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Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT DEVELOPMENT SERVICES PERMIT #: ELR2005 - 00369 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/21/2005 PARCEL: 2S109DA -12600 SITE ADDRESS: 12931 SW KOSTEL LN ZONING: R -7 SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 115 JURISDICTION: UR Project Description: Security, intercom, audio. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: X BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: INTERCOM X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: Owner: Contractor: DON MORISSETTE COMMUNITIES QUADRANT SECURITY INC 4230 SW 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 [UELPMT] ELR Permit 10/21/200E $75.00 [UTAX] 8% State Surc 10/21/200E. $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: 9 Permittee Signature: � • 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 r lc c. ,A- • cam Electrical Permit Application Q l < >lr ul ric l:1 sr () I \ City of Tigard "� ® Received 13125 SW Flail Blvd., Tigard. OR 97223 Data/ ; l © P— t "i t✓�01) , 9 • nT 1 ' - D te/Biow Phone: 503.639.4171 Fax: 503.598.1960 (/U inspection Line: 503.639.4175 Ut 005 , t • ' . Y Internet_ www.ci.tigard.onus Notified/Method! ''" Date Ready/By; �. {_ RD _' �1r'�4 I 1 Sec Page Z for a �` ,.� " a,w�� ' A ` ( i „ py ,p T�F„ fA \{{�*L��•L — !// NA tatloformaUou t � , , ' . •.. dL - • :i,: i� wri ,',. 7,021in ':',11 � , �h�' ikgs,i.hklit �?"�S'i+• t '7,� r d,� 1 + P� ���' ,ni ` µ' r :.. F �� Y , _ Cw construction � e �•+t +� r a � �,�Fl�v����� � ��,, •� ----- d a A N ifion/alteration/rnplaeement Please check all that apply: �" ' " ` r «. ❑ Demolition • tion •. � . Other: ['Service over 225 am comm'1 ;yJ. 4„; : � � �, �:�N� Fp ^„�. w , _ Ps. ©Hazardous location :..1 a e? ;;;;;.;"$2 i! . 2, a k a. y Y ," E;, ° _., ..r..... ,u ❑Service over 320 am rating <. and 2 - family dwelling it ' Y . ...'!i• . iii f PIN :r • •. ;„r.ic�it�,:_ 40.' I of l•• and 2-family ❑$or more over residential sq. l C] Commercial/industrial y 4 or more new residential ❑ Accessory building ['System over 600 volts nominal units in one Structure ❑B Q Multi - family 0 Master builder Building over three stories OFeeders, 400 amps or more ❑ Other: mS y? -y'r +v �` ❑Occu pers ❑Manulhctur d str ucture !.,{ve.•x:v� w 4 3 ..tb. .. Q 1 t , e 71 ` ,� ' .; 1 ` "•,y, .s,�,:;,:.,� ., a Pant load over 99 a or '�12 Y is % "�•: �n ?('k ❑R ress/lighting plan kV park Job no.: . 3 ' Job site address: — ✓ t ∎� L ❑Health- are faeiliry ClOther. Submi ; l , ■ 2_ sots °PAWS with any of the above. The above are not applicable to temporary con no.: , P ry seeder service. Suite/bldg./apt. , r 4 Aa arairt r < i , i ` 1 ' , „ r ° .' r 5 Cross sutet/directions to job site: °eic`ll'u"° Qtr s� Total •• New residential tingle or multi-family dwelling unit. Includes attached garage. 1,000 sq. ft or less 145.15 145. Subdivision: Jia,a I Lot 4 L t . E a. a sq• ft• or portion 33.40 1 Tax map/parcel no.: ;' :; } ,.. Limited energy, residential 75.00 .�i3f.'.rli.. ' 3i:; {.•' vii . �.,x�.,t.! 1 'tl 4ir . d w . S i ., y •.,.{ Limited energy, non-residential 75. UO V r , �' '' � =? Each manufactured or modular V . dwelling, service and/or feeder 90.90 2 . Services or feeders installation alteradun, and/or relocation • =t •�: .,, d �•. ,�„ � � 200 less 80.30 ; ..t8rF o Q! 4 7 ;, AujSf��� �S. r ' c[tid�W j '" l M" P S 2 „ ° t; 1, + s ;a:k rZ•. :7 :n•.Za t 201 amps to 400 amp _ 106.85 2_ 401 am, - to 600 amps 160.60 2 Address: 601 amps to 1,000 amps _ 240.60 2 Over 1,000 amps or volts 454.65 2 City/State/ZIP: liecoruuct only 66.85 2 Phone: ( ) F Temporary services or feeders installation, alteration, and/or ux: ( ) relocation Owner installation: This installation .isbeing made on property that I own which is not 200 amps or less 66 85 I intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701, 201 amps to 400 amp 1 33,75 100.30 v Own Owner signature: 401 amps to 600 amps 133.75 2 { s i g n . t �. �K k y Date Brunch circuits — 2 V ,,.':{,`: c.{. •14.1.. AllA k.�7..,• ; ' 'o�4y n,, } e�t7; r:: i }d w Sj •'.ry'Y 'v t „ new with alteration, or extension, per panel ELF S w ,> .t, a." -f ,. A. Pee for branch circuits with Business name; service or feeder fee, each branch circuit 6.65 2 Contact name: B. Pee for branch circuits without service or feeder fee, . each branch circuit 46.85 2 Each add'l branch circuit 6.65 2 Miscellaneous (service or feeder not included) Phone: ( } Fax:: ( ) Pump or irrigation circle ,:, , r ",,;z,,. N. 53.40 2 53 � Sign or outline lighting >2l~" A > " "'�-' 7 " ; ' tialtd i nal crcui _ . .;. ; „r, ;• ?� �'•: �d2 ±,'.'�:i''<,?°„,:1:dI�'9 ,;`:. �1 �'. ��� �''',,,'�+ "• �lt��', ' ;.��;.:,�.. - S B t {s) or I1m �' F$ 10- t i'• "' •. . .. r paneil o o LIMO '- •,iro r>':i�i�ti��.y.' • � ori ergy . al[ernti 1 , extension. Describe: Page 2 2 It Address: • ) � � c , "— *� ��� ,f Each additional inspection ever allowable in any of the above Per inspection II. 62.50 Phone: ( � '3 ) t ! , f Investigation per hour (1 hr min) 62.50 ' ti -,555c: 55 a Fax: ( 0 • )a 2 )t(� •` 1 � '7 J Industrial . lant per hour r 73.75 �� Suprv. Lie.:3851 `.' • r''' ?"`z2 " ' Suprv. Electrician signature, required: subtotal L . + , ; Plan review (25% of permit fee) Print n8rnc : t1 . ' l� Date: 0 it C State surcharge (8% of permit fee) t Authorized s ere: l � 1 L r�, /� t J TOTAL PERMIT FEE �To a ,jai .1 This permit sppiIcadoa expires if a permit le +wt obtained within ISu .� 3 r t _, , Date: `?l� days alter It has been accepted as complete feint name: ,,� Foe methodology set by Tri- County Building Industry Service Board [:a[ulti iegIPeroth,: iz.PonehAPP -doe 12/01 " Number of inspoetiooe per permit allowed 440 -4615T(1 /02 /ComfW 5y CITY OF TIGARD BUILDING DIVISION ,,, , PERMIT #: ELR2005-00369 13125 SW Hall Blvd., Tigard, OR 97223 . DATE ISSUED: 10021/2005 Phone: (503) 639-4171 :,figillifl'\ Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 10/27/2005 TIME: 4:11PM PAGE: 40 ' - SITE ADDRESS: 12931 SW KOSTEL LN CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 115 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE NO, 2 DESCRIPTION: Security, intercom, audio. OWNER: DON MORISSETTE COMMUNITIES, PHONE #:. 503-387-7538 CONTRACTOR: QUADRANT SECURITY INC PHONE #: 503-234-5558 Inspection Request Scheduled For: Date;. 10028/2005 Pour Time: Code # Inspection Description nfirm # Contact # Message 136 Low voltage 019646-01 603 519-6452 N Corrections/Comments/Instructions: - 6 \V ' L c S. , ,.. ' / i d — 1 r ttl AL .1 1.6.1, It i ,, . 4, A ,,,i,'.i.i. . . ' Al Ai ' aii I , _ . , • VO \19rej) V (.--< Cirv\&9 pq9), ,_.......- .... i \ ( .....„- PASS , PARTIAL APPROVAL fl CANCEL 0 NO ACCESS 0 FAIL I CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED 4 - Inspector: ElL 4 6 Date: , Phone #: (503) 718- ! . . . -