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Permit
CITY OF T I GA R D ELECTRICAL PERMIT - RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT #: ELR2004 - 00001 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/2/04 SITE ADDRESS: 12426 SW ASPEN RIDGE DR PARCEL: 2S110BC 07800 SUBDIVISION: THORNWOOD ZONING: R - BLOCK: LOT: 049 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: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 0 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 #: SEIP1- 5551;211JLE LIC 96806 ELE 26- 565CLE FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 1/2/04 $75.00 Elect'l Final [TAX] 8% State 1/2/04 $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 J / /f / ii 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 12/31/2003 16:22 5032362322 QUADRANT SYSTEMS PAGE 02 E ,�tP�Ca� Perm A " i l [ FOR OFT [1SI. ONLY ' Received r•'� ' " Electrical �� Datc/By: 0 : 6 Permit No. a ©p c�_ 000 "/ Date / n A rdv tl City of Tigard 1 ^ Planning pF Sign 13125 SW Hall Blvd. �� 3 y L Date/By: then No.: Other Tigard, Oregon 97223 O �,�� Date/By: Permit No,: Phone: 503-639-4171 Pax: 503 598 f �v"' • Post- tzcview Land Use _ Internet: www- ci.tigard.or.u.s O`�- "'' h' " l'!'li ' Contact "' � Datc/B Y+ Case No.: �� � � _ � � Juri s.: 24-hour Inspection Request: 503 .; See Page 2 for Namc/Method: G Su lementai informafloti. +.!p_lrli l �� i li [ ��� i �� +1 � 91 'l' • �'litl 9 E�, r `� I' +�F + f "�f. ti�leU� t�ti @ °�iu�' S y y ]Fiii i � °t r u,.� .J M ,, „ilt: ,V a a �, , kl'' ri r' ili rs 1 a ' c+il; Y., ,;'M.:�1 {: , �t:. ,4;;:r1tlf!�. +Y. } i ..,.� r p•, -�. 'tom �• _ � 1 / q y ti 1 --� � rt � �y. ' 41��it�T' It: �. rl���Fi }�?..tr �: a. ..:... • Demolition lJ Service over 225 amps- OD Health -care facility I Addition/alteration/re •laeerx> 111111 Other: commercial ❑ Hazardous location " • l'; ;' j' i';''' Y: j.Gh:rairt • l „ ;1 :I YN G' 0 , 4 , , 10 ., ❑ Service over 320 amps - rating of ❑Building over si 000 square i;.::!1, iir'•i r. ® ? ;.:� 'i., : r; I Sc 2 family dwellings four or more residential unite rti Z. I & 2- Family dwelling • Commercial/Industrial ❑ System over 600 volts nominal one structure ❑ Building over three stories ❑ F eeders, 400 amps or more 111 Accesso . Buildin ' Multi- ,1 ildi h p n Occupant load over 99 persons ❑ Manufactured structures or RV park _ ■ Master Builder El Other: ❑ Egress/lightingplan ❑ Other: °r ''I , Otr i ,')1 D ." � i ,@ 'r' .'l t a 1Kli' : Me 1g g Submit ,� � y� JIB: 1 ' ��'��;�' {1!` " ,.'t ` sets plans „ .,,,S,,O,kr, p any of the above. Job site address: 242 r � '� : The above arc n livable to tem.ore construction Service. l AS v :`i'3 �,'' ' :" 'i';S N ?''�Mk1' �'�'',..�FuVliF as � � "1 r a :.�ihe . �_ Suite #: �Bld.g. /Apt - #: l.�'. l,' N � ii �,. -� � r:r.� Number of inspections pe permit allowed Pro Nam t Descr tion I Qty Fee(ea.) Total Cross street/Directions to job site: New residential- single ormulti- family per y dwelling unit. includes attached garage. . Service Included: 1000 sq. ft. or less 145.15 4 Each additional 500 sg. ft- or p ortion thereof 33.40 ' ( 1 Subdi,ViSiOn. Limited energy 7 j �W1'JQ'�. riot residential I 75.00 ' L. 2 Limited energy, ilea residential 75 00 2 Tax ma,/ arcel #: _ Each manufac Tax q , � "� g���,� _ _ _ ltrred home or modular dwelling - ,..n , ,,2„ Tamar .7.J11,1f U4r1NlG'� .1;et'.1��i l0 s lGr rK° , "'� ' .3 � n lyilY?rlE:$�i u i, " 6� service and/or feeder 90.90 2 Services or feeders - Installation, - -1 `"'t ► di 0 ' I_! )— d Lt !,4(. 4 fti alteration or relocation: / 200 amps or less 80.30 2 201 amps to 400 amps to6.as 2 401 amps to 600 amps 160.60 2 ' pp�� �'�� ;��,, r l•.�`lUi.'G 1..'1 a 7 m �' I l t 3 r11 1) Bf 0 L ,d r r',:,':1 rp r y -�,4:.,.� 601 amps to 1000 amps �.k 9 iaiS. 5�i5a,eu1�! %3x>3,;,U,;,,z:,!.:' r: �i 240.60 2 Over 1000 amps or volts 454.65 _ 2 Name: Reconnect only _ 66.85 — 2 — Address: Temporary services or feeders - installation, City/State/Zip: — • alteration, or relocation: 200 amps or less 66:85 I Phone: F ax: 201 asps to 400 am _ 100.30 2 aP '+ a , ,••n , , 401 to 600am e - • rt tl ., .. 4 it a tilt ke G ,i I 1 I� �`" • ° " "l' p', R 133.75 2 "n / R- . r 1 t�'�" '�t�`- a' '`� I' ' "FpW",' Branch circuits - new, operation, or __ Name: W ) . f i . , v,;(d.WIZIMMAINIIII extension per panel: Address: S 33 A. Fee for branch circuits with purchase of � n__ service or feeder fcc, each branch circuit 6.65 2 City /State /Zip: i.(1/ric (] ie e17-1, B. Fcc for branch circuits without purchase of service or feeder fcc first branch circuit 46,85 , 2 Phone: '?� 58 Fax: T 2 . ' • Each additional branch circuit 6.65 2 E-mail: Misc,(Servicc or feeder not inbluded T li 1t3r7B 71!SN k f,1�r �^ �' F} t 114 fir' Ar * ac um irri$ )' 53,40 2 �iltrlLE�ItIi .�1 +� F`.:�]� m �.2W ' j .,�' P � ,ytul.lil:itif e :;1•l,tti {i�s.s�ty h a °�ot'i.C.4ir' F h si ar or outlihe aci 1 gn Job NO: 53.40 2 S ignal circuit(s) or a limited energy panel. Business Name: � � alteration, or extension Page 2 12 t I.4, ' .1. 1, A Description: Address: Po (I -i-$33 ^ C1ty /Stair /ZipQ -� q '��GJ 5 }each additional inspection over the allowable in any of the above: Per inspection r er hour (min. 1 hour) r 62.50 Phone; / . Fax: 2 (P 2 22 Investigation fee; ..' CCB Lie. (y� " e. #: ZI2 CU--; Other: Je.1.C. #: 1 � ivU r Li r . ��^7 • e. k s-r T"C7 � p. - r *rr.. , Y n p g electriciary '.1.. 1 { I .� �y , C L iSlll _- L .:J,i i tarOV 7 i !i7fS'.Pti 7l�'! 1Ji,tl 4t 'i � "'irf 'i .. . Subtotal $ `� DO signature vA Plan Re view (25 %of Permit Fee) $ . Print Name: ( (h ji,Li k tar Lie. #: / ;/ ( 1. C./— _ State Surcharge 8% of Permit I'ee) $ TOTAL PERMIT FEE $ Authorised 1 i + Notice: This permit application expires if a permit is not obtained within Signature: I. 1 d- _ Date: 1__gllia 180 days after it has been accepted ns complete. A it ''Fcc methodology setby Tr9- County Building industry Service Board. - Please print name) i: \ Dsts \Permit Forms \ElcPermitnpp.doc 01/03