Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
41il (4� I 'l. DEVELOPMENT r S O ERV SERVICES 639 -4171 DATE ISSUED: 3 -00162
13125 ED: 6 16 03
SITE ADDRESS: 13612 SW LEAH TERR PARCEL: 2S109BA -08400
SUBDIVISION: DAFFODIL HILL ZONING: R -7
BLOCK: LOT: 010 JURISDICTION: TIG
Proiect Description: Installation of All Encompassing low voltage.
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:
HEIGHTS CONSTRUCTION QUADRANT SYSTEMS
P.O. BOX 91249 PO BOX 14833
PORTLAND, OR 97291 PORTLAND, OR 97293
Phone: 503- 209 -1794 Phone: 234 -5558
Reg #: MET 00002466
SUP 1211JLE
LIC 96806
FEES ELE Fiec~nspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 6/16/03 $75.00 Elect] Final
[TAX] 8% State Tax 6/16/03 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 throuc
Issued by o _� � �� ! Permittee Signature 011)4 gt � �
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
— SIGNATURE- OF— SUP-R.- ELEC'N DATE:
LICENSE NO: .
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
0E/12/2003 11:30 5032362322 QUADRANT SYSTEMS PAGE 01
lectrical Per �onlit A licatio> _ FOR OFFICE USE ONLY
Date/B
' F;cccived Electrical
v ifo Permit No.
City of Tigard RECENED P ... 3 Planning Approval gi 3 -00/4e,a
13125 SW Hall Blvd. Date113y; Permit No.:
Plan Review Other
Tigard, Oregon 97223 JUN 1 2 2003 Date/By: Permit No.:
Phone: 503- 639 -4171, Fax ;,,503- 598 -•1 -960 Post - Review Land Use —
lnternet: www.ci.ti ard_or.lasLai 11( Ur I IIa „: 41 1 ?\ batc/By, Case No -:
g i s m NG plvI$ n =4� rA i ' Contact 1ufis Sce Pape z for
24 -hour Inspection Request• 503 - -4175 Namc/Method:
Supplemental Information.
New : , "'P c1t+�.Z�tt�till',tliatca ' -
construction Demolition Service over 2z 5 a p�1Y�
Min- 0 Hcatth -cafe facility
Addition/alteration/re - commercial I- aza
ther Service over 320 am s•ratin q on
�,.,: : ::� Gs't�,iT•BO�1'1Ct � P 8 f ❑ Building over
.. . ., .., r, -. : ,• . X.OF;:CoNs ttjex'fos...' : I g i r 10 An t l units feet.
'• _ p 2 family dwellings four or more residential units in
1 & 2 - F amil y dwelling mmriercial/Industrial
❑ Co ❑ System over 600 volts nominal one structure
Building
El Building over three statics ❑Feeders, 400 amps or more
1 g ❑ Multi- Family_ 13 Occupant load over 99 persons p
�] Master Builder Other' El plan ❑ Oh Manufactured structures or R park
k
i, :a',`.'''' '. ... : 1; s 1' , r' Iaori :Is.1r.'•aN,rb mg.rioNlitid : LOCATI S above.
Egress/lighting a
+ � 1 _
lob site address: �
Suite t 5 w L�f7 (rl T� Y i'Q t? The Above are not applicable to temporary construction servic
#: . /Apt.#: f ;na 5.>~ ,, :, ; . �,.
Bldg ;�.: ' • �.'I�„''`':��;'. .. �;�,, .,
Number of Inspections per permit allowed
Project Name: i Description Qty Fee (ca.) Total I
• Cross street/Directions to job site: New residential-single or multi-family per
dwelling unit Includes attached garage.
Service Included:
1000 sq- ft. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 I
Subdivisi Limited energ resident
��Vt.7 1 USE t� J Lot lt}`: I td 75.00 2
Tax ma /pe> CcI Limited energy, non residential 75.00
Each manufactured home or modular dwelling 2
la'' . " ''';' : Il" "'r ' :• ;; .DIY , ' "u ±!:.11 service and/or feeder
1` � �'����;X��:i 1�'�yF;r ' ... ..,.. vi d/ fr 90.90
2
Services or feeders • Installation,
t, ,a ..- . IIi I AA . t j iA. ..s • / . Q _ alteration or relocation:
St „ .1 `/ t 200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
r 401 amps to 600 amps. 160.60 2
,'9 iii I. r, +� ', ,.,. ... .i�,i:'" Ih}L�''NA ;+ti5: -at f " .';I„r• ' GOl amysto mp9 _
Name: Oyer 1000 am ps 1000a or volts 240 -GO 2
454,65 2
Reconnect only 66.85 2
Address: Temporary services or feeders - installation,
City/State/Zip: alteration, or relocation:
200 amps or less 66.85 1
Pbozre: Fa 201 amps to 400 amps
`°; s 7Pr 1r A1V yy 00am s 100,30 2
�- p T.::',I! :; ',, :;!, : : : : ;!::'r'IElIt 1 0.Nii :: -
401 p 133.5 2
Name: � - �- Branch circuits - flew, altcratioa, or
,1i. /i . - .: 'll, extension per panel:
Address: Po X4833 ' A. Fcc for branch circuits with purchase o
Clt service or feeder fee, cash blanch circuit 6.65 2
y /State /zI p: J-'�7y , Q.1/t� Orr. ( 's.'1 �t B. Fee for branch circuits without purchase of
Phone:'- 23 4 $ Fax: • z.3(p• a 22 6.65
service or feeder fee, first branch circuit 46,85 2
a' -2 Each additional branch circuit 6,65 2
E -mail: Misa(Scrvice or feeder not included):
I i: ,; ; : ,: " . P Gh ut11 ar i rri a
1Thh . =.r.:. ,.Ill � " ;.Ji.fi ;i�ki:j;��f' i� WI--'1 �' r . "'':. - ' P P R lion Circle 53.40 2
' . I ... ,:... .. Each sip�n or outl lighting _
Job No: 53.40 2
Signal eireuit(s) or a limited energy p::ncl,
1 �' , r. I alteration or extension ' P:•e2 '25.00 2
Business Name: 6 '` Description:
Address: !< X ti -,g1,b
City/State/Zip �(,� � , q1 each additional Inspection aver tl�hwable in any of the above:
Pcr inspection per hour (min. 1 hour) _ 62,50
Phone; 503 2 3y X1555 Fax: 503- 2 3(12 2,322_ Investigation fee:
CCB Lie. ,Sc io Lie. Z&.' EP O ther:
alt ?ZtY'4Ca1P�!i°fihli� �.n..:
rY`= "i'iilf'
Supervising electrician ... �r:, � `�'. � ": i>�' "�� � ,rq ll�r F „ r.
signature required; � Subtotal $ • f
Pla R ev i ew (25% of Permit 1~ eel $
Print Nar..acg1'C,II 4'291 t 0 V I Lie. #: (2. -(/ — State Surch PGrnrit t $ ce -00
Autftorizcd_ TOTAL PERMIT FEE $ 'Qi -
r ` Notice: This permit Application expires i a permit is not obtained within
Signature: !/1i /{' 64.4 j G� • bate: // 2 1 days after it has been accepted as complete.
�Jl •Fee methodology set by Tri -County Buildinx Industry Service Hoard.
41 P)us o - L &lrrlilvl,j rttt AAaanal Y. U2QS�e - PUI X buck C n&k. '
(Please print name) , '' r
is \Dsts \Permit FormslElcPermitApp -doe 01/03 a,yL�t�