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Permit
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ° A�1 DEVELOPMENT SERVICES PERMIT #: ELR2005 00368 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 4171 DATE ISSUED: 10/21/2005 PARCEL: 2S 109DA -11700 SITE ADDRESS: 12957 SW BLACK WALNUT ST ZONING: R -7 SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 106 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: Owner: Contractor: DON MORISSETTE COMMUNITIES QUADRANT SECURITY INC 4230 GALEWOOD ST. STE. 100 PO BOX 14833 LAKE OSWEGO, OR 97035 PORTLAND, OR 97293 Phone: 503 387 - 7538 Phone: 503 234 - 5558 Reg #: LIC 96806 ELE 26- 565CLE FEES Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 10/21/200E $75.00 [TAX] 8% State Surchar€ 10/21/200E $6.00 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 1 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699. Issued By: , 4 Permittee Signature: )-7.1 OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N DATE: LICENSE NO: Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. rI - EXectrical Permit A licati'on ��� • City of Tigard l lilt OFh 1( 1.: I M. c»1.1 13125 S W Hail Blu Tigard . Received o Phone: 5 03.63q.4171 Fast; x503.598.1960 ` bate/$ L, ,./ �� Permit No.: Inspection Line: 503.639.4175 2005 k "1��1 { fl`' Dete1B ' Inspection w ins: tigard onus ZOO;! •43 -_w Date Read /B Other Permit: 2 0 y y: ;t k � Fj a Nodtied/htcthod. NMI See Page o for Internet: r_ u ��, ..1:v. :`?: ',fl,.. ,"'� .4 "+w ti �'t?. o ��'�ol"`aSU•t•,l� ,�. ,,� Su. amen Information �IffY u �ific huff. I w '' .�{ Tr + n, " r ��fi ? r e dl! on New cons •ia: t :;rns.•. , � , i. a'^ -,. “ , • construction t H ' d.!�f. Jt, 7} YmZ�cr � 1 t Y3 � er g ' p y r . Q Demolition It � DIVISION QSer ment P lease c hock all that apply; �' :4-.-PI: * 1 0 , t e m° ' � P � .n' N, , vice over 225 amp F! 'd , t — - •, Yr - pr' ., e � C.4 .. a. com © te location 0 .. ,. !' '�`d�G R .M . *,2 e rr q.. n co .0, "t ") . . ,, ,,,.,� ceover3 amps 10,000 s l d 2- family dwelling •; � `."en� °..::� "�''x' •' . r. ❑ Servi n8 (]Builds over l q, `�sW• vaS° of 1- and over 60 ly dwellings 4 or more new residential tial g ❑ COrtlmtlrcial/fndustrial ❑ Accessory building 0 System Duty' 600 volts nominal units in one structure IN Multi-family ❑ Master builder s < " ° ' r at t� v K r ❑Other; ❑Building over three stories .1, t } y r ❑Feeders, 400 amps to more ' 1=. c :$ RY,. i "� s' e, = . . _: A • i t k + . 7 „ .., . ' • . y' "- s UQccu ant load _., ; r �,t3 a ; 0 i. u '. ' o , ' . 4 . > : a., .A .ve P over 99 persons O Par ciured structures or Job no.: 35 Job site address :l r7Egresa/iighting plan RV park ± . • CI Health-care facility El Other City /State/ZIP; 1 Submit 2 sets ofplans with any of the above. � 5`-r .r The above are not applicable to tam Suite/bldg,/apt. no.: Project 81e r w - r- „ , Poetry construction service. Project name: , 1 rite i ?:,^a : a, is' • t'.;pl °' ' • .. Cross Street/directions to job site: ~` nr.ertpuaa °�' "')1' •Qv, Eon Total '" New residential single - or mull - family dwelling unit. Includes attached garage. Subdivision; sail 1,000 sq. ft. or less 4 1 r Lot no. " q. R, or portion Tax map/parcei no 4 - L La. achrl 500 s III. 33.40 f ; , , rile : a^, Limited energy, residential 1 _...,,, ref : y net ,M `', � " : i iwi„ ,„,, s r.,s, r , ,::, Limited ens : , non-residential 5.00 . 2 L c_ , . t PA � . a ' ; a, ' e:;xr , Each man eular 75.00 • 2 I. ufactunedormodular II . 11116...„_.:. Cur ca dwellin service and/or feeder 90.90 1111 2 Se rvices or feeders installation a u r` ;3 ,rw s 0 ilia. a or nd/or relocation 20 r a less . v y?x f ePs 1 ,y 80.85 2 Name: 601 amps to 1,000 amps > a ,�. �IG.v?�s1... ,ti tiV +,µId , '' Y 20 t steps to 400 amps � 401 am -s to 600 amps 106.85 2 Address: 2 r 2 240.60 • 2 Over 1,000 amps or volts rN_ 2 City /State/ZIP: Reconnect only IN 66.85 2 Phone: ( ) Temporary services or feeders installation, alteration, and/or Fast: ( ) relocation Owner installation; This installation is being made on property that I own which is not 200 amps or less intended for solo l runt, g 66.85 l e, or exchange, according to ORS 44 449, 670, and 701. 201 amps to 600 amps amps to 400 amps 100.30 r Owner Signature: 401 2 Date: ? 5 �t� rt' ; :a' ;< ; te a s ' ( rf • tt '"1 W ;r --� Branch circuits - new, alteration or extension, • er panel b' r °,� ". • ` . 0 1 4 r s ' i` �7;'TO:, A. Fee for branch circuits with " x branch circuit t fu fee, each br Contact name: branch 2 B. Foe for branch circuits Address; without service or feeder fee, each branch circuit 46.85 ■ 2 City/State/ZIP: Each 1141'1 branch circuit r 6.65 Miscellaneous (service or feeder not included) 2 Phone: ( ) Fax: ; ( ) Pump or irrigation circle r 53.40 E nor out th 2 Sign :' m a ' S F ;y °x> ' 1 rrtk�J "' . r g line li _ S3 2 Sc *,V fa ; < o :— p Signal circuit(s) e r do limited- , or Business name: g :"t'a' !$r , • ; ; ; energy panel, alteration, or , l .g G - '' extension. Describe: Page 2 2 Address: y L - � .� tr ` I. n Each additional inn action over allowable io an of the above City/State/ZIP: At ) i Per inspection r 62.50 _� Phone: (t" )3 ) ^ L ) _ C, a F < (4 ^ ° Investigation . cr hour (1 hr min) MI 62.50 (50 3 )03( Indundul plant per hour �� CCB L1� " : r 7 ' 55 3 1.i Electrical Lic.:�� r oe Suprv. Lie. : , 5 C "} 4 k S. ' �t� . ' x ' � Suprv. Electrician signature, required: Ai ir subtotal reaMI a. ...... 4 - ) � J ,� Plan review (25% of permit fee) Print flame: {r Date: I 2 � OM State surcharge (8% of permit fee) , c* Authorized signature: 7 ` ex TOTAL PERMIT PEE �� e r �t '�, This Print nume: r� 1 i (� /� . ltermlt application expires If n permit la not obtained within 184 CA I�3tt ' a day - after It boa been accenttd ae complete eQ . • Fee methodology set by Tri County Building Industry Service Board islauildinalPer ,rtityl,C.pm„iipPAdoc 12.003 " Number of inspections per pernut allowed. 440.461311(1 otovCOMrvrea CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2005 -00368 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/21/2005 Phone: (503) 639 -4171 ay/1N i Inspection Requests (24 Hrs.): (503) 639 -4175 �..' .. ° INSPECTION WORKSHEET FOR DATE: 11/1/2006 TIME: 7:06AM PAGE: 102 SITE ADDRESS: 12957 SW BLACK WALNUT ST CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 106 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE NO. 2 DESCRIPTION: All encompassing low voltage. OWNER: DON MORISSE I I E COMMUNITIES, PHONE #: 503 -387 -7538 CONTRACTOR: QUADRANT SECURITY INC PHONE #: 503. 2345558 Inspection Request Scheduled For: Date: 11/1/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 019919 -01 503 - 2345558 N Corrections /Comments/ Instructions: 4 • • K DASS _____ PARTIAL APPROVAL CANCEL ❑ NO ACCESS FAIL I � CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspect., : 1_ Ali�� Date: `7 Phone #: (503) 718- Inspections Required for: ELR20O5 -00368 • Code Inspection Description PASS Date By ✓ Code _ Inspection Description PASS Date By BUP - Building Permit ELC - Electrical Permit 405 Excavation 105 Underground/slab cover 410 Fill 110 Temporary electrical service 415 Grading 115 Electrical service 205 Footing 120 Electrical rough -in 805 MFG - Structure • adin: /footin • 125 Wall cover 210 Foundation walls 130 Ceiling cover 215 Footing drain 135 Low voltage 220 Slab 140 Sign installation 310 Crawl drain 145 A/C or heating unit circuit 225 Post/beam structural 150 Hot tub /spa/pool 230 Underfloor insulation 195 _ Misc. inspection: 235 Shear walls /anchors 199 Electrical final 240 Exterior sheathing 245 Firewall ELR - Restricted Energy Permit 250 Roof nailing 255 Wtr proofing basement walls X 135 Low voltage 260 Tilt -up panel 195 Misc. inspection: 265 Masonry X 199 Electrical final 270 I Reinforcing steel (rebar) 275 Framing MEC - Mechanical Permit 8 10 MFG - Structure set -up 605 Post/beam mechanical 280 Insulation 610 Gas line 285 Drywall nailing 615 Mechanical rough -in 287 Suspended ceiling 620 Hydronic piping 295 Misc. inspection: 625 Duct work 899 MFG Structure final 630 Fire damper 498 Grading final 635 Smoke detector shutdown 299 Final inspection 640 Exhaust hood • 695 Misc. inspection: 699 Mechanical final BUP - Fire Protection System Permit 905 Sprinkler underfloor /slab PLM - Plumbing Permit 910 Sprinkler rough -in 305 Plumbing underslab 915 Fire alarm rough -in 310 Crawl drain 920 Suppression trip test 315 Post/beam plumbing 995 Misc. inspection: 320 Plumbing rough -in 998 Alarm final 325 RP/backflow preventer 999 Sprinkler final 330 Water service _ . 335 Rain drain 340 Storm drain SIT - Site Work Permit 505 Sanitary sewer 405 Excavation 345 Culvert/catch basin • 410 Fill 350 Septic tank 415 Grading 395 Misc. inspection: 205 Footing _ 399 Plumbing final 210 Foundation walls 215 Footing drain 420 Sprinkler supply lines SWR - Sewer Permit 495 Misc. inspection: 505 Sanitary sewer 498 Grading final 595 Misc. inspection: 499 Final inspection 599 Final inspection I I: \Building \IVR \InspCard- AOP.doc 06/17/2005 CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT l DEVELOPMENT SERVICES PERMIT #: ELR2005 -00368 f�l, DATE ISSUED: 10/21/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109DA -11700 SITE ADDRESS: 12957 SW BLACK WALNUT ST ZONING: R -7 SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 106 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 1 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: Owner: Contractor: DON MORISSETTE COMMUNITIES QUADRANT SECURITY INC 4230 GALEWOOD ST. STE. 100 PO BOX 14833 LAKE OSWEGO, OR 97035 PORTLAND, OR 97293 Phone: 503- 387 -7538 Phone: 503- 234 -5558 Reg #: LIC 96806 ELE 26- 565CLE FEES Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 10/21/200E $75.00 ill [TAX] 8% State Surchart 10/21/200`. $6.00 Total $81.00 • N Q This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes anc all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not 6 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- 1 -0100. You may obtain copies of these rules or direct questions to OU 503- 244 ac) - Issued By: / Permittee Signature: ,0 c _'/ ""` c! L ` `- -- W 5 . 'N OWNER INSTALLATION ONLY CC) 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.