Permit CITY TI CHARD ELECTRICAL RESTRICTED ENERGY PERMIT
I DEVELOPMENT SERVICES PERMIT #: ELR2005 -00406
`�-� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/14/2005
PARCEL: 2S 109DA -07400
SITE ADDRESS: 15084 SW HAZELCREST WAY ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 051 JURISDICTION: TIG
Project Description: Audio & Data. Job #3456.
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: DATA : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE COMMUNITIES LLC 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
[TAX] 8% State Surcha 11/14/200E $6.00
[ELPRMT] ELR Permit 11/14/200: $75.00
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: Permittee Signature: ,Qe
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 n....11,14.--
, Electrical Permit Application
,
City of Tigard e _,, 0 t /B //' -- P - / 4`'f '7 , Permit 11/41° • : L.L1---,2,,OrZ0211
.13125 SW Hall Blvd., Tigard, OR 97223
Pln Rev
' ' Phone 503.639.4171 Pax: 503,598,1960 S,t,V , 44 '' .. N411 ,/ •! Da iew Other Perin'•:
Inspec 'Line: ine: 503.639.4175 4' Ready/By.
1 .
..,... .. __, Date
Internet: www.ci.tigard.or.us 14,(V. Notified/Method: Y . i ki s u
. -------
.e.gt Wn. . J & .1!5 ".. .'.1:1.10*0:, :;',..&!-6411C10..4tet#ICS*211gRiMigigfir:;:
N New construction 0 Addition/altest/reR I Please check all that apply!
ID Demolition 0 Other: 019 °Service over 225 amps, comm'l Dllazardous location
.• . S. 0 mice over 320 amps - rating 011uildng over 10,000 sq. ft.,
4 or more new rcsiciontini
and 2-family dwelling 0 Commercial/industrial 0 Accessory building 1pSystem over 600 volts nominal units in one structure
°Building over three stories °Feeders, 400 amps or more
0 Multi 0 Master builder ID Other:
0 Occupant load over 99 persons °Manufactured structures or
4 . - MtAtliat j ae,iiittaa '' . 1 .• ' ."..: - , !".: ',. : i ri i ..'; ! :Y• i iii440441Jkitiia-Ni:00448';4i DEllreaeliening plan 1W park
Job no,: 3 • . , Job site address: II: i*Ca 6 (C rrS+ IA) :• .. °Beall facility D Other:
Submit 2 sets of plans with any of the above.
City/State/Z1P: 17 0i2 • The ahove are not applicable to temporary construction service.
ti4':.',:• 41;144Wiciaittintt.404/aillit44WARW:::
Suite/hIdgiapt. no.: 1 Project name: ,S4eilrin nj t
i 1 Qty. I izeo. 1 mots "
Cross street/directions to job site: YlVde Ne single- or muld-lamily dwelling unit.
Includes attached garage.
1,000 ag. ft. or lesa 145.15 4
— _
SubdiViSion: , aniy(' ( Lot no.; ,.. Ea addl 500 sq., ft. or portion 33A0 1
Limited eriergy, residential 75.00 2
Tax map/parcel no.:
Limited energy, non-residential 75.00 • 2
'T.:0:t47::-W44iiA'..!:Lt?:‘,Niaitt•bit 1. 1 7 .. 1 : 1: r 0h RibittO'i-". : ':•.;1 , 0'1$11" 7 :;;'R;.1ggs'il.Vt! ' 4D;' Each m„utuctured or modular —.—
dwelling, service and/or feeder 90.90 2
titnAlL .A_ -ev I /Ai - . 1 a. i of audio
Services or feeders Installation, alteration, and/or relocation
r
200 amps or less 11. 80.30 2 - ••:‘... A ; ..,.2.1v, ,. 04 lsstle 201 am • . to 400 arn .s
,, ... , ... ,: x.N.:' , WaileastA ' ,. . avaLIAL. ‘1514, ..;,. - .7,• • , , 'IwIctz - iNa • ,. ..e., • '. , - •?.)., %; 40 i amps tp 600 amps
Ell 160,6U 2
Name:
601 am •s to 1,000 amps Mill 240.60 2
Address: Over 1,000 amps or volts MI 454.65 2
„
Reconnect onl Mil 66.85 2
City/Stale/ZIP:
Temporary services or feeders inatallation, alteration, aucvor
relocation
Phone: ( ) Fax: ( )
- , 200 amps or less MI 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 am Pa to 400 am a 1111. 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701,
401 amps to 600 amps =WEI 2
Owner signature: Date: Branch circuits - new alteration, or extension, per panel
ij,•5/01, i ) ;#40600tro l gireatitV' T liirat - MiarddircsfkiticaRANT, ,„ — A'..Fee for branch circuits with
- ' • - - "' ''''''''' -I "' ' ' . * -- " I ''''''' .• • ."- ' . - - - '''"'' -'''" service or feeder tee, each
6.65 2
Business name:
branch circuit
--------7 13 Fee for branch circuits
Contact name:
without service or feeder fec,
46.85 2
each branch circuit
Address:
_______ Each add'I branch circuit 6.65 2
City/State/ZIP:
Miscellaneous (service or feeder not Included)
Phone: ( ) ( )
Pump or irrigation circle 5340 2
Fax: :
____________ out line 53.40_2_
E-mai Si si l
Signal circuit(s) or limited-
.-v • ::44 )&b : k=4;g:ei.i:fiNigg,iihilig,' r2VM.M.,`..flarr'2..;;P•F' '' . '.. !A,01 energy Panel alteration, or
extension. Describe; ..1 Page 2 , 76.co 2
.
Business name: • ) 7 I . ' ,1 i 4 c 5-- : . - . . c—
— - 4 . .
__..
Address: r ) . - 3' I L. (-1 ;.- ) ' ".:: . Bach additional inspection over allowable in any of the above
City/State/ZIP: PO ii r ..., ).... ii . ".4< 4 ,..'"? 3
,
Investiga per hour (1 hr min) 62.50
Phone: (,5('3 ) 7 L)- 555 ' f
Fax: ( 562 )( :),3t p _, , Q -- Nu
C
CC} Lie.: ci it Electrical Lic.Q1 Suprv. Lie,: ' 1-4
subtow 15 CO
,
Suprv. Electrician signature, required:
• Plan review (25% of permit fee)
Print name: oc)f),-) 1 c Tuc. y6-7.p5s Date: I ) iCj 05 ___, State surcharge (8% of permit fee) t. ()01
Authorized signaturr pcth
This permit application expires Ira permit is not obtained within ISO
1 i / An t I '
Print name; days atter it has been accepted as complete
cidbt-74 . 6 4,r c cad/74 ---771;71-7/0/a5--
-I 4 Foo mothodolog set by Tri-County Building lodustry Service Board
** Number of inspections per permit allowed.
1!113 ullailiOunnits■ELC•ParmItAppdoc 12/03
440-4615TO 0/02/C oM/WEI3
CITY OF TIGARD
BUILDING DIVISION PERMIT #ttSttO05* 60
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: v t. Hp
Phone: (503) 639 -4171 u +��� i '
Inspection Requests (24 Hrs.): (503) 639 -4175 �
INSPECTION WORKSHEET FOR DATE: lit • �Z. -�5 TIME: PAGE:
SITE ADDRE S15cfil SU IELc -fC T W 4 • CLASS OF WORK:
SUBDIVISION: I LOT #: TYPE OF USE:
PROJECT NAME:
• DESCRIPTION:Aub)
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: b Pour Time:
Code # Inspection Description Confirm # Contact # Message
1 1:31.14ci4 /321411" Of
Cirrections /Comments /Instruction :
PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: ti Date: #A Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: El_I=Z O0 &01110Ci
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11//412005
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/11/2006 TIME: 7 :01AM PAGE: 77
SITE ADDRESS: 15084 SW HAZELCREST WAY CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 051 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: Audio & Data. Job #3456.
OWNER: DON MORISSE.TTE COMMUNITIES LLC, PHONE #: 503-3137 -753€
CONTRACTOR: QUADRANT SECURITY INC PHONE #: 503 -2344 -5658
Inspection Request Scheduled For: Date: 1/11/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 024731 -01 503 -234 -5568 N
Corrections /Comments /Instructions:
•
.t/
K PASS ❑ PARTIAL APPROVAL (l CANCEL ❑ NO ACCESS
I I FAIL I I C LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: `-' hone #: (503) 718-