Permit , v CITY OF TIGARD
ip
ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00018
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/23/2008
PARCEL: 2 S 102 C D - 05300
SITE ADDRESS: 13899 SW 95TH AVE ZONING: R -4.5
SUBDIVISION: FLETCHER WOODS LOT: 003 JURISDICTION: TIG
PROJECT: C & L PROPERTIES
Project Description: installation of audio, security, and data systems
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: X BOILER: LANDSCAPEIIRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA /TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: DATA : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
C & L QUADRANT SECURITY INC
11755 SW CLIFFORD PO BOX 14833
BEAVERTON, OR 97008 PORTLAND, OR 97293
Phone: 503- 646 -1309 Contact #: PRI 503- 234 -5558
FAX 503 -236 -2322
FEES Reg #: ELE 26- 565CLE
LIC 96806
Description Date Amount
[ELPRMT] ELR Permit 1/23/2008 $75.00
[TAX] 12% State Surch 1/23/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: �� - Permittee Signature: 4 - --
IX -X
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 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Application , , I !'-i FOR OFFICE USE ONLY !
't i'' 1.. �. p..
r Receiv i
�` City o f Ti 11► Permit No.:
a Date /B /�7 ♦ ���, ��
_ 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready /By: lurk: f See Page 2 for
Internet: www.tigard - or.gov Notified /Method: Supplemental Information
_ • TYPE 'OF WORK PLAN REVIEW
New construction ❑A ddition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
. • ' =OF;, CONSTRUCTION j , . . • exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
X - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
a ❑ Emergency system. larger separately derived system.
JOB O :INFORMATION :AND LOCATION! . ': the I00HP or more. occupancy.
❑ Addition of new motor load of
Job no.: Job site address: I f // 1 1
❑ "A", "E ", ' l -2", "I -3",
Clq p �iJ 1 197 ;
p ) / ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /Stale /ZIP: � ( / ❑ Health-care facilities. ❑ Supply voltage for more than
/l ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: (' _:_,« ' ❑ Service or feeder 600 amps or more.
-' / FEE • SCHEDULE
Cross street/directions to job site: Fled'- X in )c _. - 1 S Description I Qty. I Fee. I Total I
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.:
1,000 sq. ft. or less 145.15 4
Tax map /parcel no.:
• •: 'DESCRIPTION OF WORK ' .- Ea. add'I 500 sq. ft. or portion 33.40 1
k)a �()_lEj -'- fi r�Jri. ;.{:0;(aj
/l Limited energy, residential
0 :(X. / l✓ (with above sq. ft.) 75.00 2
PROPERTY. •_• I _ 0- :TENANT •• . • • • n Limited energy, multi - family
Name: t: r C4---z- J!� �� residential (with above sq. R.) 75.00 2
— = III
Address: (( - 7 Sc .G. i C if Services or feeders installation, alteration, and /or relocation
City/State /ZIP: „�,J !G ` � �� q7 8' 200 amps or less 80.30 2
Phone: (s--0' ) (-co — ( "Vo-e t Fax: ( )
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 106.85 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Owner signature: Date: 401 amps to 600 amps 160.60 2
❑ APPLICANT`. .'. , • • EL C ONTACT PERSON . •
Business name: C__.,,j -- L prof i .i,\ 601 amps to 1,000 amps 240.60 2
Contact name: �� �
Address:
Over 1,000 amps or volts 454.65 2
City/State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax:: ( ) 200 amps or less 66.85 '1
E -mail:
.... .. ' .a'CONTRACTOR • .. . . -
i' 201 amps to 400 amps 100.30 2
Business name: a )7(7 1 ” eYS
Address: p( L5 / r � z.._.....,----.)
401 amps to 599 amps 133.75 2
City /State /ZIP: p / (V cJ ,—(9,_:,:-.5- Branch circuits - new, alteration, or extension, per panel
3-
Phone: (J( ) .,„3/1- '� 5 l S Fa ( � - 6 �� t- 3 ) 7 7 ? A. Fee for branch circuits with
1C�C above service or feeder fee,
CCB Lie.' f 1(2 /jt ✓+ �' i Electrical Lic.: (1 51u �( _ Suprv. Lie.: ,..3W-/. each branch circuit 6.65 2
` B. Fee for branch circuits
Suprv. • Electrician • signature, required: ,. � tvilhotit service or feeder fee, 46.85 2
J i first branch circuit
Print name: W / �
0 , /7.4(1 }r r Date: I a
j / ��' ! / ( Each add'I branch circuit 6.65 2
Authorized signatur ,�Q j i %J / e, �t /I�
. (' t � /!� f j2.s/O
^ Miscellaneous (service or feeder not included)
Print name: � f/�/ �� Date: t
I:\ Building \Permits \EI_C- PermitApp.doc 05/23/06 440 -4615T( I I /05 /COM /WEB
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CITY OF TIGARD a
BUILDING DIVISION : PERMIT #: FLR7OO8- 0001a
. 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:,, 1123/2008 ,
Phone: (503) 639 -4171 u i �
Inspection Requests (24 Hrs.): (503) 639 -4175 �..'J am m•JI
INSPECTION WORKSHEET FOR DATE: 1/2'200& TIME: 7 :02AM PAGE: 62
SITE ADDRESS: 13999 SW 96TH AVE CLASS OF WORK:
SUBDIVISION: FLETCHER WOODS LOT #: 003 TYPE OF USE:
PROJECT NAME: C & L PROPERTIES
DESCRIPTION: installation of audio, security, and data systems
OWNER: C & L, PHONE #: 503 - 016 - 130g
CONTRACTOR: QUADRANT SECURITY INC PHONE #: 503.2345558
Inspection Request Scheduled For: Date: •I129/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage Q 061077 -01 503.234 -5658 N
Corrections/Comments/Instructions:
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PASS I I PARTIAL APPROVAL 1 I CANCEL Il NO ACCESS
l FAIL I I CALL FOR INSPECTION I I ADDITIONAL F ES ASSESSED
Inspector: UrlitAj Date: 1 1-6 Phone #: (503) 718-