Permit CITY OF TIGARD ELECTRICAL PERMIT —
COMMUNITY DEVELOPMENT DEPARTMENT RESTRICTED ENERGY
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PERMIT #: EL R9 6 —0 181
DATE ISSUED: 06/03/96
PARCEL: 2S103DD -00700
SITE ADDRESS...: 13775 SW PACIFIC HWY
SUBDIVISION • ZONING:C —G
BLOCK • LOT •
Project Description:
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & RAGING..:
BURGLAR ALARM BOILER • LANDSCAPE /IRRIGAT..:
GARAGE OPENER • CLOCK • MEDICAL •
HVAC • DATA /TELE COMM..: NURSE CALLS
VACUUM SYSTEM • FIRE ALARM • OUTDOOR LANDSC LITE:
OTHER: .. HVAC • PROTECTIVE SIGNAL..:X
INSTRUMENTATION.: OTHER..: ..
TOTAL # OF SYSTEMS: 1
Owner: FEES
THE CABINET BROKER type amount by date recpt
13775 SW PACIFIC HWY PRMT $ 40.00 CJS 06/03/96 96- 280110
SPCT $ 2.00 CJS 06/03/96 96- 280110
TIGARD OR 97223
Phone #:
Contractor:
ADT SECURITY ALARMS $ 42.00 TOTAL
703 NE HANCOCK
REQUIRED INSPECTI
PORTLAND OR 97212 Wall Cover Elect'1 Final
Phone #: 503 -284 -3265 Elect'1 Service
Reg 4$.. : 59944
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm it ee Signature
applicable laws. P11 work will be done in accordance with � •
approved plans. This permit will expire if work is not started C �
within 180 days of issuance, or if work is suspended for more �—,� ,4
than 180 days. Issued By
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for
sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' N : f')/1 05r,hrr o n DATE:
.LICENSE NO:
Call for inspection — 639 -4175
•
' Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT # , RcJ6 -C(RI
/49,000 of 1 ;� Phone (503) 639 -4171
a I� FAX (503) 684-7297 DATE ISSUED -3 -96
TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY Cho rl -r telm;rill-
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTAL TION 4. TYPE OF WORK
/� 77� �f( , '
Addr , RESIDENTIAL — Restricted Energy Fee $40.00
/i.,,f_ n _ or, 9 (FOR ALL SYSTEMS)
City d State Zip 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
180 DAYS. ❑ Burglar Alarm
2. CONTRACTOR APPLICATION ❑ Garage Door Opener*
ADT SECURITY SYSTEMS.
MP
❑ Heating, Ventilation and Air Conditioning System*
Contractor 703 NE HANCOCK T ype C b- 12-YJ(-- ❑ Vacuum Systems*
PORTLAND, OR 91212 ❑ Other
Address 1503) 28443265
Date 5-241---9. COMMERCIAL — Fee for each system $40.00
(SEE OAR 918 - 260 -260)
Property Owner Id _ / dL / /_ %)_I _ _r Check Type of Work Involved;
Contractor's Board Reg. No. 57Cf /-57 ❑ Audio and Stereo Systems
❑ Boiler Controls
Phone # ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
_/1L A . di -. . . ... ❑ 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*
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 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 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 for a final inspection when all of the 5. FEES
corrections are completed.
Uo
The erson signing for this erm' be the applicant or a person p g g pp p a. Enter Fees $
authorized to bind the a is U U
4/., t b. 5% Surcharge (.05 x total above) $ -------
Signature TOTAL $ 1 7
Authority if other than applicant
ENERGAP.CHP
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /Flr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: 7 ,
Date: CO 1/7/ 9{o A. P.M. Entry:
_
Address: • ! S
i
Tenant: Ste: MST:
BUP:
Con /Own: la 0--C' - 340 Ii MEC:
C7 C ��J PLC:
�-C ELC:
THE FOLLO G CORRECTIONS ARE REQUIRED: ELR:
. 7 , ‹
__s_ � ,, (- e " e ‹ '� i �J.4 -_ f
J 4 Ins ector: 'A , • d — A c Date:w --l7 —(.r
APPROVED _ DISAPPROVED /CALL FOR REINSP. al CO
ffi7 p:C/