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Permit CITY O F T I GA R D ELECTRICAL PERMIT - RESTRICTED ENERGY Y k DEVELOPMENT H B Tigard, SERVICES (503) 639 -4171 DATE ISSUED: 10/9/03 03 - 00310 - 13125 SITE ADDRESS: 13715 SW 124TH AVE PARCEL: 2S103CC -06100 SUBDIVISION: WHISTLER'S WALK ZONING: R -4.5 BLOCK: LOT: 008 JURISDICTION: TIG Project Description: All encompassing low voltage. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: X BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: X CLOCK: MEDICAL: HVAC: X DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: X FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: : X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: Owner: Contractor: DON MORISSETTE HOMES QUADRANT SYSTEMS 4230 GALEWOOD STE #100 PO BOX 14833 LAKE OSWEGO, OR 97035 PORTLAND, OR 97293 Phone: 503- 387 -7538 Phone: 234 -5558 Reg #: SUP 1211JLE LIC 96806 ELE 26- 565CLE FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 10/9/03 $75.00 Elect'I Final [TAX] 8% State Tax 10/9/03 $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 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699. Issued by � Permittee Si nature Y Ems . /.. g C"Lp c l _ 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 i.2E/2Oi 3 12:54 • 5032362322 QUADRANT SYSTEMS PAGE 02 Electrical Perpation FOR OFFICE USE ONLY Received � , Electrical B Datc : t 43 I Permit No - 0100'3 -0 0 3/0 I City of Tigard Planning A.p •val Date/D ; Eillil 13125 SW Hall Blvd. OCT 8 2003 Plan Review Other Tigard, Oregon 97223 Date/E1 : Permit No,: Phone: 503-639 -4171 Fax: 3P, ?9RD Post - Review land Use Datc/B : Case No. Internet: www.ci.tigard- orml3UILDING DIviSI., r I • I Ii : ' Contact el See Page 2 for 24 -hour Inspection Request: 503- 639 -4175 - NameRvlethod: Su Iemental lnformatioti. • �� JRA. ; j,af.• !r` li " ' `• :. " .: i �+,F4 ,h F7t`+ Y "7 - . . s - 7,105':-;' 1 y��r'���py,� t � ay a �� 't � ?r'• r �: ��� Kt��'�� ;,'l�•. ,,. 3£�;�` a il'i�'ii�jw�`^,.,�.T: 2 . �ii,:: � : 1�.:.,oJS�idi "11 ... 6 ' . ,�r�r t � �•, � i ,, •�y,. �.i��. +r.' ;I New construction • Demolition ■ Service over 225 amps- ■ Health -care facility commercial ❑ Hazardous location IN Addition/alteration/re lacement • Other: [] Service over 320 amps - rating of 0 Building over 10,000 square feet, pk7 ' ' a,i .ltla'0 "' a•OE.G 1 '3 I• a i o T r* ail it 4.;' i,�� - „�� „ .�+.LAkr4` 1.; "_. ; 1 & 2 family dwellings four or more residential units in 1 Sr. 2-Family dwellin - Commercial/Industrial El System over 600 volts nominal one structure y 0 Building over three stories ❑ Feeders, 400 amps or more • Accesso Buildi _ - Multi -Famil 0 Occupant load over 99 persons ❑ Manufactured structures or RV park • Master Builder © Other: ❑ Egress/lighting plan ❑ Other: _ 4 , t/ ;�y ; , 9• 1 .,�. Submit sets of plans with any of the above. �'� "� � � � � � ,`�' - moo' - © ? . a,•.yti 71te above are not a licable to tem orar construction service. Job site address: 13 '11 C S� I . - 4 T v 4 I.' t MiE.M z'li`f T :ifi t .1;•, , ar . Suite #: Bldt. /A•t. #: Number of inspections per permit allowed Project Name b ' i rYt- t 7 . 4 4 - a / J c , Description Qty - Fee (es.) Total i Cross street/Directions to job site: New residential- single or multi- f *nrily per l dwelling unit. Includes attached garage. r t Ct 1 e.' Service Included: 1000 Sc- it or less 145 -15 4 Each additional 500 sq. ft. or portion thereof 33.40 I Subdivision: S } �� 5' 4s ,x,%-14_ I Lot #: Limited energy, residential I 75.00 s, d 2 Limited cress, non residential 75.00 2 Tax ma. / . arcel #: Each manufactured home or modular dwelling e��r��q�,g W -t ., - 1 ° ° ; service and/or feed: 90.90 2 k'�l.' s �`' I�lf +sir Q ., �. Q' �8 �r� ���� :�r� "�'��,EJ.�� • ',' o'dYCiEkSrrr :LL �f,� �. J Services or feeders - installation, J ■( G.fr�, ltrl t; - 4.0181 alteration or relocation; UU 200 amps or less 80.30 2 er-.4.u ruA d;- 201 amps to400amps 106.85 2 401 amps to 600 amps 160.60 2 .1 ,.":,.7qaT 1 041 ', _ lti lM.g'i 1 *Mbs'1J:'.7' s' fi3l :I I r,. . F ' Ovc 1' 400at 454.65 2 Name: 46.11. _ m1I1 Fti _ Reconnect only 66.85 2 Address: Temporary services or feeders - installation, alteration, or relocation: City /State/Zip: 200 omps or less 66.85 1 F ax 201 amps to 400 amps 100.30 2 Phone:5 c. 4 l S En t 600 amps 133,75 2 � ��� f �. I r 4 t;yry"S u a r1 I�j i t) °i ni 'f 1 CFG' 1t i�+ ; 1 51 p .i�a.i,����C� ��illuL��+.! L�i�J.,.�.�- ::iu Branch circuits - new, alteration, or Name: extension per panel: Address: A. Fee for branch circuit: with purchase of service or feeder fee, each branch circuit 6.65 2 City /State/Zip : B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit _ 46,85 2 Phone: Fax Each additional branch circuit 6,65 2 Email ' Misc.(Scrvicc or feeder not ini:luded): p•a„ t rZ F F a - 4' - � - "+f"•":n: ti lT x 7` ,' Each trump or lira Lion circle 53,40 2 `il Vii' 1k r.t, a iJ i c. c tlhr w) a' 41 ; u i ,:r, fu.v — ,L., , ,s �, � t.Sll �,c,i „ i� iw,�l..},.I£. • M;.a� il:� ,a.i1 tw .It _ -.w, i_., e a._. . � Each sign or out lighting 53,40 2 Job No: y Signal circuits) or a limited energy panel, Business Name: �a YC- ��, c S alteration, or extension Page 2 2 Description: Address: Po I •F (i3 City/State/Zip: �., t .c• o�r.eQ , Q r 9 -4 Z �3 Each additional inspection over the allowable In any of the above: inspection per hour (min. 1 hour) 62,50 Phone: dat s'1- 3'5 - cf Fax: 503 -d 3 b . 3 lnvc-sti: ation fee: CCB Lie. #: 'LPL- Lic. #: 12.-I l Lfiq Other: t`'s `y } �.,..� to .. 7(4 1.•: ALL. Fi of �,!' �I Ii,1.. ...af {�i.. l:. 3 +t ^i i 1 MY: af'. 7 Supervising electriaia I //.. Subtotal $ 7 OU signature required: c -t/l r Plan Review (25% of Permit Fee $ Print Name: 4 i;r1 n'l+ i I f✓- I Lic. #: ( ,/ ( ( -,/ - State Surcharge (8% of Permit Fee) $ to .6 TOTAL PERMIT FEE S el, (1.J Authorized Notice: This permit application expires if a permit is not obtained within Signature: I -L• b hti 7 i r- — Date: 16 le k 180 days after It has been accepted as complete. *Fee methodology act by Tri- County Building Industry Service Board. (Please print name) is \Dsts\Per mit Forms \ ElcflermitApp.doc 01/03