Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #:` ELR2005 -00444
��� DATE ISSUED: 12/21/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 109DB -03200
•
SITE ADDRESS: 13126 SW HAZELCREST WAY ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 070 JURISDICTION: TIG
Project Description: Audio.
A. RESIDENTIAL 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 Contact #: PRI 503- 234 -5558
FAX 503- 236 -2322
FEES Reg #: LIC 96806
ELE 26- 565CLE
Description Date Amount
[ELPRMT] ELR Permit 12/21/200E $75.00
[TAX] 8% State Surcha 12/21/200E $6.00 REQUIRED ITEMS AND REPORTS
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 Signature:�.e., K', \ D 1 c
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.
r tc. k- - c:,-7‹ti -1�Yr1
E2ctrica1 Permit Application
g EMOVED iteeeolved wit 0141(4: t .tib: t) \I,y
City
of Tigard
03.598_l96Q
! 3125 SW Hall ldlvd., Tigard, OR 97223 DatDate/13 :.. _, 0 /� Permit No.6 - / / 6 �y f/'
Phone: 503,639.4171 Fux:5 (� •. Plan Review /
171 Fax! 5 0 Ec 1 1UUc ") I � { ' p.m : Other Permit:
Inspection Line: 503.639.4175
Internet: www,ci.tigard.or.us '` � Date Ready/By: See Page s for
Noti
;;;u.'.. aa' j flud/Medtod:
�,r r �, , , a nn Supplemcatalieformattee
y a
ti`+r:� "?:':�Si'a -t.F � 4,. ,, k y t pl. d �'�dq � in } �� jK �uY A�'�. ✓)�^.� ;fit• •. <f5 �S�d +• z>,��,, C•T'i" a.s 4 • n M2
' ' .,,fir& :ti K �7s±,�s.d:sR r'',7 :a i!. , !,, , t,.,:+f�. ^ ?5 y n '4 :' rid"', .�'`' r �, ,c, k r + e �i ' '^f -P, 1�' r tea, t'- 9.9
r9..3..�"cahrl.y.�t+�it f �.; F, �� 'p �h %:;:s��s,.�:iw,l�'�':
New cons
truction ' ❑ Addition /alteration/replacernent Please check all that apply;
0 Demolition pP y
❑ Other ❑ Servi ce over 2 2s amps, comm'I ❑Hazardous location
+�'� i��ST awdi::•w =s.m _d. a, ; - - , ❑ Service over 320 amps - rating OBuildng over 10,000 s ft.,
.'' • : z z i- . i ",., dwellings so.
"�• •H•1 •. x" :a: :a r ? oft- and 2- family gs 4 or more new residential
P 1 - and 2 family dwelling ❑ Commercial/industrial El Accessory building ❑System over 600 volts nominal units in one structure
❑
❑ Multi ❑ Master builder Building over three stor ❑Feeders 40
� 0 400 amps or more
'' `" "' ' �� �n��, , . ❑Occu ant load over 99
" y^ ; 1xvii,732 ' d!.M51;c, �,1s'�5�''.' �k�`! : !j+asa } �;Vh_ p , ;y 0 . g. i„•• 2 �:. P persons ❑Manufactured structures or
" " t;R€ ,. s lit: S ❑Egressaighting plan RV park
Job no_; °Health_ cu
Jo s ite address: '3 ` t re facility Q Othei a. -& — - Submit
City /State ZIP: ( sets of plans with any of the above.
' The above are not applicable to temporary construction service.
Suite/bldgiapl. no_: Project name: ..5‘30.-e.,- f ar ' `: ,, 7 .' t • >•• w:...
�Cdpt4w Qty. t Y'°lat
Cross Street/directions to job site: — New residential single- or multi - family dwelling unit. -•
Includes attached garage.
_ 1,000 sq. l;, or less I4S.15 4
Subdivision: 1 t - k ' CIF I Lot no.; 70 Ea
Limited add'1 500 sq. ft or portion 33.40 1
Tax map/parcel no.: }`!� rarer; rest Amer 2
y, residential 75.00 A
r '�i``,'�- +cviS'f'i. ESS �'�Y�. ,i:i ;y; ','W ",,W.yrA . ti,., ^'; °l::i ^=` ••.1:. ° A r:,.� Limited energy, non - residential 75.00. � .
�' r.nF: ,. rti'.tae t+ „sax �t,' n i 2rs Eech manufuchued or modular
i_ rt 2
/►�� dwelling, service and/or feeder 90.90 2
j Services or feeders hnstallation, alteration, and/or relocation
,��� 4Dr 200 amps or loss 80,30
'' ^:'i ir;W1°n�A' if�lCM, ,� 4l, 1,4_40A-444. l�71 49 , ,x , ,,. , wI . 201 dm 2
_o. ..i,,,,,,,^, k �,�',�5.�,iJ �:,. ' _ v:' amps to 41x1 amps 106.8
• • Li.n , :tie:, 2
N 40! amps to 600 amps 160.60 2
Name:
601 amps to 1,000 amps 240,60 2
Address: Over 1,000 amps or volts 454.65 2
City /State/ZIP: — Reconnect only — 66.85 2
Temporary services or feeders installation, alteration, and/or
Phone: ( ) 1 Fax. ( ) relocation
Owner installation: This installation is being made on property that I own which is not 20 amps to
or 400 00.30 1
-
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 201 amps to 400 um s 100.30 2
401 amps 600 : , , 13
Owner signature: 2
Date; — e Brans , alteration, or extension
t;., . ` h circuits - new alter , per panel
: fi;.,,� l ilia ' i :Wi t o o r:4 , : y” , :,,. j ra h�r ',,,m a, .. 40 ' 's n . i A. Fee p
Business name: i for branch circuits with
service or feeder fee, each
-"'�- - branch circuit 6.65 2 —
Contact name; B. Fcc for brunch circuits
wuhoul service or feeder fee,
Address; _ each branch circuit 46.85 2
City/State/ZIP: Each add'l branch circuit ` 6 2
—
Miscellaneous (service or feeder not included)
Phone: ( ) l Fax:: ( ) Pump or irrigation circle 53.40 - 2
B -mail: . Sign or outline llgh
'= •::'��dl %...- �l:Ya� ? r. 'L'i':�. k,C`' y , ,. SlgnaiCll'Calt -�
�,'�ow ;; ��' *.tyM:�`rC ?5..�`�w.a�� p;7riafi energy panel alteration, or
Business name: • ( ( de - , ' fi e.' .cr• C.- De
" extension. scribe: Page 2 2
Address: / L ' C'Y� - M
I Each additional ina eaten over allowable in any of the above
City /Stafir✓ZlP :^ � � ! �' �f ) _ 62.50 4 Phone: (,j3 ) i,J F 1 lS� 2/ Investigation 62.50
CCB Lic.: d a ' �� )��r )l4 c� /,Y� Ns w.` �l „�'B1b[ 73.75a
a. A Suprv. Lic.: 65L. P
Subtotal ` `1 5 : ;c, ;�' °!r
Snprv, Electrician signature, required: sub a I ~ j
�r Plan review (25% ofpermit fee)
Print name: a�r `I �. 7 , Da f - State surcharge (8% ) PAW ( permit
signature: f ,
_ -- • TOTAL PERMIT FEE b • I , a a L� 1 This permit application
Aires it'll permit is not obtained within Igo
Print name: I ``/ / ( Dale: � days otter Litt been accepted! us complete
i :i. a �/ I , !!�- `/ , p P
4 A Fee methodology net by Tri- County Building Industry Servite amid
1 : 1 BuildingiFenniudELC -PennitApp -doe 12/03 °° Number afinepeutioas par permit allowed_
440- 4614T(10/02lCOM/wEe
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005-00444
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12
Phone: (503) 639-4171 a ftplitit
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12127/700 TIME: 7:03AM PAGE: 39
SITE ADDRESS: 13126 SW HAZ.ELCREST WAY CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 070 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: Audio.
OWNER: DON MORISSE1TE COMMUNITIES, LL ,C, PHONE #: 503-387-7538
CONTRACTOR: QUADRANT SECURITY INC PHONE #: 503.234-5558
Inspection Request Scheduled For: Date: 12/27/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 024016-01 503-234-5558
Corrections/Comments/Instructions:
k-ASS •
PARTIAL APPROVAL n CANCEL I NO ACCESS
FAIL I Iv' L FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspect° : A AL _ Date: (Z-- 7 ° #: (503) 718-