11185 SW 125TH PLACE ADDRESS:
I u 95 SW S#r# PkA ~,
i
P,ecordslmicroflmltxrgeislbuilding.doc
..J
CITY OF TIGARD
DEVELOPMENT "ERVICES ELECTRICAL PERMIT
A 13125 SW Hall Blvd.,Tigard,OR 9720 (503)639.4171 RESTRICTED ENERGY
PERMIT #: ELR97-0058
DATE ISSUED: 02/2'8/977
PARCEL: 1S134CB07200
S T"FF ADDRESS t 11 8"; sw t 25"'H PI_ ZONING: R--7
SUBDIVISION. . . .. : ANTON PARK
BLOCK. . . . . . . . . . . LOT. .. . .. . . . . . . . . . :34
r',roject Descrj ,-,CiOn- instl bl.trglar alarm
--———————— COMMERCIAL—
RESIDENTIAL B. AUDIO & STEREO. . : INTERCOM & PAGING— :
PUD'An 6 9TEREO_ : :
BURGLAR ALARM. . . . : X BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. .
GARAGE OPENER. . - - -. CLOCK. . . . . . .. . . . . Mr- DiCot-
1AVAC. . . . . . . . . . . . . DATA/TELE COMM. . : NURSE CALLS. . . . . . . .
VACUUM SYSTEM. . . FIRE ALARM. . . . . . .. OUTDOnR LnNDSC 1.. JTE:
OTHER•. HVAC. . . . . . . . . . . . .. PROTECTIVE SIGNAL.... . :
INSTRUMENTATTON. OTHER. . :
TOTAL # OF SYSTEMS: 0
Owner: FEES
TERRY REGAN type amoi-tnt by date rer.-pt
P R MT $ iio., 00 TnT
1 2 5 T!-I P L SPCT $ 2. 00 TAT 02/28/97 97-291-028
*T IC7PRP OR 97223
Phone #:
Contractor:
ADT SECURITY Al.-ARMS $ 4�7% 00 TOTAL
703 NE HANCOCt'\ REQUIRED INSPECTIONS
1-T)RTLAND OR 97212r;pi. 1 ing Cover Elect' 3, Service
hone 503-284-32F*,75 Wall Ccver Elect' 1 Final
# 000599
This permit is issued subject to the regulations contained in the
Tigard Municipal Cod,I State of Ore. Spec ialty Codes and all other Perm , t
applicable laws. All work "ill be done in accordance with
approved plans. This perv,it will expire if work is not started
within 18@ dayi of issuance, or if work is suspended for iore
Is �-ied By
than 16 days. .-OWNER INSTALLATION ONLY
ie installation is being made on p-opet-ty I Own which is not intended for
_ale, leaso, or rent.. DATEt
'4NER' S SIGNATURE:
rf)NTP(-)CT9P INMTOi.i_nTION ------------
TGNATURF OF SUPR. ELECIN-
DATE:
2
TCENSE NO:
LIJ
Call for in,.jpection -- 639--4175
CITY OF TIGARD BUIL ING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framing -Mach.
Plbg.Und/Flr/SIFu Plbg.Top Out Insulation sect
Post/Beam St uct. Mach. Rough-in Gyp. Bd. -Bldg.
San. cc,R, ties Line Appr/Sdwlk Reins.
Other:
Date: _��% C_ A.M. P.M.P.M. Ent _.._
Address:
Tenant: Ste: MST:
SUP: _
Con w� - ,- MEC:_
PLM:
THE FOLLOWING CORP,E.CTINS AHE REQUIRED: ELR: a '
a
r
J
C7
W
J
Inspector: fr _� � Date:
APPROVED T DISAPPROVED/CALL FOR REINSP CF CO
JqCITY C)F TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by: b 4
13125 SW!-TALL BLVD Date Rec'd: qI
___
TIGARD OR 97223 PRINT OR TYPE �. ry
V- 503-639-4171 X304 Permit#:
F - 503-684-7297 7117 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED -RESIDENTIAL
Restricted Energy Fee........................................ $40.00
(FOR ALL SYSTEM',)
JOB Street Address Ste#
ADDRESS �����5�.5%i.� /�� � -(, _'
Check Type of Work Involved:
CitV/St to ' / T Ph ne# „ Y ❑ Audio ano Stereo Systems
� r
- — Name Burglar Alarm
c)? r� t ❑ Garage Door Opener-
OWNER Mailing Address
'seating.Ventilation and Air Conditioning System'
City/State Zip Phone#
-, lJ Vacuum Systems'
Name /Z3 2 7
AA SS�CURNTY SSERrIC1El,Qt `1(�:>C� \ ElOther- — —
CONTRACTOR Mailino A–deW OR ) 'TYPE OF WORK INVOLVED -COMN.ERCIAL
(503)28284.3M.3 —
(Prior to issuance a City/Stam Zip Phone# Fee for each system............................................ . S40.Ut
copy of all licenses (SEE OAR 918-260-260)
are required if Oregon oPtr,9tPf Lir,.# Ex . ale
expired in C.O T — Check Type ;':Jork Involved:
data base). Electrical ontr. Lic # Ex ate ❑
Audio and Stereo Systems
C.O T, or Metro Lic.# Exp Date ❑
Boiler Controls
Owner's Name
_ ❑ Clock Systems
OWNER - Mailing Address
❑ Data Telecommunication Installation
APPLICANT
City/State Zip Phone# I f l Fire Alarm Installation
This permit is issued under OAE 918-320-370 This applicant agrees to J L❑J HVAC
make only restricted energy installations(100 volt amps or less)under this
permit and to do the following ❑
Instrumentation
1 Only use electrical licensed persons to do installations where required.
Certain residential and other transactions are exempt from licensing ❑ Intercom and Paging Systems
These have asterisks(') A'I others need licensing;
Landscape Irrigation Control'
2 Call for inspections when installation under this permit are ready for
❑
inspection at 503-639-4175; u Medical
3 Purchase separate permits for all installations that are not ready for an ❑ Nurse calls
inspection when the inspector is out to inspect under this permit;
C- 4 Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting'
cc inspector are done,and; ❑ Protective Signaling
t-
5 Assume responsibility fLr calling for a final inspection when all of the
h corrections-ire completed E:] Other_
Permits are non-transferable and non-refundable and expire it work is not
started within 180 days of issuance or if work is suspended for 180 days Number of Systems
r�
JThe person signing for this permit must be the applicant or a person No licenses are required Licenses are required for all other installations
authorized to bind the applicant — —
• FEES:
ENTER FEES $
Ignatur
5%SURCHA7.:3E(.05 X TOTAL ABOVE) $ r21 GY�
Authority if other than Applicant TOTAL t L
aesele dcr. 12/911