Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
Mit DEVELOPMENT H B (503) 639 -4171 DATE ISSUED: 11/7/00
00 -00269
- 13125
SITE ADDRESS: 12436 SW QUAIL CREEK LN PARCEL: 2S103CB -09100
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 049 JURISDICTION: TIG
Project Description: Landscape Controller
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: ;ONTROLLER : 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 Elect'l Final
PRMT CTR 11/7/00 $75.00 2720000000
5PCT CTR 11/7/00 $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 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by f Permittee Signature 4 ' LQ1-64
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
C[IVEr Per no.:
Datereceived: iris -AD � J
A Cl of Tigard Project/appl. no.: Expire date:
dJ ®ii 97132000
City of Tigard Address: 13125 SW Hall Blvd Tigar , Date issued: CID 1,���I Receiptno.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 • COMMUNITY DEVEI.OPMEN Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial O Multi - family 0 Tenant improvement
New construction 0 Addition/alteration/replacement 0 Other: ❑ Partial
JOB SITE INFORMATION
Job address: c 3!0 S W &..UG.t-Q. ,,Ter. (A/7 ", Bldg. no.: Suite no.: Tax map /tax lot/account no.: (CBS
Lot: L(9 B lock: , !Subdivision:(yu UGC / / / %CTC -L)
Project name: (,1,(a,CQ, /`70// ) I Description and location of work on premises:
Estimated date of completion/inspection: Dec. /S -
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: `I — — to ( D — a . Fee Max
Descr Qty. (ea.) Total no. insp
Business name: p✓o6/�c e SS % ail CISLupc New resident single or multi- family per
Address: /gq5 5 w Kins y)C.cN 2t'
L ) dwelling unit. Includes attached garage.
City: (-Ole S v I / f -e— I State:Ok I ZIP: c/ 7L '7 0 Service included: 4
Phone a — (�,C I Fax: ( ,3, _ 9 7 f ;E-mail: 1000 sq. ft. or less
Each additional 500 sq. ft. or portion thereof
CCB no.: GI 3 (p I Elec. bus. lic. no: Li energy, residential 2
City /metro lic. no.: cc, 3 )--( Limited energy, non- residential 2
C 2�-.4 4 .0a ( ,RA-) Each manufactured home or modular dwelling
sing electrician Date Service and/or feeder 2
Signature of supervising electrician ( required) Services or feeders — installation,
Sup. elect. name (print): D / t°n spAr c .) License no: alteration or relocation: •
PROPERTY OWNER 200 amps or less 2
L !� �� ,, _ 201 amps to 400 amps 2
Name (print): Dcm !170 - Y% G' 7 r t rS 401 amps to 600 amps 2
_
Mailing address: L f,. p &(.t_ 661_1 J)J cod S-T i52ui c k.. )0 601 amps to 1000 amps 2
City: LP-1C e.. D S2. y C) I StateO ,ZIP: cj 76,3 3 4f Over 1000 amps or volts 2
Phone: IFax: E-mail: I Reconnect only 1 -
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 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
Branch circuits - new, alteration,
or extension per panel:
Name: - A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
I State: I ZIP: B. Fee for branch circuits without purchase
City: 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): 2
Each pump or irrigation circle
O Service over 225 amps- commercial • ❑ Health-care facility tig 2
O Service over 320 amps - rating of 1&2 0 Hazardous location Signal Each h sign ggn nc or r outline
or a limited ligghh energy panel
family dwellings 0 Building over 10,000 square feet four or g , 2
❑ System over 600 volts nominal more residential units in one structure alteration, or extension*
❑ Building over three stories ❑ Feeders, 400 amps or more 'Description:
O Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan ❑ Other: Per inspection I I I
Submit _ sets of plans with any of the above. Investigation fee
The above a re not applicable to temporary construction service. Other .
Permit fee $ �—
Not all jurisdictions accept credit cards. please call jurisdiction for more information. Notice: This permit application Plan review (at %) $
O Visa ❑ MasterCard expires if a permit is not obtained ,
/ / within 180 days after it has been State surcharge (8 %) .... $ GG
Credit card number: Expires TOTAL $
accepted as complete.
Name of cardholder as shown on credit card $
Cardholder signature Amount 440-4615 (6/00/COM)
Electrical Permit Fees: • Limited Energy Fees:
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4, Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ 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 El
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 they 4
amps to amps $240.60 2 p � / S - C
Over a , /7 � _
Over 1000 amps ps or volts $454.65 2 [ �f `-`ln G /r -n `7
Reconnect only $66.85 2 C_l—n) L le
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
2000 0 aonmps or less Installation, or relocation $66.85 2 Fee for each system $75.00
amps o l
201 amps to 400 amps $100.30 2 (SEE OAR 918 - 260 -260)
401 amps to 600 amps $133.75 2 Check 600 amps to 1000 volts, heck Type of Work Involved: •
•
see "b" above. ❑
Audio and Stereo Systems
Branch Circuits
New, alteration or extension per panel n Boiler 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 p Data Telecommunication Installation
without purchase of service •
or feeder fee. I t Fire Alarm Installation
First branch circuit $46.85
Each additional branch circuit $6.65 l l HVAC
Miscellaneous ri (Service or feeder not included) Instrumentation
Each pump or irrigation circle $53.40 SI I I
Each sign line lightir.^ $53:40 n Intercom and Paging Systems
Signal circ or a limited r, . _rgy
panel, motion or extensior $75.00
Minor Labels (10) $125.00 n Landscape Irrigation Control
Each additional inspection over El Medical
the allowable in any of the above
Per inspection $62.50 Nurse Calls
Per hour $62.50
In Plant $73.75 r --,
Outdoor Landscape Lighting`
Fees: n
Protective Signaling
Enter total of above fees $ 53 `
17 n Other
8% State Surcharge $ CA g
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 , 6 7 Fees:
Enter total of above fees $ 75
❑ Trust Account #
8% State Surcharge $ 6 03
Total Balance Due
i:\dsts \forms \elc- fees.doc 10/09/00 •
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business ' • 9-4171 MST
BUP
Date Requested ` -_ / -10 PM
/_ // / BLD
Location • f ? ( -(3 J� L i, 47 Suite MEC
Contact Person Ph PLM 4 — dd `4/ Y'
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR a 004 (
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: r / /- SGT
Slab / isJ" 441r244 Z�/Z — Kiel-4 SIT
Post & Beam
Ext Sheath /Shear �! /AAA /1 I , / _
IN / /r � •°/�n�
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Roof Ceiling
Roof
Misc:
Final
PASS PART FAIL
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains , _ _ � 4
PA S PART FAIL
HANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
RIC
Service
Rough In
UG /SI
!.w Volt
Fire Alarm 1.41 4
A FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ I 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: [ • able to inspect - no access
ADA
Approach /Sidewalk
Other Date �� 7 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.