone it: Wall Cover Elect' 1 Final
Reg #. . .
This permit is issued subject to the regulation; contained in the
Tigard Municipal Code, State of Ore, Specialty Codes and all other Pet-at '',t e� tri gnat I.,t-e/
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
..:thin IN days of issuance, or if work is suspended for more
than 180 days. Tssued By
.._17WNER INSTAI ;_ATION ONL_Y----
'-he installation is being made on pr-operty I own which is not intended for
-;,Ale, lease, ot, r-ent.
f?WNER' c SIGNATURES: DATE.:
INSTALLATION
'IIGNnTURE: OF SUPR. EL.EC' N: DATE=s
I CENSF- NO.
I
Call for inspection - 639-41.75
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard,OR 97223
PF ne (503)639-4171
FAX(503)684-7297 DATE ISSUED �.
TDD No. (503)684-2772 --- -�
CITY OF TIOARD Inspection (503)639-417; ISSUED BY
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATIO ' 4. TYPE OF WORK
�: _ L-
Addre. RESII.,,!. :I e,L—Restricted Enemy Fee . . . . . . . . . $40.00
_ (FOR ALI_SYSTEMS)
Cit; State 2ip Lb_tk.1wv_oLWmkJaw1y€d:
PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDAB'E AND EXPIRE IF WORK
IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR rrrr❑ Audio and Stereo Systems
180 DAYS. Burglar Alarm
2. CONTRACTOR APPLICATION Garage Door Opener*
�RIN:;S HOME SECALARM EJ Heating,Ventilation and Air Conditioning System*
UR
Contracto _ _ lie _ ❑ Vacuum Systems*
Address _8059 S.W. CIRRUS DRIVE, BE_AVERTON 97005 ❑ Other _____
Date� � i COMMERCIAL--Fee for each system . . . . . . . $40.00
(SEE OAR 918-260-260)
Property Owner l�y�
Type Qfy_4tk111Y41YEL-
Contractor's Board Rer, Jo. 044421 ❑ Audio and Stereo Systems
��— ❑ Moiler Controls
Phone# _ (5t:-) 641-0574 ❑ 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 Cr,,itrol•
City State Tip ❑ Medical
This permit Is issued under OAR 918.320.370.This applivant agrees to make only ❑ Nurse Calls
restricted energy installations(100 volt amps or less)under this permit and to do the LJ Outdoor Landscape Lighting'
following:
1. Only use electrical licensed persons to do installations where required.(Certain 71 Protective Signaling
residential and other transactions are exempt from licensing.These have 173 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 Syst,ms
3, purchase separate permits for all installatinrs that are not ready for inspection
when the inspector Is out to inspect nder this permit. •No licenses,re 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 S,. FEES
corrections are completed.
The person signing for this permit roust be the applicant or a person a. Enter Fees $
authorized to bind the applicant.
b. ..5%Surcharge(05 x total above) $
Signature
11A# TOTAL $....... ,---�
Authority 17otiFer than apNlican
ENERGARCHP