Permit \ A . CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
A-tir ro DEVELOPMENT SERVICES PERMIT #: ELR2003 -00017
13125 SW Hall Blvd.. Tigard. O 97223 (5031639 -4171 DATE ISSUED: 1/24/03
SITE ADDRESS: 12750 SW 68TH AVE PARCEL: 2S101AD -01300
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 033 JURISDICTION: TIG
Proiect Description: Job No. 2827
Tenant Improvement - Audio & Security
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X INTERCOM & PAGING:
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: 2
Owner: Contractor:
HAMPTON BUILDING, THE LLC QUADRANT SYSTEMS
PO BOX 94 PO BOX 14833
CAMP SHERMAN, OR 97730 PORTLAND, OR 97293
Phone: 5541 -595 -2495 Phone: 234 -5558
Reg #: MET 00002466
SUP 1211JLE
LIC 96806
FEES ELE F$qe €$nspections
Description Date Amount Ceiling Cover
[ELPRMT] ELR Permit 1/24/03 $150.00 Wall Cover
Elect'I Final
[TAX] 8% State Tax 1/24/03 $12.00
Total $162.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 throuc
Issued by c,�!Yjil�al.e Permittee Signature
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 DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
1-23-2003 3 : 21PM FROM QUADRANT SYSTEMS 503 236 2322 P. 2
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[Electrical Permit Application IIIIIIIIIIIIIIIIIMIMIIIIO
. . Dat oceiv____424(1 Pent
Mt •
C of Tigard RECEIVED Project/appl. no.: . Expire date:
Addres: 1315 SW a
Cif) ofTigard • s 2 Hll Blvd, Tigard, On vizL_.
• Date issucci; • By: Receipt no.: •
• •
• Phone: (503) 639-4171 °
Fax: (503) 598-190 • . JAN 2 Case file no.: . .
.
• Payment type: H!-
2003 - • '''`ii
• •
immii mmitit. . 1Land use approval: CITY OF G
TIARD ue9
i......i
O 1 & 2 family dwelling or accessory liSECommcrcial/industrial • 0 Multi-family 0 Tenant improvement 1
O New construction 0 0 Addition/alteration/replacement 0 Other. • 0 Partial
3013 SITE INFORMATION . •
Job address: I so .s....1 tpe A f 4 u.,..er • , Bldg. no.: . Suitc no.: . Tax map/tax lot/account no.: •
•
Lot : J Block: • ' . • • . ;L
Project name As-444 Description and location of work on premises: (au. e..1 174- 1.1 , ',..19_,A l ' Lr
Estimated date.cgcompletion/inspecdon: • . • • im _ . _ . . 4 I 01
CONTRACTOR APPLICATION FE'. SCHEDULE
Job no; , . . • Fee
.
Business name: . Q. tnr.t.A4rryd- Z.1..tS.I.netS, . : Description Qty. (ca.) Total noOnsil
Ness reddened -skigleormaltl-family per . 1
Address: ',..,;),„..• I <f' - . • din:I:lingua Inch:dee attached garage.
City: ez4.4-k - ' Er2M ZIP: 9'42' 3 . serviccinchded; .
. 1!
Phone: ai - 4 , - Fax:.)/- E-mail: . 1000 $q. ft. or less • . ' . i il
Each additioni1500 pOrtion tliercof
CCB'no.: 0 1 . fat. I Elec. bus. lie- n-.- cit. v
' Limited energy, residential 2 IL
7
City/metro lic.. , • . ty,.. .5)(101,• . • tedenergy, non-residential -. 1-•
• /it?L - Qt .J.Sin 0.1 .
Each manafactured borne or modular dwelling • - !
• Signature of •. - ing electrician (requited) • Date Service and/or feeder • • • ....21 -
sup. dace_ name(pr ‘ y License R0 1 - 21 i L — Services or feeders-; Installation, • • . :I
.
alteration or relocadon: .
ZOO amps or less 2
• •
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Name (print): ° I' • . • .
• • 201 amps to 400 amps - • •
401 amps to 600 amps ' ' • • ._____.2
Mailing address , • • 601 amps to 1000 amps .• • . 2 .
City: . ! • I State: I ZIP: Over 1000 amps or volts il
Phone: : ' . 1 Fax: E -mail: 1 Reconnectonly . L_Lt
Owner installat4n: The installation is being made on property 1 own Umporiny serdons or feeders • • :2.
installation,alteration, or relocadom I!
which is not int4nded for sale, lease, rent, or exchange according to
zoo amps er less . .2 9
ORS 447, 455, 479, 670 . i n 701. , •
1 • . 201 anips to 400 amps 2
Owner's Si ; . • . .. Date • • 40I ro sop • ' •ri.'
Branclictrisitts -new,ulteration, • -
. ! . . or sattension per punch • . 11
Name: ' ; • • • A. Rotor branch circeits With perebaae Of
Address: I • . SetViC0 Or feeder fee, each branch circuit • • 2
. . • . 11—
City: I !State: 1 ZIP: brunch circuits without purchase .
of service or feeder fee, first branch circuit: . :2 ij
Phone: 0 Fax: E-mail: •
Each additional branch circuit: .
Afisc. (Service or feeder not Included): '
o Service ovcr22.5 inaps.oenunercial ' Health faciliti : . • Each po or itri : lion citc —
i
0 Service over3201unps-rating of 1&2 . 0 Hazardous loctition • Bichsign or outhting.2ine
family dwellings i ' CI Building over 10,000 S . . quare feet four or Signal citcuit(s) or a limited energy panel. : r
o System over 600 irons nominal • more residential units in one structure alteration, or extension* • A /5" " • IS
0 Ruikling over dile stories CI Feeders, 400 amps or more 'Description: ' . - — 11 - 0
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C1 Occupant load ovF 99 persons 0 Manufactured structures or RV park Each additional Inspection otter the allowable in any of the above: , !
„i 0 Egress/lighting Pilo Cl tither • Per inspection . 1 1 ---- L L.
•
Sabah — sets of plans with any of the above. . ' Investigation fee .
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The abeielire not applicable to temporaty construction service. Other . , . : 1 14 0_14 I .
1. at all jurisdictions uxfrpt Feat cants. pleats call jurisdiction for mom irtfonnation Notice: This permit application , P r nit fee .
0 Visa 0 • MasterCard erCard . expires if a permit is not obtained • riAn review (at • $ _L(1
..._. %) $ ______:___;
crust card samba: • i. /_____ within 180 days after it has * been • TO surcharge (8%) — $ :
accepted complete
• f '2.
. • . , Expires TOTAL $ I
as .
Name of eartholder as shown co eteeftt ca 0 rd • . .! 1
• 5 • . i
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. Amount . • • 440.4615 (6,400/Cat)
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CITY 0F 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date a gue ed l AM PM BUP
Location 0 2 ✓ o S4 s Suite MEC
Contact Person Ph ( ) S � PLM
Contractor Ph ( SWR
BUILDING Tenant/Owner 'Ei vv 19 ELC
„Footing oundation ELC
Access: /
Ftg Drain ELR G •-
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors Q/ .- 5( C L 1 i j )/
Ext Sheath/Shear 9 � 1 a
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
U .b
1 ow Vol
Fire arm
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspe ion RE: I Unable to inspect — no access
Fire Supply Line /
ADA Date
r
Approach/Sidewalk Inspect Ext
Other:
Final D I OT REMOVE this inspection record • om the site.
PASS PART FAIL