Permit CITY OF TIGARD ELECTRICALPERMIT -
RESTRICTED ENERGY
5Ot DEVE B r SERVICES � 639 -4171 DATE ISSUED: 6/10/03 03 00158
SITE ADDRESS: 13691 SW LEAH TERR PARCEL: 2S109BA -09200
SUBDIVISION: DAFFODIL HILL ZONING: R -
BLOCK: LOT: 018 JURISDICTION: TIG
Project Description: 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
PO BOX 91249 PO BOX 14833
PORTLAND, OR 97291 PORTLAND, OR 97293
Phone: 503- 291 -2550 Phone: 234 -5558
Reg #: MET 00002466
SUP 1211JLE
LIC 96806
FEES ELE R60 € 1 nspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 6/10/03 $75.00 Elect'I Final
[TAX] 8% State Tax 6/10/03 $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 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699.
Issued by �1 ,; 4 11" / Permittee Signature Ar i t � cif
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
46/10/2003 @7:55 5032362322 QUADRANT SYSTEMS PAGE 02
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Electrical Per 1 17- t
mi pp..' lea ton FOR OFFICE USE ONLY
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City of Tigard JUN 1 0 2003 pi arini7*, Approval
Date/By: Sign
, Permit NO.:
13125 SW Hall Blvd. Plan Review Other
Tigard CITY OF TIGARD , Oregon 97223 Date/B: Permit No,:
FA
Phone: 503-639-4171 Fat-36.30WS315U I SIO,.. ,, . , Post-Review Land Use
_Case No.:
Internet: w-ww.ei.tigard.orms N..612,4,t11
_A el 11 Date/B,y;
Contact ,..-irci,s al See Page 2 for
24-hour Inspection Request: 503-639-4175 ''''''' -- Narnevlethod: I (--3 Su lemental Information.
. .::...::•::.•''' • ..: f ,• • '..i.•• '...TYPEADF•WOR.K: • :. ' , •• .:.• • • . • .... • : :. ••••,••:.' ; ' . • .PLAN.REMW:(P16ase cheek till:Alintkikik)• * • '
10 New construction D Demolition iti over 225 amps- I:1 Realth-eare facility
commercial El 1-lazardous location
0 Addition/alteration/re_plaeernent • Other: p Service over 320 amps-rating of 0 Building over 10,000 square feet,
::: ..j'•''' CATF.CORY OF , CONSTXUCTION : :..- • ' . . t & 2 family dwellings four Of more residential units in
1 & 2-Family dwelling Commercial/Industrial 1:1 System over 600 volts nominal one structure
ID Building over three stories 1:1 Feeders. 400 amps or more
III Accessory Building • Multi-Family_ 0 Occupant load over 99 persons 0 Manufactured structures or RV park
111 Master Builder 0 Other: 0 Egress/lighting plan 0 Other:
':: :',7:::, :•i';;; !VIM:SITE:IN . ORMATIONLOCOION ''.•:. , • Submit sets of plans with any of the above.
.e.„ The above arc t_______ uH_Lig,,.able ernpo construction service
Job site address: I 3 Cp I L . ..I CL . , 1 - . ..0 . . : . :]...,:....,., : „.,, ,..,•:,..;•,..,,,,,. ,,.,:,•.::.!:. • :.
Suite #: Bld../Aet.#: Niober of inspections eer permit allowed
Pro ect Name: Dacription . Qty Fee (e.A.) Total
New residential-single or multi-family
Cross street/Directions to job site: , , A
-welling unit. Includes attached garage.
8 u -s- - A - 1 4 -1. 1-,c.ncl , ,ala v:Aa-11/4 service included: • .
_ )000 sq, ft. or less 145. 4
— 145.15 _
Each additional 500,so. R. or portion thereof 33.40 fr 1 ,
Limited energy, residential .,-t 75.00 VS' 2
Subdivision.: Lot #: 4," . Limited energy, non residential 75.00 2
Tax ma •/ • arcel #: Each manufactured home or modular dwelling
i •!:1,';''.!'V;'' iff:;' ,;.: ';'. .. .,, . 'vice and/or feeder 90.90 2
1 I • Services or feeders' installation,
- l ter% • It 1 Alteration or relocation:
a -200 amps or less 80.30 2
1 61‘ :•■•• ‘1( ° I t• C- 4 46 1 ( M"4 *. 411 C 201 amps to 400 amps 106.85 2
401 amps to 600 arnps 160,60 2
FAIE, 9.Prit.' : 'ill 0 j ; , •Rg:: .' H:t!ll 10,102U"Sleiffiffill 60 i alltY tD 1°°° arntk 240,60 2
Over 1000 amps or volts 454.65 2
Name: Reconnect only • 66.85
2
...._
Address: Temporary services or feeders - insitallation,
alteration, or relocation:
City/State/Zip: 200 amps or less 66.85 1
_
Phone' Fax: 201 amps to 400 amps 100.30 2
401 to 600 a_mris ,
133.75 2
. •:; :•■: VitilICA.11 r;;;i1'!•;,:!. '•::.. : :.." if' 0!Ols -::'.. .... . Branch circuits - new, alteration, or
Name: extension per panel:
A. Fee for branch circuit; with purchase of
Address: service or feede fee, eac branch circuit 6.65 2
Cit /State/Zip: B, Fee for branch circuits without purchase of
— service or feeder fee first branch circuit 46.85 2
Phone: Fax: Each additional branch circuit - 6.65 2
E-mail: Misc.(SetVice or feeder not included):
4:•?•-:.;1'0-11;iii::.;;;;i:,,ilii,!IF, iV.:....,•:lpCONviatkeroR.,-.: i, : ..,..• :.... , ..• • • Each pump or irrigation circle 53.40 2 • Each sign or outline lighting 53.40 2
Job No: 10e, ,;_ Signal circuit(s) or a limited energy panel,
alteration, or CMCTLSiOn • Page 2 2 ,
Business Name: 5 , • adr- W......, 4-, 5 Descripticm
Address: J & 1 8 - ern .CCtoff
Each additional ins win over the allowable in an of the above:
Cit iState/Zi. t : ?..4.4A-1 or clq Z • 4' 7)9 5 Per ; d • hour min. 1 hour MI 62.50 J
Phone: •s. ,-,:l 4 - 55 , Fax:S• , ,a31 , - a 4.,,._ 'mutilation fee: EMI
- s Lic # Lie # A s
al . : . : Z..„ 0 - Cce Other:
C MI
. : • . 7: : ;.. ; ':.' .0. :;:; :.,:,..4::::EtatEJ otret . If12.'
Supervising electrician 1 • . . .
, . ,-- . Subtotal $ 7 <,.36
si.. attire re. uired: ' •.• •• A . ,,t,/,...e___--i• - --- - ..-:. Plan Review 25% of Permit Fee $ .
Print Name: .., • ' 101111EIMESEIMIE state surchar. e 8% of Permit Fee MEWL • • .,A ..
TOTAL PERMIT FEE $ - I
Authorized ..._frit..„?
- - L Notice: Tills permit application expires if a permit is not obtained within
Signature: c Date: G 10 3
5. 11)30days been complete.
'Fee methodology set by TO-County Building Industry Service Board.
— :13 t4r)
(P1 care print name)
i:\Dsts\Permit porms\EleperrnitAppAoe 01/03