Permit F•
CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR2003 -00148
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/30/03
SITE ADDRESS: 13555 SW 124TH AVE PARCEL: 2S103CC -05500
SUBDIVISION: WHISTLER'S WALK ZONING: R -4.5
BLOCK: LOT: 002 JURISDICTION: TIG
Project Description: Installation of security system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: X BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE HOMES QUADRANT SYSTEMS
4230 GALEWOOD ST PO BOX 14833
STE 100 PORTLAND, OR 97293
LAKE OSWEGO, OR 97035
Phone: 503- 387 -7538 Phone: 503- 387 -7538
Reg #: NPBT- 55580002466
SUP 1211JLE
LIC 96806
FEES ELE Iic}a$nspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 5/30/03 $75.00 Elect'I Final
[TAX] 8% State Tax 5/30/03 $6.00
Total $81.00
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
tat
Issued by l i U Permittee Signature d'Al /j (
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
05/28/2003 12:36 5032362322 QUADRANT SYSTEMS PAGE 01
Electrical Permit Application' OF FICE USE °NIX
Received , Electrical
Datc/Ey: s /zel•3 , .if. . emit No.&7. -60/ re
City of Tigard Planning Approval
Sign
Date/By Pcrmit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 9722110608. Permit No.:
Phone: 503-639-417f - 960 Post - Review I.,[nd Use —
g �/ d r' �1 {
Contact Case No.;
Internet: www.ci.tigard.or.us 1 Date/By:
24 -hour Inspection Regt Y, 503 -639 - Su See eat 2 for
"r/-{ 2 Name/method: Supplemental Information.
,f r ' 200J
' ` ' cQ Q 0 e,1,2A VIEW.,(Pleas check'�t�U l<hataapp�v_),'; ,.
ya:t�
10 New construction i f !%�' Demolition Se rvice over 225 amps - Health.
carc facility
• Addition/alteration/re .lacement I■ Other: commercial D Hazardous location
; L Service over 320 amps•rating of 0 Building over I 0,000 square feet,
.�:
CONSTRUCTION • .. • . •- • 1 & 2 family dwellings four or more residential units in
.. !';;;:';'.7 s ,.:;!',.; � � !�GiYi;'il?E�i7ItX;011�
F7 1 & 2 -Famil dwellin • ■ Commercial/Industrial D System over 600 volts nominal one structure
111.Clukilts B • l.1 • 0 Building over three optics ❑ Feeders, 400 amps or more
�� D Occupant load over 99 persons
•
❑ Manufactured slructurca nr RV park
Master Builder • Other: 0 Egress/ighting plan ❑ Other:
j'OR,S ;;1(NkOR VIATION; n'}1`,Z;OCATION Submit seta of plans with any of the above.
Job site address: l 35 $ J S l� L( f� V2 The above are not applicable to temporary construction service, • Suite #: B -- j A r t. #: . , .. Er ; c, � SST E. 1, :. ��i 11.41 . ._ __.___F:::'..........
Number of inspections per permit allowed
Pro'ect Name: Description Qty Fee (ea.) Total '
Cross street/Directions to job site:
New residentlal•singlc or multi - family per
dwelling calf includes attached garage.
Service Included:
1000 sq. ft. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 i
Limited energy, residential 75.00 2
Subdivision: Lot #:
Limited energy, non residential 75.00 2
Tax ma./. arcel #: Each mane [sutured home or modular dwelling
2 1;1:7!41 <' . :' ; ily� ` S '+ 'T1OltlibF;WOR1 :; service and/ feeder 90
I rn ceder 90 2
Services or feeders - instaiiatlon,
a>< of I R • All alteration or relocation:
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
401 amps to 600 traps 160.60 2
tr M n :a K 1O' oat R l •;, ..i i� I v..!$i,itiYf..... 601 amps to 1000 amps 240.60 2
Over 1000 amps or volts 454.65 2
aloe: .6N rii S5 ar iMEs Reconnect only 66.85 2
Address: L S/ Ge LE S'`7 /ere Temporary services or feeders - installation,
Ci /State/Zi.: E OSzJJECo r , . 9 es
alteration,
amps or relocation:
66.85 1
Phone: Fax: 201 amts to 400 amps 100.30 2
401 to 600 amps 133.75 2
' C
�:a.ONx A C Ci 1<'>SON B ranc h c ircuits - new, alteration, or
Name: extension per panel:
Address: A. Fee for branch circuits with purchase of
service or teeder fee, each branch circuit 6.65 2
Cit . /State /Zi .: B. Fee for branch circuits without purchase of
Phone: Fax: service or feeder fee, first branch circuit 46.85 2
Each additional branch circuit 6.65 2
E -mail: Misc.(Scrvice or feeder not included);
,.6;. ~ :. ¢ . ,, • i ' ; r� i f
l. ; ' 1 , - . um fir i Ri (ion circle 53.40 2
•, , ,. � • •� � ..��. .., . ,. ��.t": 'Ni'Z?I2:��C, �d�;b' , ,,•,.. _ p p fa
Each Egn or outl light 53.40 2
Job No: . Signal circuit(s) or a limited energy panel,
alter or extension
Business Name: fi , „, e v v ) • • LA_ u - ....11 I Page 2 _ 75 2
Description:
Address: P. a . I r: 3 I
Cl /StatC /Zl • : P. a s 9 Each additional Inspection over the allowable in an of the above:
Pr in lion r hour min. 1 hou 62.50
Phone: Ta' — - ., 7� investigation fee:
Other
electrician Supervising elec �, � - .. : s ;;d,a.; '; ' c�9�1,��'i` �'a'�r,ti�x�iildi���;ll:rK ��c: �•EL •;�Lr= ::::;
// ll �. - . • _ Subtot $
si • store r- , aired: L fi(.' Plan Review (25% of Perth Fee) S �
a ' I ,,; State Surcharge (8% of Permit Fcc) $ _ t Q , (�
Authorized TOTAL PERMIT FEE $ q ( . Co
Notice: This permit application expires if a permit is not obtained within
Signature: Date: 150 days after It has been accepted as complete.
*Fee methodology set. by Tri- County Building Industry Service Board.
(Please print name) -
i: \Dsts\Pcrmit Forms \E1cPerntitApp.doc 01/03