16185 SW 108TH AVENUE 1
ADDRESS:
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ELECTRICAL PERMIT - /
CITY OF TIGARD RESTRICTED ENERGY
'COMMUNITY DEVEL OPMENT DEPARTMENT PERMIT #: ELR96--01 Std
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171 DATE ISSUED: 05/13/96
PARCEL_.: `S115AA-01100
SITE ADDRESS. . . : 161£15 SW 108TIA AVE
SUBDIVISION. . . . : WILL_OWDR001,< FARM ZONING:R-25
BLOCK. , I_OT. . . . . . . . . . . . .
P'roject' Description : �+
---------------------------
A.
-- - - --
A. RESIDENTIAL--.--------- D. COMMERCIAL
AUDIO & STEREO. . . : AUDIO & STEREO. . : INTERCOM & PAGING. . :
BURGLAR ALARM. . . . :X BOILER. . . . . . . . . . : LANDSCAPE/IRRI('7yI;T. . :
GARAGE OPENER. . . . . CLOCK. . . . . . . . . . . . MEDICAL. . . . . . . . . . . . .
Hr:,'�C. . . . . . . . . . . . . . DATA/TELE: COMM. . . NURSE CAIJ..S. . . . . . . . .
VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR LANDSC LITE.:
OTHER: . . HVAG. . . . . . . . . . . . . PROTECTIVE SIGNAL. . .
INSTRUMENTATION. : OTHER. . : . .
TOTAL # OF SYSTEMS: 0
Owner-: _____.___._..._____._.______________,__.__._._.____.._.._._.__________-_ FEES
PHILLIP BANES type amount by date recpt
1.6185 SW 10-81'H PRMT 4 40. 00 CJS 05/13/96 96-;-279284
5F'CT $ 2. 00 CJS 05/13/96 96-279284
116AFZD OR 91223
Phone #:
Contractor-:
BRINKS HOME. SECURITY $ 42, 00 TOTAL
6059 aW CIRRUS DR
REUU I RED INSPECTIONS -- ----
BEAVF RI ON OR 9700E Wail Lover Elect' 1 Final
Rhone #: 503-641-•0574 El ect' I Ser-vice
lReg it. . : 44421
This permit is issued subject to the regulatiuns captained in the
Tigard Municipal Code, State of Ore. Specialty Codes ;nd ali other Perm i t e.e S i gnat ore
applicable laws. All work will be done in ac^_ordance with
approved plans. Thie permit will expire if work is not started
within 180 days of issuance, at, if work is .suspended for more � �,[ _ 111, / •__._.—___ ______. __ ..
than 180 days, Issr-red By
INSTALLATION
The in- `allation is being made on property I o-n which is not intenued for
sale, lease, or rent.
OWNER' S SIGNATURE: DATE:
___--_--_----_--.-._-____---CONTRACTOR INSTALLATION ONLY-------•-------______________-
S I GNAT URE OF SUP'R. E1_EC' N: 6 y) _�,Q 1 r Ci't1Lvr1n._--_-, DATE: __5 3: _
w T
LICENSE NO:
r
Call for inspection - 639-4175
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT# i Rg 6-o
> Phone(503) 639-4171
FAX(503)684-7297 DATE ISSUED
TDD No. (503) 684-2772
CITY OF TIGARD Inspection (503)639-4175 ISSUED BY �/r- Ser
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
Ad IrSyc RESIDENTIAL—Re-tricted Energy Fee . . . . . . . . . $40.00
(FOR ALI.SYSTEMS)
City C — State Zip -Check Typeof Work InvoJ :
PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems
IS NOT STARTED WITHIN 160 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
100 DAYS. [5�Burglar Alarm
2. -ONTRACTOR APPLI ATION ❑ Garage Door Opener*
��,, //^ C3 Heating,Ventilation and Air Conditioning System'
on�r�t friP� ► �,�. y e L�.G ❑ Vacuum Systems'
`„'' '�f�`� /'�j� ElOther-----
Address e- �!r----
Date? / COMMERCIAL—Fee for each,system . . . . . . . . . 14Q,,QQ
/) (SEF OAR q1 fi-2G(1-2G0)
Property Owner _ Check Tyne of Work Involved:
Contractor's Board Reg. No. T 7 ❑ Audio and Stereo Systems
�� ❑ Boiler Controls
Phone# Y _. � ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phon^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 El Nurse Calls
restricted energy Installations(100 volt amps or less)under this permit and to do the ❑ Outdoor Landscape Lighting'
(allowing: i-
1. only use electrical licensed persons to do installations where required.(Certain t 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 out to Inspect tinder this permit. t No licenses are required. Licenses are required for all other installations.
a. Assume responsibility for assuring that all corrections required by the inspector -_
are done,and
5. Assume responsibility for calling for a Anal inspection when all of the 5. FEES
corrections are completed.
The person signing for 0lis permit must be the applicant or a person a. Enter Fees $
authorized to hind the applicant. —
b. 5%Surcharge(.05 x total above)
Signature ETOTAL $
----� --
Authority if other than licanl
ENERGAP.CHP