12933 SW FALCON RISE DRIVE ADDRESS:
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i:'recordslmicrofimltargetslbuilding.dcc
DEPARTMENT OF LAND USE&TRANSPORTATION
WASHINGTON LAND 155 NORTH F RSTDEVELOPMENT
H I.LSBORO,OR 971SERVICES 01'. 24
COUNTY INSPECTION REQUESTS: 503/640-3561/693-41!6
PHONE: 503/648-8761
UF OREGON Pace i of 1
Date 02/08/93
Time 15: 35
Permit Type Residential Electrical Permit Permit 4 t 05037378
Permit Status APPROVED Applied 02/08/93
Situs Address 12933 SW FALCON RISE DR TI Issued 02/08/93
Permit Title SFR - ELEC/BUP.GLAR ALARM Completed :
Permit Descr . LIMITED ENERGY '.co Expire 08/u7!93
Project Title SFR - ELEC/BURGLAR ALARM Project # P00289'.;8
Project Descr, LIMITED ENERGY * EROSrON
Parcel Number 251TI - Land Use District: :
Valuation 0
Legal Descr.
Owner INSPECTION - TIGARD Construction OTH
Applicant Name PROTECTION ONE Clausification 900
Applicant Addr. : 15500 SW 72ND AV Occupancy R3
PORTLAND, Ulf 97224 Validated b-i s KF
Applicant Phone : b24-0244 Inspector Are" :
CONTRACTOR : PROTECTION ONE Lic. C 34-232C b24-0244
Fee description Units Fee/Unit Ext fee Data
--------------------------------------------------------------- ----------------
Limited Energy/Alter. /Extension 1 40 . 00 40. 00
Subtotal Electrical Fees : U 40 . 00
State Surcharge of 5% 0 2 . 00
Total Electiical Fees : 0 42 . 00
*** Fees Required +* *** Fees Collected & Credits **�
----------------------------- ------------------------------------------------
Receipt No. Date Payment.
02/08/93 42 . 00
TOTAL THIS DATE ********* 42 . 00
Fees : 42 . 00
Adjustments : , 00 'Total Credits : . 00
Total Fees: 42 . 00 Total Paymentst 42 . 01
Balance Due: au
NOTICt: This perfnM brumes null and void If tfte work or construction for which It Is Issued Is not commenced within 180 days, once construction hos started,
the permit becomes null and void it conetWlon to Interrupted for a period of ISO days. 1 certify that the Information presented by the applicant and
his agent or agents In support of talo permit Is true and correct to the beat of our knowledge. I acknowledge that the ew!ding Denartmsnt'F reliance
upon taloa and misleading Information may Invalidate this permit. All provisions of applicable laws and ordinances governing:ne conetructlo,i and use
of this building or structure will be compiled vdth whether or not specified on the plans or noted on the pians correction sheets. I acknowledge that
the granting of a permit dors not grant authority to access private property or to use easements. I further acknowledge that the,sae or(.�cupdncy of
the structure or building permitled depends upon my calling for Inspections at various times during the process of construction end trip-building
Inspection staff vsr!fying compliance with the variouo codes. Use or occupancy of the t Wiling or stnicture permitted prior to approval)y the
Building Deportment Is solely at Lite risk of the appCcant and such use or occupancy Is revocable until all Inspection requirements are satisfied and
approval Is glvnn by the Building official. I further acknowledge that a lipr may be placed o:. no:lila of the property upon which the pt,rmlt IF Issued
specifying that the use or occupancy of the building or structure Is p.ov clonal and revocable until the sallgfactlon of NI Inspection requirements.
APPUCA MS SIGNATURE
Militia
WASHINGTON COUNn' RESTRICTED
Department of Land Use & Transportwtion
Electrical inspection Section
155 North First Avenge, #350-12 ELECTRICAL ENERGY
Filliaboc a, Ot .goo 97124 APPLICATION
Information: (503) 640,U70 �a.�c: (503)693-4412
PLEASE PRINT
• . . -�3
1. Project No._.------ Permit No.
I. Locatlim of installation Label No. _ Date __�
FA
Issued By _ Office _
Address �,�9I � S_0__rA�k 4 1� i021
city 116A K 0 Zip Code %"3 4. Type of work:
Thomas Map Book; Page ,— Section RESIDENTIAL Restricted Energy Fee $40.00
(for all ayatems)
Directions _ _ Check type of work involved:
Commercial E j Residential _ udio and Stereo Systems"
Tenant Name V Burglar Alarm
(it commercial) Telephone Systeme*
This permit becomes null and void If the work authorized by the Garage Door Opener*
permit Is not comment J within 180 days from date of Issuance F=ire Alarm
of such per mil or It thr!work Authorized Is suspended or abandoned Heating,Ventilation and Air Conditioning Systems"
at any time after work Is commenced for a period of 180 days. Vacuum Systems"
Electrical Perrnalts are non-refundable and non-tranaterable. Other _
2. Contractor ap licatlon:
24 Q� (ati 6��. �- COMMERCiAL Foe for each system $40.00
Electrical Contractor (see OAR 918.260-280)
Address _15SW__ 1.1 Af
Date Joh Number _ Check type of work Involved:
Pruaerty O.„ner ------ ----
Contractot , mse No. _ Boiler Controls
Contractor _ -•)ard Reg. No. _ Clock Sys
Phone No. Data Telecommunications Installations
Fire Alarm Installation
3. Owner application: HVAC
Instrumentation
Print Owner's Name Phone No _ T Intercom and Paging System
Landscape Irrigation Control"
Address - -- ----� -� - — — Medical
Nurse Calls
r _ talo ___71_P - Outdoor t andscaoe Lighting"
This permit is Issued under OAR 918-320-370. The applicant agrees Protective Signaling
fn make only restricted energy Installations(100 volt amps or less) Other
t unc this permit and to do the following: -----
1. ',nly use electrical licensed persons to do installations where
required. (Certain residential and other transactions arms exempt Number of Systems
from licensing. These have asterisks('). All others need licens-
ing.) •No licenses are required. Licenses are required for all of-ger Installations.
;�. Call for nn lnspectlon when r+rl the ins+allallons under this permit e+7
are ready for Inspection.
3. Purchase separate permits for all installations that are not ready 5. Fees (�l`1 /�,
for I.r spect/on when the Inspector la out to Inspect under this Enter fees $ / v' w
permit.
4. Assume respornlbllity for assuming that of/corrections regv'red ??
by the Inspector are done,and 5% Surcharge . 05
S. Assume reaponsihility for calling for a final Inspection when all of g (U5 X total above) $
the corrections are completed.
The person signing this permit must belhe applicant or a person Total $
authorized .b/nd thsepplicant. \
signature Space below reserved for validation.
Authority N olhnr than applicant
For inspections call
640-3561 or 693-4415
244,nur recordrer,one working day In advance of need