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Q 3:
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd. l?qS_-
Tigard,OR 97223 PERMIT# DD ?
Phone (503)639-4171
FAX(503)684-7297 DATE ISSUED -9- 99
TDD No. (503)684-2772
CITY OF TIGARD Inspection (503)639-4175 ISSUED BY C/7 c,- ler -Cc 417'
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSI-A10,LN. 4. TYPE OF WORK
i
4s5�24,1�
Adds RESIDENTIAL—Restricted Ener Fee. . . . . . . . . $40.00
/ (FOR ALL SYSTEMS)
City UState lip !;heck T,yype of Work Involv.:�l:
RK
ISRMITS ARE NOT STARTED WITHIN 518 DAYS OF(ISSUANCE OR IF WORK 155 SUSPENDED FERABLE AND NON-REFUNDABLE AND EXPIRE IF OFOR ❑ 1O and Stereo Systems*
180 DAYS. Burglar Alarm
2. CONTRACTOR APPLICATION El Garage Door Opener*
❑ Heating,Ventilation and Air Conditioning System*
Contractor Type _Q/L(��❑ Vacuum Systems*
/'� ❑ Other
Address � _—� —
Date—�: ��`9� COMMERCIAL—Fee fore:ch system . . . . . . . . . $40.00
(SEE Or.R 918-260-260)
Property Owner
Check Type of Work Involved:
Contractor's Board Reg. No. a ❑ Audio and Stereo Systems*
❑ Boiler Controls
Phone# _� — ❑ Clock systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
lOc � � ❑ 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*
fallowing:
1. Only use electrical licensed persons to do Installations where required.(Certain ❑ Protective Signaling
residential and other transactions are exempt from licensing.These have ❑ Other
asterisksm.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 not 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 fora f at ins1wrtion when all of the corrections 5. FEES
are completed. / )
The person signing for i e/ I must he the applicant or a person a. Enter Fees $
authorized to d th ant.
b. 5% Surcharge(05 x total above) It a�
.Signature
TOTAL $ yU
Authority if other than applicant
ENERGAP.CHP
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink, Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Port/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San, Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Harm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall /c,/ Gyp. Bd. -Elect.
Date Requested: I�� ( �1 5— Time: AM XLPM
Address:_ `f C.' �� 1 1t ---
Builder:} ����� GAG ��S Permit#: C(,f� 7 7
THE FOLLOWING CORRECTIONS ARE 3EQUIRED:
2z 7 AQP C(c;I Zy —74.43 (R)
r ��
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V) —
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Inspector: 014
� ��r
�PPROVED _DISAPPROVED `APPROVED SUBJECT TO ABOVE
__Call For Reinsp.
INSPECTION NOTICE it. -;-
City of Tigard Building Department
13125 SK Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O--Pbone): 639-4175 Business Phone: 639-4171
Inspection:_ ✓! "C l� �L`' ^ _
Footing Plbg. Underalab Hecfi. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested: `� /`7 7 —Times _Z AH __.__PM
Address: / �.� ! L Ferm�t1r: _=
Builder• --
THE FOLLOWING CORRECTIONS ARE REQUIRED:
41
i
Inspectors /' �^! Date:_,
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVP
call For Reinmp.
CIT1f. IT�(O� TICS RD �
OF Tk�A
COMMUNITY DEVELOPMENT DEPARTMENT oR
13125 SWFWIBlvd. P.O.Bax 23997,Tigmd.Onagon 97223(503)e� AI 75 1-'LUMDIN. . E_Rh1I-I -
PERMIT -# PLMS1' I
639-4171 DATE ISSUED: 1214/29/9:
SITE PDDRESS. . . : 1544121 SW aisT AVE PARCEL: cS1l��CN-1: 14'ili
SUBDIVISION. . . . : ASHFORD OAKS 2 -ZONING: R-7
BLOCK. . . . . . . . . . . LOI.. . . . . . . . . . . . . . 135
CLASS OF WORK. . :ADD ____ GARBAGE-: DISPOSALS. . : __i- -MOBILE HOWE SPACES. :
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : BACKFLOW PREVNTRS. . : 1
OCCUPANCY GRP. . : R3 FLOOR DRATNS. . . . . . . . TRAPS. . . . . . . . . . . . . . .
STORIES. . . . . . . . : iR WATER HEATERS. . . . . . : CATCH BASINS. . . . . . . : i
FIXTURES-________.___._ LAUNDRY TRAYS. . . . . . : rF RAIN DRAINS. . . . . .
SINKS. . . . . . . . URINALS. . . . . . . . . . . . : GREASE TRAPS. . . . . . . .
LAVATORIES. . . . . : OTHER FIXTURES. . . . . :
TUN/SHOWERS. . . . : SEWER LINE (ft) . . . . :
WATER CLOSET5. . : WATER LIME: (ft ) . . . . :
DISHWASHERS. . . . : RAIN DRAIN (ft ) . . . . :
Rpmarks : RESIUENTIAL BOCK-FLOW FOR SPRINKLER `.�YSTE~II
Owner,: -------------------------------------- ____--------__•__-- FEES __-_-----__
STF-VE:N SHREWSBURY type nmol-lnt by date re(--pt
1544121 SW 81ST AVE PRMT $ 15. 00 PCR 04/29/92 -
SPCT $ 0. 73 5CR 04/29/92 -
T'IGARD OR 9'72:4
Phone fit: 639-2563
CantrActor,:
OWNER
Phone #: $ 15. 75 TOTAL
Rey #. . : 121121000
--------- REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the F'j.nA 1 Inspection
Tigard Municioal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with
approved plans. This permit will eyoire if work is not started
within IN days of issuance, or if work is suspended for more
than 168 days.
Permittee Si.11natut-e1
Call for- inspection - 639-•4175