13760 SW 114TH AVENUE 4'
ADDRESS:
J4 AV
167!�Q� EMU
i:\reoords\microhm\tnrgets\buiiJing.doc
CITY OF TIGARD ELECTRICAL PERMIT -
-COMMUNITY DEVELOPMENT DEPARTMENT RESTRICTED ENERGY
13125 SW Hall Blvd.Tigard,Orogon 97223.8199 (503)839-4171 PERMIT #: ELR96_.0056
DATE= I»UED: &`/06/')c
PARCEL: 2'S 103DC--00810
3ITE ADDRESS. , . : 13670 SW 114TH AVE
.SUBDIVISION. . . . : VIRGINIA ACRES ZONING: R 5
L{l_OCGK. . . . . . . . . . . LOT.. . . . . . . . . . . . . :3
.roject Desk-ription:
1. RESIDENTIAL- ---__._._._._.- D.
AUDIO R !STEREO. . . : AUDIO & STEREO. . : INTERCOM R PAGING. . :
BURGLAR ALARM. . . . :X BOILER. . . . . . . . . . a LANDSCnPE/IRRIGAT. . :
GARAGE OFTENER. . . . . CLOCK. . . . . . . . . . . . MEDICAL. . . . . . . . . . . . .
HVAC. . . . . . . . . . . . . : DATA/TELE COMM. . : NURSEZZALI._5. . . . . . . .
VACUUM S\'STEM. . . . : FIRE ALARM. . . . . : OUTDOOR LANDSC LITE:
OTHER: tt : HVAC. . . . . . . . , . . . : FIROTECTIVE SIGNAL. .
INSTRUMENTATION. : OTHER_ : . .
TOTAL # OF SY�:TEMS: 0
Applicant : -- _.._..__.._. _..__.____.__.___ ._..__._..- _._ ____.______._._..__._____.__.____ ..__. FEES
MICHAEL JAVER type 4-amount by date recpt
.L -670 SW 1141H AVE PRMT `ti 40. Q1 C;,15 0�/06/9G I`,--.-;_'7 5C,L,u
5RCT $ 2. 00 CJS 02/06/96 96-c75668
T'IGARD OR 972j3
"hone fl:
- :iJTi3Ak &-aJQr 4h!-+=�1_�E $ 4 . 00 TOTAL
1407-
70 3 NF Hnp c REUUIRED INSPEC"rIONS
Iqr �0r.47,11klectI I Service
!-',hone 4 - Elect' l Final
Reg #. .
This permit is issued subject to the regulations contained in the •_ —
Tigard Municipal Code, ;;tate of Ore. Specialty Codes and all other F er^rn i t e—e_S i g__na_t a1r^e
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
olthin 180 days of issuance, or if work is suspended for more _ 0rJ.•1—
than 180 days. I sG r..1ed Py
..OWNER INSTALLATION
Fhe installation is being made on pr^open-ty I own which is not intended for-
,ale, :lease, or rent.
CL iJWNER' S S I GNATURL: __ _ . _._�. _ DATE
cn _CONTRACTOR IN5TA1_LATION ONLY- _ ......_._.____.._._....._ .
)IJTHORIZEA 5It3NATUR177 : J9'ILkt�ss� __ __...__.___..._..._ DATE:
_1 GE:NSE NO".
Call for- inspection - 639-4175
_ J
Community Development RESTRICTED ENVRGY ELECTRICAL APPLICATION
' 13125 SW Fall Blvd.
Tigard, OR 97223 PERMIT # a/1,j6_0Q 56
*- Phone(503)639-4171
FAX(503) 684-7297 PATE ISSUED; C 96
TDD No. (503) 684-2772
CITY OF TIGARD Inspection (503) 639-4175 ISSUED BY
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF �Aj1STl L�I4. TYPE OF WORK
Address L� RESIrtNTIAL-- Restricted Energy Fee. . . . . . . . . SAUD
d 9- Na-3 -
(FOR ALL SYSTEMS)
City State lip 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 �- y
180 DAYS. V_'T1;r9Iar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener"
❑ Heating,Ventilation and Air Conditioning System`
Contractor AW-90IR1t'Y S1rSTEMS,00- Typt. [] Vac i dm Systems'
103 NE HANCOCK ❑ Other
Address FMTtAND,OR 97212 -- -- -----
- --
iii 784-3M_—
Date ;If? COMMERCIAL—Fee
fOAR 1181 260m60) -40M
Property Owner s �� -/--Check Tyne of Work Involved:
Contractor's Board Reg. No. ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone # ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No
�� Instrumentation
Address `- ❑ intercom and Paging Sy,items
❑ 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 onagy Installations(100 volt amps or less)under this permit and to do the ❑ Outdoor Landscape lighting*
following-
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 _
asterisks(•).All others nerd 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
1. Purrhaw 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.
c 4. Assume respxnsihliily for assuring that all corrertinns required by the inspector
c^
are don.-,and
5. Assume responsibility for calling fora final inspection when all of the 5. FEES
corrPolons are completed.
The person signing for t r must he the applicant or a person a. Lnter Fees $
authorized la bin th p nl.
h. 5% Surcharge(.05 x to(al above) $�
Signatu
TOTAL $ 4Z4.D0
Authority if other than applicant
ENERGAP.CHP