Permit CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
^� I DEVELOPMENT SERVICES PERMIT #: ELR2005 -00071
E DATE ISSUED: 3/25/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 109DA -S R037
SITE ADDRESS: 15092 SW GREENFIELD DR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 037 JURISDICTION: TIG
Project Description: Installation of low voltage for security. Job No. 3470
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 COMMUNITIES LLC QUADRANT SECURITY INC
4230 GALEWOOD ST # 100 PO BOX 14833
LAKE OSWEGO, OR 97035 PORTLAND, OR 97293
Phone: 503- 387 -7538 Phone: 234 -5558
Reg #: SUP 1211JLE
LIC 96806
FEES ELE 26- 565CLE
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 3/25/2005 $75.00
[TAX] 8% State Surchari 3/25/2005 $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 O 01 -! 0P You may obtain copies of these rules or direct u tions to OU C at5 3- 246 -6699.
Issued B : \ 0 IP . i ' Permittee Signatu . ( CL"---
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.
City lif Tigard E V l" Received
.. ' 44, ilee,
ir.R% re' Datral ; ef NADIR, I. it niN l II:
13125 SW Bull Blvd„ 'rigard, OR 9i7.2.;23r_C —I E Pen
Rise Review jr , -
Pheou, 503.639.4171 fax: £.)8J9.0- .. . ji 1 Ilue/13 : Other ' II • V
inspection Line: 503.639,4175 „At* "IL Date Ready/By:
Internet; www.citigard.or.us MAR 4 : 211°5 NotificdAuthod: l eg. s .,..
,..........__________________-::::.. ::
lew construction 1:1 AaaltaidattereitirMepte — Ple3INC check all that apply;
0 Demolition 1:1 OtWer: li I 1 1 I:Service over 225 amps, con= 1 0Hazardoes location
0 Service over 320 amps — rating 0Buildng over 10,000 sq. 6
. , .. , . , .. . ..... .
: 2•X . ..' i:. ;'' . ' * ';' '.. ..:. . • • ;.; .,:.! . ,: .... • . '....: . , : of 1- and 2-family dwellings 4 or more new residential
!.:4 1- and 2-family dwelling 0 Commercialimdustrial 0 Accessory building 0Systein over 600 volts nominal units in one structure
0Building over three stories 1:1Feeders, 400 amps or mar
0 Multi-family ' p Master builder 0 Other: Ei
Occupant load over 99 persons 0 Manufactured structures c
.... • L':''':.:'..;.i::.'::; ..::.; '.:-..:..:4910*Wi tiS' . -; ..": ....1 ; ;: ::': " ::: . .. ':' .;.t ciE p RV park
Job no.:3 '17 D Job site address: 0 Heatth-caro facility 0 Other;
' I nc • C-7 e id Or Submit 2 sets uf plans with any of the above.
City/State/Z1P; 7 j 0 R ■ ■ The above are not applicable to temporary construction service,
,,.;;;,.:',i-la,„,;.;.,:;.:,,,7! . ' P' ', e ;:.,.....1. , :1;;' , ...7'.' '4:'i '.i:1:.%.
SuiWbldg./apt. 1 Project name: Dic c31 . 3 1,...-.. _p
''` ‘ Description t QtY- I Fee- L r°44 ....L.:
Cross strcet/directions to job site:
New residential single- or tit ulti-fatully dwelling unit
includes attached garage.
1.000 sq. ft or less 145.15
Subdivision: . n 'i-k z - f`<',..)-id 1 Lot no,: 3-• Ea. add i 500 sq. ft. or portion 33.40
Limited energy, residential 75.00
Tax itiap/parcel no.:
75,00
; ;'-',.•.; - ' ..':'''''''''••:":.'''',''...-.1.''''''V•i•:.`f.'N't.tEr1gAio0191 00641t*itliaig4:;-•■T'. :?.t: : !' ":.:: ' • ' Each manufactured or modular
/0 CU VO I . — Se ' t uri. dwelling, service and/or feeder, _ 90.90
Services or feeders iustalladun, alteration, and/or relocation
1 111/
200 amps or less 80.30
S '.• Stat : ' "1•.5: ..,, :. .,:.!iiQ ,'"::::::: : 0 ::.: ., .., i : :•:;7 1 :: • .. - . • , 201 amps to 400 amps 106.85
401 amps to 600 amps 160.60 •
1
Name: NM& ._ ' ' ' - HE-5 601 amps to 1,000 amps — 240.60
1 .■ 11 -t . a.
Address:
Over 1,000 amps or volts 454,65
Reconnect only 66.85
City/State/ZIP:
Temporary services or feeders installation, alteration, and/or
Phone; 7— 75-3,g 1 ( ) _ relocation
200 amps or less 66,85
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps
' 100.30
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
401 amps to 600 amps 133,75
Owner signature:
Date: ,
Branch circuits — new, alteration, or extension, eer panel
—
"I ':: ' ':''.....'' • '•••.f.::31:li'./..ikittiqiidoili'0..:7;::N.';''Wfi:?::::".•;.: " A. Fee for branch circuits with
service or feeder fee, each
Business name:
branch circuit 6_65
B, Fee for branch circuits
Contact name:
without service or feeder fee,
46,85
Address: each branch circuit
, Each add I branch circuit _ 6,65
City/State/ZIP:
_— Miscellaneous (service or feeder nor included)
—....
Phone ( ) Fax:
Pump or irrigation circle 53
: : )
Sign or outline lighting 5340
E-mai ( l:
Signal circuit(s) or 'United-
' ' ": ; •; =: ':' ..- ' , 'K's .;:i:;:. Z : ' :,: ;:tiii . g'; ' :. ' t'.. ...''.:::'', 7:'..: : •: s f:: : energy Panel alteration, or
Business name: extension, Describe: } Puge 2 - 7 54
eb
. . • 4111 , .....
.1.1.k
MP
AddresN: i c , _., Ji_is, Each additional inspection over allowable in any of the above
Per inspection 62.50
City/Stare/ZIF: R r - x it 1 c.,( „ qr ac Investigation per hour (1 hr min)
1 Fax: (5( ) cl'c a - as a a c 3, 4,,d. . .; 73.75 .
: L : • .-;'.... Y•,:.;;',..,,„E ,.
- CCB Lie.: q (" va 1 Electrical ',in.:a-51 0 &spry. Lic.: la ii LP
Subtotal '7
Suprv. Electrician signature, required: 1 [ .., .." waliall iftlie _
Plan review (25% of permit fee)
Print name: R \ M ' 1 ''' e Date: 5a AM State surcharge (8% of permit 6:0)
_.
TOTAL PERMIT FEE ?1
Authori2ed signature: rert •
. _IA 0 _ . Two permit applicaUon expires if a permit is not obtained within 180
/
gays after it has been accepted am eumpiete
Print name: ., _. i . . I 4 r- i Date: a..,,,ABR Fee methodology set by Tri-Couniy Building Industry servi Bout/
.4 Number of insevetione Oar permit allowed.
Z13 39Vd SWaLSAS iNvelayno ZZEZ9EZEOS 6T:VT 9007/VZ/E0
CITY OF TIG.ARD c_,
BUILDING DIVISION PERMIT #: ELR2005 -00071
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/25/2005
Phone: (503) 639 -4171 Jir I iInspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/28/2005 TIME: 7 :10AM PAGE: 62
SITE ADDRESS: 15032 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 037 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: Installation of low voltage for security. Job No. 3470
OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503 -387 -7538
CONTRACTOR: QUADRANT SECURITY INC PHONE #: 234 -5558
Inspection Request Scheduled For: Date: 3/28f2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 002975-01 503- 234 -5558 N
Corrections /Comments /Instructions:
?AN t — c
■ -
Q
k PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESS
i
®
Inspector: Date: hone #: (503) 718-