Permit CITYOFTIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
; DEVELOPMENT SERVICES PERMIT #: ELR2000 -00268
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/7/00
SITE ADDRESS: 12541 SW QUAIL CREEK LN PARCEL: 2S104DA -00200
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R-4.5
BLOCK: LOT: 039 JURISDICTION: TIG
Project Description: Landscape Controller
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPEIIRRIGAT:
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 SW GALEWOOD ST 29895 SW KINSMAN RD
STE 100 WILSONVILLE, OR 97070
LAKE OSWEGO, OR 97035
Phone: 503 - 387 -7538 Phone: 682 -6076
Reg #: LIC 6136
FEES Required Inspections
Type By Date Amount Receipt Elect'I 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 ( Permittee Signature "rlit:2-e_44?
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
. 40 .
Electrical Permit Apili : 9n
Date received: Permit no.: /0 24
;' :i City of Tigard g ard, OR�9 nn'' ``'' Project/appl. no.: Expire date: -
Add 13125 SW Hall Blvd, Ti 223u 20�� Date issued: ( (l1
City of Tigard n B Receipt no.:
Phone: (503) 639 -4171 111
Fax: (503) 598 -1960 COMMUNITY DEVELOPME file no.: Pa ent type:
Land use approval:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement
■ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
. JOB SITE INFORMATION
Job address: fa 5/-) J QUCL.LL Creez. Lan - Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: 3 9 I Block: I Subdivisions .LLB[ -1( dip I I cn,u / .. t 9 c ti On.
Project nameatLW ( Hp( Jim 3' I Description and location of work on premises: La eel t✓ (11771, / /er
Estimated date of completion/inspection: 0 3 • tf •
CONTRACTOR APPLICATION I M
FEE SCIIEtE
Job no:
UO -- Ga (P sq - ' Fee Mart
Business name: PrO ( t S S / ail GS Cap Description Qty. (ea.) Total no. insp
N ew residential idential - single or multi- family per
Address: c c:-/ gq5 .5 LI2, K,r ' nc:LA dwelling unit Includes attached garage.
City: L1) i (S L`71 v t / 1-�.• f State:O/Z_ I ZIP: G / 7 or .) Service included:
Phone - 4c07 I Fax: 6SP), -9671 -mail: _ 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
CCB no.: p f E l o �l �� Limited energy, residential 2
City /metro lie. no.: CC) :)-( Limited energy, non- residential 2
C --/7 / u /1...4T-/1...4T-G43 .4� Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date / -0'-00 Service and/or feeder 2
Services or feeders - installation,
Sup. elect. name (print): Ej / e S 74 r 6 .-1..0 License no: alteration or relocation:
- -. - - -- - - PROPERTY OWNER - - 200 amps or less 2
Name (print): Dc non- % SS C , lir mts_C 2
.1� 201 amp to 400 amps 2
. 401 amps to 600 amps
Mailing address: Z.-/-,30 �U 6a /e_ .) cad ST i 60 601 amps to 1000 amps 2
City: LO—KG GS -7C, I State° fj.ZIP: e/ 763 _ Over 1000 amps or volts 2
Phone: • (Fax: 1 E -mail: 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
ENGINEER 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
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): / 53� — 2
O Service over 225 amps - commercial • 0 Health -care facility Each pump or irrigation circle
O Service over 320 amps-rating of 1&2 0 Hazardous location
Each signor outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or ex tension* 2
O Building over three stories 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lighting plan 0 Other. Per inspection I I I I
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
• Permit fee $ 7 S- cio
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
Plan review (at %) $
O Visa 0 MasterCard expires if a permit is not obtained
Credit card number C. v
/ / within 180 days after it has been State surcharge (8 %) .... $ .-��
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card S
Cardholder signature Amount 440-4615 (6/00/C0M)
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 y 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 El
401 amps to 600 amps $160.60 2 Other r
601 amps to 1000 amps $240.60 2
Over 1000 amps or volts $454.65 2 !an lifs-C C f
Reconnect only $66.85 2 Cern 7 //>°, '
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation F for each system $75.00
200 or 201 amps to less $66.85 2
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 El Data Telecommunication Installation
without purchase of service
or feeder fee. ,
Fire Alarm Installation
First branch circuit $46.85
Each additional branch circuit $6.65 HVAC
Miscellaneous
(Service or feeder not included) I Instrumentation
Each pump or irrigation circle / $53.40 53, Leb
Each sign or outline lighting $53:40 El Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 El Minor Labels (10) $125.00 Landscape Irrigation Control`
Each additional inspection over n 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:
Protective Signaling
Enter total of above fees $
53 , -/C)
8% State Surcharge $
O7 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 $ 5 7, G 7 Fees:
Enter total of above fees $ 75- ,&._
❑ Trust Account # •
8% State Surcharge $ COP
•
Total Balance Due $ 5 N
•
I :\dsts \ forms \elc- fees.doc 10/09/00 •
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 -
BUP
Date Requested 2-7 AM PM BLD
Location /Z-P/( S w Qo Gt � f GrEc ' Suite MEC
Contact Person Pr' t24 55 Ph 5Z3 -6YZ'' PLM Zee-r. - O (a 3
Contractor Ph IX-0V 7 SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR 7144) ci c' Z(
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
PLUMB
Post & Beam
Under Slab ��
Top Out ((,� j
Water Service
Sanitary Sewer
Rain Dr -'Is
Fin,
• 'ART FAIL
HANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
C€LECTRICZ7
Service
Rough In
UG /Slab
/Cow Volta
e
Fi -
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 h /Sidewalk D ! /9 �7 Inspector /t�-t
Other tor Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.