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Permit 'CITY O F T I GA R D ELECTRICAL PERMIT - RESTRICTED ENERGY il DEVELOPMENT SERVICES PERMIT #: ELR2003 - 00042 13125 S Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/11/03 SITE ADDRESS: 13611 SW LEAH TERR PARCEL: 2S109BA 08500 SUBDIVISION: DAFFODIL HILL ZONING: R - BLOCK: LOT: 011 JURISDICTION: TIG Project Description: LLW r / GITtk6e (JILL_ E\torAlD ere NA) A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: 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: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: Owner: Contractor: HEIGHTS CONSTRUCTION QUADRANT SYSTEMS 1 PO BOX 14833 PO BOX 91249 PORTLAND, OR 97293 PORTLAND, OR 97291 Phone: 503- 291 -2550 Phone: 503- 291 -2550 Reg #: 1VPBT- 55560002466 SUP 1211JLE LIC 96806 FEES ELE l46ged$nspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 2/11 /03 $75.00 Elect'I Final [TAX] 8% State Tax 2/11/03 $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 6m 4La r ±�+J'(� Permittee Signature _C__ S 1 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._ELECN_ _ DATE: LICENSE NO: Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day 2 -1E 36PM FROM QUADRANT SYSTEMS 503 236 2322 P. 5 s a. ' • ]EiectricalPermitApplication 1 Datereeelived c -11_0 5 Permit no.: F0, .. ,y • ` Tit City of Tigard � 23 l ro ect/appl. no Expire date; , A ddress: 13125 SW H(a11 �a'd OK City of7 Ti Date issued: Sai3 Receipt no.: i Phone: (503) 639 -4171 1 Fax: (503) 598 -1960 FEB 1 0 2003 • Case file no.: Payment type: . :i i. • Land use approval: CITY OF Tir;ABD - F TYPE OF PERMIT 'el 1 & 2 family dwelling or accessory CI Commercial/industrial Cl Multi - family Q Tenant improvement r j 1 New construction © Addition /alteration/replacement U Other: • 0 Partial i • JOE SITE INFORMATION • Job address: i (JO $ w A to recto. — Ti , l._ Bldg. no.: Suite no.: Tax map/tax lot/account no,: il Lot I ' Block: Subdivision: - - j ' tom C►t; L t t 1 Project name: Description and location of work on premises: c)--A ti-i-, ' }.,� 3 �� S' s '4�4. • a P p Estimated date of completion/inspection: • ,,,, ,u R ,-e-(3 r(, t . ' ' • 4 • w ~ CONTRACTOR APPLICATION i FEE SCIIEDLu ..E Job na Re • 1 1 _" �, Description Qty. (tom) Total no: its Business aazne�s7.�_c1Crc1} rc'•"?� — New residerdird- single ormniti- family per Address: TO ( j -1 Q33 dwelling unit. Includesattacbedgarage. 1 City: PqR.� -Q (.a- -4 . I State:E - I ZIP: Z- Sc,�icchtcluded: • t• Phone: < 4• -5 f 1 Fax•.D3t -3j E -mail: 1000 sq. ft.,orless• 4 1-1, • CCB'no.: c/L, I Elea. bus. lic. no:, •5 l.S } Bach additional 500 sq. ft. or onion thereof ( Lim energy,sesidential -%.` x t I' Cst metro lie. n. ajt .1.4 l • i.intlted energy, non - residential ' 7.', 11 • O r 0 c.to ' Bach manufactured home or modular dwelling F Signature of stspersiising electrician (required) Date Service and/or feeder 2 � Sup. elect. name (print): CM a I . Lic no: 42., l l 1--F----4 Servl or deno insta liatio Altet$tionorre - n, t o j I'ROi E1 'I'YY OWNER ?AO'amps.orless '4 i Name (print): • 201 amps to 400 amps C • • Mailing address:. 4 01 am ps to 600 amps 2; g 601 amps to 1000 amps 2 City: State: ZIP: Over 1000 amps or volts Zl i Phone: Fax: E -mail: . Reconnect onl • 1` i . Owner installation: The installation is being made on property i own Temporary services or feeders.- ! , installation, alteration, or relocation which is not intended for sale, lease, rent, or exchange according to Zoo or le ss . ii a ORS 447. 455, 479, 670, 701. '. — 201 amps to 400 amps 2 Owner's signature: Date: `. • • 401 to 600am.. Z - ENGINEER Scratch circuits - new, alteration, r, • . • . or extension per panel: Name. • • • - A. Fee for branch circuits with.purchase of Address: • service or feeder fee, each branch circuit ' 1 City: I State: - I ZIP: . B. Pee for branch circuits without purchase . Phone: Fax: E-mail: service or feeder fee, first branch circuit: .f2 • Bach additional branch circuit: i• PLAN REVIEW (Please Cheek all that apply) Misc. (Scrviceorfeeder not included): ' O Service over 225 ampscommendat O Health- Care facility 5achpump o[ irrigation circle • �c''�_ © Service over 320 amps-rating of 18a2 ❑ Hazardous location • Bach signor outline lighting . l family dwellings C1 Building over 10,000 square feet four or Signal cireuit(s) or a limited energy panel, it O System over 600 volts nominal • • more residenial units in one structure alteration, or extension a O Building over three stories 0 'Feeders. 400 amps or more SDeaer ption: ti o i. Occupant load over 99 persons • 0 Manufactured structures or RV park Each additional Inspection over the over in any of the above: O Egress/lightingplan . ❑ Other: Per inspection - -1 1 Submit , sets of plans with st of the above . investigation f e e • The above are not applie ble to temporary construction service. Other '14ot all jurisdictions accept count cards, please can jurisdiction for more information- Notice: This permit application Pel fee $ � ✓, . — - O Visa Cl MasterCard expires i£ a permiris not obtained Plan review_(at_ %) $._ jI Credit card Dumber / / within 180 days after it has been State surcharge (8%) .... $ ° ) ' Expires accepted as complete, TOTAL • $ 1 • . marts et cardholder as shown on credit card : . $ , • 441I ` Cardholder signature Amount . 440.6615 (C+K7�l/C0 ) . Z CITY OF TIGARD 24 -Hour /, {� 1 BUILDING r Inspection Line: (503) 639 -4175 MST — v G INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested ��� AM PM BUP Location 34 ).p Suite MEC - Contact Person il�,iv Ph ( ) -CJ • 9 -/ 7q=ii' // PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING (-- Post & Beam Under Slab Rough -In 1/)1 Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post& Beam Rough -In Gas Line Smoke Dampers Final PASS - PART FAIL e E C Tg1CAL ce Rough -In UG /Slab Low Voltage Fire Alarm final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. - ART FAIL ❑ Please call for reinspection RE: 111 Unable to inspect — no access Fire Supply Line ADA Date LC) � 3 Inspector _' ' 8% Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL