Permit . A CITY OF TI GARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
41P.tosa I ' DEVELOPMENT SERVICES PERMIT #: ELR2000 -00254
I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/1/00
SITE ADDRESS: 12192 SW QUAIL CREEK LN PARCEL: 2S103C6 -10400
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5
BLOCK: LOT: 062 JURISDICTION: TIG
Project Description: Installation of limited energy for irrigation control.
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: IRRIGATION : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE HOMES PROGRASS LANDSCAPE SERVICES
4230 GALEWOOD STREET 29895 SW KINSMAN RD
SUITE 100 WILSONVILLE, OR 97070
LAKE OSWEGO, OR 97035
Phone: 274 -5223 Phone: 682 -6076
Reg #: LIC 6136
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 11/1/00 $75.00 2720000000 Elect'l Final
5PCT CTR 11/1/00 $6.00 2720000000
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 o ' ' rough OAR 952 - 001 -0080. You may obtain copies of these rules or direct quest s to OUNC at (503) •
246 -1 • :7.
Issue • • y (�,t n t Permittee Signature �2 j ..A21_12 .-4
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
Electrical Permit Application
• Date received: /p- pjp -CO Permit no.: O - op a
..,1 ' i,
' �•��i i City of Tigard � Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, 97223 Date issued: 134Debl Receipt
Phone: (503) 639 -4171 '511a Fax: (503) 598 -1960 ()CI % Case file no.: Payment type:
Land use approval: rtZAn 21.1 E1¢P1I •
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement
`I4 construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job address: / 9 Q C -e-Liu-e_- ' , ' Lai)e. Bldg. no.: Suite no.: Tax map /tax lot/account no.: 6 55 13 c
Lot: Block: (Subdivision: HU / /CTU(
Project name: a-lajle Hr((tSLU (A oL I Description and location of work on premises: Land S Ca e , I r'Y7q Ai," OY1
Estimated date of completion/inspection: av 34-ei4 • _y i r et' ✓
_ ONTRA OR AEPLLCAT.ION --�-._. FEE SCIIEDU.E
Job no: 00 - , - Co a - P Fee Max
Business name:Pjo LandSCQfo-e.___ Description Qty. (ea.) Total no.insp
New residential - single or multi - family per
Address .' f S SIG() k ( r}S - /na/L•.l 2 •D dwelling wilt. Includes attached garage.
City 1 ! gtY1 011 I-C•i n I S tateO/L_-I ZIP: q 707 Q Service included:
Phone'a -6 Cal n lFaxtc k a- Y1 E-mail: 1000 sq. ft. or less 4 ,
,J Each additional 500 sq. ft. or portion thereof
CCB no.: (� / 3 (p I Elec. bus. lic. no: Limited energy, residential 2
City /metro lic. no.: ()) 3 2.4 Limited energy, non - residential 2
uell )etri [ /b/, L/ /OO Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2
Sup. elect. name (print): License no: Services or feeders- installation,
alteration or relocation:
- -- • — - - - - --- - . - - - - - -- PROPERTY OWNER 200 amps or less 2
Name (print): bp-r) /f tTYI S S C / /C /JZ3r - 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address:9,93U S.t.(> Gc c��czyd., / 601 amps to 1000 amps 2
City: A I«', D g't, v I State. R_ ,I ZIP: g 7O3¢- Over 1000 amps or volts 2
Phon . 3)/o$a —(�Or7 ax:/,,,$A- 77ti E -mail: Reconnect only 1
• Owner installation: T 1 tion is being made on property I own Temporary services or feeders -
which is not intended for se, lease, rent, or exchange according to llation, alteration, or relocation:
200 amps or less 2
ORS 447, 455, 479, 670, 701.
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: ; service or feeder fee, ::ia:h branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E-mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
O Service over 225 ampsommercial •❑Health-care facility
Each pump or irrigation circle / 53 y`)1/4.
S.- A 2
❑ Service over 320 amps - rating of 1&2 ❑ Hazardous location Each sign or outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, .
❑ System over600 volts nominal more residential units in one structure alteration, or extension* 2
❑ Building over three stories ❑ Feeders, 400 amps or more *Description:
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lightingplan ❑ Other. Per inspection I I I l
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other [-
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ �1, ' c7
❑ Visa CI MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ to . CO
Expires accepted as complete. TOTAL $ cF/
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440-4615 (HW/COM)
•
Electrical Permit Fees: Limited Energy Fees: ..
..
TYPE OF WORK INVOLVED - RESIDENTIAL ONL
Complete Fee Schedule Below: c
Restricted Energy Fee $75.00
•
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total Check Type of Work Involved:
Residential -. per unit
1000 sq. ft. or less $145.15 4 El Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 ' 1 ❑ Burglar Alarm
Limited Energy $75.00 •
Each Manufd Home or Modular Garage Door Opener
Dwelling Service or Feeder $90.90 2
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less $80.30 2 Vacuum Systems'
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 they �
Over 1000 amps or volts $454.65 2 /"
Reconnect only $66.85 2 c2O71 7 //ey'
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation
200 amps or less $66.85 2 Fee for each system $75.00
201 amps to 400 amps $100.30 2 (SEE OAR 918 -260 -260)
401 amps to 600 amps $133.75 2
Over 600 amps to 1000 volts, Check Type of Work Involved:
see "b" above. ❑
Audio and Stereo Systems
Branch Circuits
New, alteration or extension per panel Controls
a) The fee for branch circuits
with purchase of service or ❑
feeder fee. Clock Systems .
Each branch circuit $6.65 2
b) The fee for branch circuits ❑ Data Telecommunication Installation
without purchase of service
or feeder fee. 1 1 Fire Alarm Installation
First branch circuit $46.85
Each additional branch circuit $6.65 HVAC
•
Miscellaneous
(Service or feeder not included) ❑ Instrumentation
Each pump or irrigation circle I $53.40 53. y a
Each sign or outline lighting $53:40 ❑ Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00
Minor Labels (10) $125.00 ❑ Landscape Irrigation Control
Each additional inspection over ❑ Medical
the allowable in any of the above
Per inspection $62.50 n Nurse Calls
Per hour $62.50
In Plant $73.75
ri Outdoor Landscape Lighting
Fees:
53 b 0 Protective Signaling
Enter total of above fees $ ' `�
/
8% State Surcharge $ /7 / • a 7 n Other
Number of Systems
25% Plan Review Fee
See "Plan Review" section on $
• No licenses are required. Licenses are required for all other installations
front of application.
•
Total Balance Due $ 57-€.0 7 Fees: S Enter total of above fees $ ''
7 J
❑ Trust Account #
8% State Surcharge $ C'
Total Balance Due $ 8I - oz)
i:\dsts \forms \elc- fees.doc 10/09/00
PITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
J / BUP
Date Requested / (" AM PM BLD
Location / 214 1-5 4i Qk 4 17 02,u1 Suite MEC
Contact Person J /,e) Ph ..70 z-f 3 7 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR Q
Footing Access:
Foundation FPS
Ftg Drain SGN
Slab I Drain Inspection Notes: �
Post & Beam /` ` ifi' /'' SIT
Ext Sheath /Shear /
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
tCTR[gAD
ice
Rough In
UG /Slab
ow Voltage')
ire arm
Fin
PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA `
Approach /Sidewalk /
Date /6 - 0 Ins Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 - Business Line: 639 -4171
BUP
Date Requested 1/- Z AM PM BLD
Location ( Z / 9 Z_ Otter ! GZ.c.c. t Suite MEC
Contact Person f7rL 5) Ph 5 G Z ,C PLM V U
Contractor Ph ex 2 / 7 SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR 7...e>011-0 2.5
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL 1 A
Post & Beam
Under Slab
Top Out t 4C/C clot,
Water Service
Sanitary Sewer
Rain Drains
F'n .
PART FAIL
ANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ECTRI
Service
Rough In
UG /Slab
Fire Alarm
Fi
4 PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA / Other Date //72V, Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.