Permit CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2005 -00063
I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 4171 DATE ISSUED: 3/21/2005
PARCEL: 2S109DA -SR078
SITE ADDRESS: 15131 SW HAZELCREST WY ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 078 JURISDICTION: TIG
•
Project Description: Low voltage all encompassing.
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 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 3/21/2005 $75.00
[TAX] 8% State Surcharl 3/21/2005 $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 OAR 95 ,2401 -0100. You /..y obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: Air � � 4 1 4 Permittee Signature: 0.- a lat cJ €yU
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.
03121/2005 07:04 5032362322 QUADRANT SYSTEMS PAGE 01
City of Tigard - -- - - - -- � \ ' Received'?
Dates 1 8l) Permit No.; 0 e0.
13125 SW Hall Blvd.. Tigard, OR �3. r '
0 , eke Plan Review
Phone: 503.639.4171 Fox: 503. 98,1960 ,, r ,a „; I I Dete/lt Other Permit:
Inspection Line: 503,639.4175 `\n 1� 71 q 0 I. n •„ , _ L . Date Ready/fy: ,1 le See Page 2 for
Internet: www.ci.tigard.or,us 4 ,.,c, ,.,c, C1 -V . k NI NotifTed/Metb xt; t
Supplemental fntormeticm
•'''k ^; . °n , - n - ii ?'� "i a::i'i" :a!f,+Mn'r . ,�G U+ rg]I a :.a..
u ew construction 0 /t ddda " / alteration /replacement Please check all that apply:
❑Service over 225 amps, comm 1 ❑I.lemrdous location
❑ Demolition ❑ Other:
s ,: ,,.. y�p� - rating
... „ -, ervrce over 320 amps ratio 13uildng over 10.000 sq. fi
' ' �• .. = ; . , of 1 -and 2- family dwellings 4 or more new residential
I i" and 2- family dwelling ❑ Commercialfindustrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
O� ❑ Building over three stmics ❑Feeders, 400 amps or mor
❑ Multi - family 0 Master builder
::'•. ?;;'s d p raons Manufactured structures c
k , '" �rv �S
:.... ... . . :...... : :... " . ❑EgnssA,Bhnng plan RV park
Job no.: Job site address: ❑Health -care. facility ❑Other:
i 3 ( my r '� r Submit 2 sets of plans with any of the above.
City /State/ZIP:
acu 012 Oil .41-1-" The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: )� I t }yi Scetf I L,(,( - on ieri e r:,�. ir1 =� ' Ar.ry" ar& +r; +',= T e t ; ,:. <.
>�Dnoe .,I txly. Fee_ ro+al I .
Cross strcet/directions to job site; New residential single- or multi - family dwelling unit
• includes attached garage.
1,000 sq. ft. or less 145.15
Subdivision: l meek L 4� 1 Lot no.: Es, add 1 500 sq. ft. or portion 33.40
U Limited cner residential
75.00
Tax map/parcel no.: L•
.' , . a . ... '. KWI•e'+yt�pt,yey� yy ,� y , , Limited energy, non - residential 75.00
. _. WJr °:•.�7WlQeft :i," ' ;,;, (; .:•P Each m
• _. ... .;. anuthctured or modular
dwelling. service and/or feeder 90.90
11 1 1 . 1. 4 A:. -" L i L D Services or feeders installation, alteration, and /or relocation
I 200 amps or less 80.30
f. , : :.. .;.., • •ail�s� SeetfttintitPr„ jtti.�j 201 amps
.,., � .. • ' a- wr,:: < „';':.;�,�a'11`,B�'�Y1V'1',::' •:: to amps 106.$5
: 40 t amps to C.00 amps 160.60
Name:
601 amps to 1,000 amps 240.60
Address: Over 1,000 amps or vole; _ 454.65
Reconnect only 66.85
City/State/ZIP: Temporary services or feeders alteration, and /or
Phone: ( ) Fax: ( ) relocation
200 amps or lees 66.85
Owner installation! This installation is being made on property that I 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, per panel
': !? ;''' ,,,,,, h i,:: 3 A. Fee for branch circuits `� �; �TQ'Jf�' ��ZrQ •' circuits with
�'. service or feeder fee, each
Business name: - branch circuit 6.65
Contact name: B. Fee for branch circuits
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 not included)
Phone: ( ) Fax: : ( ) Pump or irrigation circle 53.40
E -mail:
Sign or outline lighting 53,40
Signal circuits) or limited -
:. :":'.`:,. f '' ;�:::ir:;;:7rV..:;`;.4;' : 1 .ittr;;X;'" .. energy panel, alteration, or
ri CO
Business name: lY kkaC c t Sft rl $ extension. Describe: Page 2 r J
Address' �� � 11 �g Each additional Inspection ove allowable in any of the above
Per inspection 62.50
City /State/ZIP: P + C 1C D(Z q 1 aq Investigation per hour (E hr min) 62,50
Phony (1 58, ) "a3q. 35 Fax: ( 2 310 2322- - Industrial plant per hour 73.75
GCB Lic.. l0$1�1D Electrical Lic ., :. . fd '1G I t. ltStSti" tiYt -r° :i.'
.:�(p�pc{,C_ Suprv_ Lie.: Pa( LEA
1 Subtotal 75. Do
Suprv_ Electrician signature, required: A/ - Plan review (25% of permit fee) -
p CO
Print name: r I uJ I Le, Date: 2, j,4 l o� State surcharge (8% of permit fee)
R.
Authorized signature; /
TOTALPERM1TFgE (.
1,��'{/I.40 Gt/lOQ_. This permit eippllcettan expires if a permit b not obtained within 180
Print name: den After It has been accepted as complete
( J q � Date: 3 + t75 • Fee methottolopy set by Tri.County FEnilding Industry Service Huard
I •• Number of inaeectiona ocr aermit allowed.
Q use pA rYl-- -* V.D cop LQ,kE ,x4(.14
.
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: ELR2006-00063
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/21/2005
Phone: (503) 639 -4171 /°m�re�iiPn�iimlli(
Inspection Requests (24 Hrs.): (503) 639 -4175 .'
INSPECTION WORKSHEET FOR DATE: 3/22/2005 TIME: 7 :13AM PAGE: 84
0 SITE ADDRESS: 15131 SW HAZELCREST WY CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 070 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: Low voltage all encompassing.
OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503 - 387 -7538
CONTRACTOR: QUADRANT SECURITY INC PHONE #: 2345558
Inspection Request Scheduled For: Date: 3/22/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 002387 -01 503-234 -5558 N
Corrections /Comments /Instructions:
, (, i_ C -. , Ge vix A Pie gwf , A, 5Pii M 5"ysri 7 d
/C/ r- P°"4/y/ T ANfr715 4 " 444 G:
■
[PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • i ‘ ♦L .`, Date: , ) Vi/ f Phone #: (503) 718-