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Permit
CITY OF T I G A R D ELECTRICAL RESTRICTED ENERGY PERMIT Fi DEVELOPMENT SERVICES PERMIT #: ELR2005 -00072 r:�l 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/25/2005 PARCEL: 2S109DA -SR046 SITE ADDRESS: 15089 SW GREENFIELD DR ZONING: R -7 SUBDIVISION: SUMMIT RIDGE LOT: 046 JURISDICTION: TIG Project Description: Installation of low voltage for audio wiring. A. RE B. COMMERCIAL AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: 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 121 1JLE LIC 96806 FEES ELE 26- 565CLE Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 3/25/2005 $75.00 [TAX] 8% State Surchart 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 f I -s adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 throw OAR 952 -00 -b 10 % You may obtain copies of these rules or direct tions to OUNC a 03 -2i 69 69. Issue B ' Permittee Signatur:. 1. . ,,, illtiP " d--'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 - -- --------- - _ -- U g P I V L ® , Received 1T Permit I Io EL/490.'5"-CM 7,01) City of Tigard Dam/By: a AK a � ter,! 13125 SW Hall Blvd., Tigard, OR 97223 qq'' , R t �, Plan Review Phone: 503.639A171 Fax: 503.598.19601k/ Other Permit: 1A 2 " `' . 1i t Damon : I I Date /flY• Juno; I tees Buse 2 for Inspection nine: 503.639.4175 C ITY OF TIGARv 1 Supplemeulal fufurluadon :inferrer: tv�vw.ci.iigard.or.us Notifiedlidet „a , - :n,. �:r. L� 'ti8t a�� 1 41,4.5.. r�F r� 1, '. k��• y{ �i 5, i ;''.�'.(��i'}G\lrg'. „ `]U, Er � ' y , i?R'�h T4 '�'. . a ... , ” ;r1ITY -a F c r 4','a 4 / 1 . ' o ,Lt:L -0101 t'y^'411 r f ,i r` ,.r, if4, ';v rt :;J. , ..y..,,, :. li :u;l 17 7 t>i .. ... a3.,� - a..,� �r.� t ; .w:'r= w k " : ' - m Please check all that apply: i 1 New construction ❑ Addition /altcrationlreplaccment I :Service over 225 turps, comm l ❑t tr e:dous location ❑ Demolition ❑ Other: :] Service over 320 amps — rating I] Bulking over 10,000 sq. 0 a n r F c rns- r , „ : a v,,4 u 1-1.-4;e; 6,.. , ,: f,. ,;,,, i1. ,_ . n: o h . , .,' 7I • ` Y C •: ~ b 5 .: � 1 ,. : a ", • • �. .. .:: , ( r c, �,, of 1 - and 2-family dwellings 4 or more new residential lair `"" ' "„ , "t"" a " ''' . ❑S over 600 volts nominal unity in one salience - and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building g dew, 400 emt s or mot ©Building over three stories ❑ p ❑ Multi - family 0 Master builder ❑ Other: []Occupant load over 99 pentons ❑Manufactured structures c r � r; RV park �. i r 4. r. t ❑ Egress/lighting hti plan �, . i, iiiim c m: v,. t• tz c .. .� .,: ;.` tw',; Egress/ g 1 ' . rQ'.' i,.: l � ❑Health -care facility ❑Other: Job no.: Job site address: I DO ao ( ed. Or Submit 2 sets of plans with any of the above. � � � c ._ p The above are not applicable to temporary construction service. Cil /State/Z1P: cum V� ^ 2 cA a r_ , W �" 1 I. �"'� � �," " + Y9' : ., i , , `f'� - ,.d.. :lt.!ri: J R � �"dW:, �+.Wrta,,,„�,, . .�ty"� CW�.,., ' . ..J rw i� 1 1 1 r,oro�c�Ef Suite/ bldg. /apt, no -: project name:l(jrcJ Cil oacripeira Qty. Feu, Tatri Cross street/directions to job site: New residential sin01.1 or multi- family dwelling unit. includes attached garage. 1,000 sq. ft. Or less 145.15 Subdivision: s '. - Ea. add I S00 sq. ft. or portion 33,40 c- Lo t no l� 9 ........70 l�Y 1 fYl / 1� � Cy` Limited energy, residential 75.00 Tax map /parcel no _ Limited energy, non - residential 75.00 i,,,, ;` Mill M1 ` ',-,,,-,,f r . F. ,a: °`v , , t: 5, '>�lv +> , `x tfi,s 06 Each manufactured or modular DUO ` r �� �� t dwelling service sidles feeder 90.90 1 vL CI k_ )ci Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 — �y lr 3t , r "' . . , ti „, 201 amps to 400 amps 106.85 I`, .7a?'u 7 ,o-, , v lf " w i a `. ' - a -�1, , ii. _ r� + '^ . i S ..'? 1, . e ; s , - ixso t �.t ::, 401 amps to 600 amps 160.60 Name: 0—.......- ~ , . s % t 601 amps to 1,000 amps 240.60 Over 1,000 snips or volts 454.65 Address: R Only 66.85 City/State/ZIP: Temporary services or feeders installation, alteration, and/or relocation - Phone: ( • ) ,r i r 76 ■ Fax: ( ) 200 amps or less 66.85 Owner Installation: This installation is being made on property that I own 'which is not 201 am ps to 400 amps 10030 intended for sale, lease, rant, or exchange, according to ORS 447, 449, 670, and 701. . 401 amps to 600 amps 133.73 Owner signature: Date: _ Branch circuits — new, alteration, or extension, per panel ” �, It t , fir ° : ,, F, v .' * s'ir t t » " "r n t y -- ' ,l l A. Fee for branch circuits with h 111; l' u ; -:� 11! r t.. ti ..a G. ' ' :, t ^ ser o r feeder fee, eac • 6.65 Business name: branch circuit - B, Fee for branch circuits Contact name: wilkoul service or feeder fee, 46,85 _ each branch circuit Address: . Each add 1 branch circuit 6.65 City /State/ZIP: Miscellaneous (service or feeder not included) pump or irrigation circle 53.40 Phone: ( ) Fax: ( ) — Sign or outline lighting 5 E-mail: Signal circuit(s) or limited - .v- e•R ^ sir A'l 'l•• • 'g '' ,1 r r cj :�r' ;er .c 'y .!.t ;"cni,, Y l -04r., ' 't; energy panel, alteration, Or m extension. Describe: I Page 2 75, Business name: a. (; )c'; (-k . - - - - ; 1; r� Each additional inspection over allowable in any of the above `'" Address: i ' , , L Per inspection 62.50 City /State/ZIP: I (� C �� . _ Investigation per hour (1 hr min) 62.50 �-, � Industrial plant per hour 73.75 Phone: (, )t_2` )) 22 �. . c'' c :� Fax: (7i ) r_�/ { .. r.- n t a - i'YC '5 ,, ,,,t4 tr ;:x' -1 3 4 -- ) a?,(L• .r wL.�. .' "��iC 1M1 N +'•R4� N:d` JF` i.tn5[eT. .�.y'� �_�c ^'1,r "i ....� CCB Lie.: Clj ( ,ci ( ry( t � I Electrical Lie. r ,.c: x,r? E Suprv. Lic -: ira! 1 l 1 Subtotal ,5 r 06 Suprv. Electrician signature, required: i /+j . .. _. .„, .._.. Plan review (25% of permit fee) • .." ! S tate surcharge (8alo of permit foe) e C) C> • Print name_ ? Date ,� 1. TOTA L PERMIT PEE ' 6 t r V Authorized signature: • / d . r .(A 2/ ii .. ,. This permit appticadoa expires it r permit is not obtained within ISO days after it has been accepted as complete �. . Print name: > Date: Fa methodology rat by "fTi - County Building industry Service Board J •• Number of inaneetions par nermit allowed. Z 0 39Vd SW31S1\S 1Ntii'IQbfli9 ZZEZ9EZE0S La :ST geOZiiZ/EB