Permit CITY F T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
I i DEVELOPMENT SERVICES PERMIT #: ELR2005 - 00143
� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/2/2005
PARCEL: 2S109DA - SR2 109
SITE ADDRESS: 12968 SW KOSTEL LN ZONING: R -
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 109 JURISDICTION: TIG
Project Description: Low voltage - 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 Phone: 503- 234 -5558
Reg #: SUP 1211 JLE
LIC 96806
FEES ELE 26- 565CLE
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 6/2/2005 $75.00
[TAX] 8% State Surcha 6/2/2005 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: ' , Permittee Signature: Se.., NI
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
-- — - - Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
r ■ A Wig. ( --- \ --)- 0 - C K-■
tir City of Tigard WED Received
Dares : ) Permit No.: _ /0 ' '5/5 13125 SW Hall Blvd., Tigard, OR 97223
Photos: 503.639,4171 Fax 503398, , n � ; �, �' Dat Review
JUN ) � 'e' J i� I'' t)atv/B : Other Permit: ` a05 =� / 7i /
Inspection Line; 503.639.4175 0 2 2005 . 1 Ipx Ready Ju i¢: 10 See Page 2 for
Internet: www.ci.tigtud or.uS Notified/Method; Supplemental Information
,i' f , , ,' s t'.:t7 i• ' t F -,, . rye " 4 , ,. , a , r r ;' :' s s7rt. . r r > r : r r r �' e,
. .1t ,' 1 . • tf ry >4 ,';74' . r • i r , ,,r /,•! r +krt r'w, ri in trbq t',C u,s r ,,�rry �^ •.; _
D rR� tit' ' p ' °' �sx; .,,,.7 G� d� �` �' �., ➢ ,��: � • �ICw CO ]]StrtlCtlQn LIIJ$BY11t���y V i� fi�2...?7 !! ; ao:,�z,.w \{�: �5a iu;tt! u1� { r ., � �j:�i';, ,
^l7- l .i �t plwae check all that apply: f 1 ��
0 Demolition ❑ Other.
['Service over 225 amps, comet I Ii
p ❑ ftzardous toaatloti
.4 „, : r � : Aw , ' , A . `. ,, t ,, w . . ,,, �.:�,� , ,.= :1.'. ,,:, ❑Service over 32 p ng OBuildng over 10.000 s fl • .. � `tr F.x; �,¢ M (` '" •-,t,. i T ::.:.' arr3 S -- rali
te ''. ' "� '+;&"ii_t - 4 4 4 .qt .0 K 4,1 4 'i� ' . �� .1, of 1- and 2- family dwellings 4 or more new residential
•
and 2- family dwelling ❑ Commercial/industrial Accessory building ElSyatcm over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 stops or mot
0 Multi- family El Master builder 111 Other.
g'ta'' -G'� e > [•1 < �ytTv jil;r� r "fit � n .,,,:� a p5 �t �,��,�.. :
. r ❑ Occupant load over 99 persons ed structures : '-r. � �"K, i {.. �'..91V G; •itt,'�'!�tiE�F'[`'..'1 " � •''", ,� `"'." p ❑ par ctur utu3 c
'r. °ti t� �?;, . •:;',._ f '.;, ya,;i,i OEgresa4ighting plan 1W park
Job no.: Job site address: 1/�� t � r]Health' -smut; facility ❑ Other: —_
City/State/ZIP: r^i t � t F\ aT�- I Submit sets of plans with any of the above.
Cf The above are not applicable to temporary construction setvic.e.
Suite/bldg./apt. no., ?v ;fi ,4, g it ' s �.
p rojeername; /�/ , J�.:, , s+�ts a p ;' � ?' t;.'
d i � Y 1 . +a.n.�V fi'+" wy� �ta..:L.., r e '9.'.. �.i;4:i�r
Cross street/directions to job site Q`• FM TOE
New residential single or multi- family dwelling unit.
Includes attached garage.
1,000 sq, ft. or less 145,15 III
Subdivision:. ( ) � J
/� / �! C Lot no.; Oil 6s. acid 1 SUU sq. ft. or portion 33,44
Tax map /parcel no.: — Limited energy, residential 1 75.00
r 7i . +�t • . C� ry q
t'41 ,m�1i. Nt ., ,c . '' , t,"a a 4 q '.tl - l l v ; T' : tl ya`'Fi o ' P' . , ?ru !r,• 1 ' ': 'C�"xntFlfi:: 4.u F , L^ , E a c h anuf turgid non-residential mulr 75.00
(DLO �O 1—k- '_ . .:!2c-it
. , Each manufactured or modular
lJ alert f dwellin_ service and/or fender 90.90
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30
�T� '�.,.!l. . w M 1 , # L'.. �, -� 1,�'V' . "�.. •:'a 'fY "" y ` ! ' 's ^�.K c�:•�
, 4,:: t, ;,. ;g ,'�,y f pia; 201 amps to 400 am
M. `iA�% ' ! :: : • ,, , y + 1 • R 4 M P amps _ I06,240,61i5 • 1 � Y,a� i i +�itir ... ti
Name:
401 amps to 600 amps 160.60
601 amps to 1,000 amps 0 —
Address: Over 1,000 amps or volts 4
City/State /ZIP: Reconnect only 66.85
�_�
Phone;( ) [Fax: ) Temporary serviced or feeders installation, alteration, and/or
relocation
Owner installation; This installation is being made on property that ]own which is not 200 amps or less — 66.85
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 201 amps to 400 amps 140.30
Owner signature: 401 amps to 600 ,imps 133.75
�.
Owner
AI i '�i°��, ` i y ��� :rstyye y �' ti,, S:, .a• Date: Blanch circuits.— new, alteration, or extension.
. ' , ..'SF'tA OOKE,A ^ , y on er panel
• - ��^.� :y i.nS,J t" ;ifs o h r !' '�i i, v ' ,,,',: A. Pee branch circuits with
Business name: service or feeder fee, each
brunch circuit 6.65
Confect name: 8, Fee for branch circuits
without service or feeder fee,
Address:
each branch circuit 46.85
City /State /ZIP: Each add I branch circuit 6.65
Miscellaneous (service or feeder Hot inelt,dcd)
Phone; ( ) I Fax; : ( ) Pump or irrigation circle 53.40
E- rnatl;
Sign or outline lighting ng
, $ 53,40
�Lun, f ,.-, , °, ; Signal c
.. ;�l...i � ,E ".c ?$�_ ' ,..., sr o; a « r, eu9, .w'' ' :`�;i:; ` u +�" „ energy panel, alteration, of
�.. a , .' w . "�r�l '' ":y' 7 v
Business name: C t )( '. Y.- .”" t 't'�r extension. Describe: Pegs 2
Address: t� """ 1 --
• I �"', }(. � - i ` r - ~ xj` .. � Each additional inspection over allowable in any of the above
City /State/Z1P: O - ak r � '� '�c' " Per inspection 62.50
Phone: (Y; "- •. a y "i I { � Investigation eel hour (1 hr rain) 62.50
,: .� . 5 Fax; (,?L,3) • �; -Q c' -� g: - Industrial .lent per hour 73.75
CC13 Lic.: CJ -, ')( - .2 Electrical Lic^ .t: r:' • , l ' ^rm acx', i :{,
1 •, _ ., 5uprv Lie - : -) { �f . •' ': S-' � u'14
l ..a. I 1 is n
Subtotal
Suprv. Electrician signature, required: - _�`�
�1 Plan review (25% of stet
p it fee)
Print name: State surcharge (8% of permit foe) Mg
L Date: /
Authorized signature: TOTAL PERMIT FEE � (y 1 ` )
4 g � Tats permit ipplieetlon expires Ira permit Is out o within Lao
name; s; - i 0 D drys atter It has bocn accepted as complete
ate:
�� . Fee methodology see by Tri- County Building Indushy Service Board
4
Number of inspections Der permit allowed.
Ze 39 d SW3ISAS 1NtieICt/nD ZZ8Z98Z805 8b :Be 509ZIZ0,�99
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005 -00143
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6!'212005
Phone: (503) 639 -4171 i ° ���iioIpuiliO
Inspection Requests (24 Hrs.): (503) 639 -4175 - __..
INSPECTION WORKSHEET FOR DATE: 7/20/2005 TIME: 7 :11AM PAGE: 30
SITE ADDRESS: 12968 SW KOSTEL LN CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 109 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: Low voltage - audio.
OWNER: DON MORIS SE I I E COMMUNITIES LLC, PHONE #: 603.387 -7538
CONTRACTOR: QUADRANT SECURITY INC PHONE #: 503 - 234 -5558
Inspection Request Scheduled For: Date: 7/'?O/?005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 011791 -06 503 - 209-4837 N
Corrections /Comments/ Instructions: F.
t o.
p< PASS 111 PA' IAL APPROVAL ❑ CANCEL ❑ NO. ACCESS
El 'FAIL C '/ FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: co " e 503
N date. Phone #: ( ) 718 -