Permit l + CITY OF TIGARD ELECTRICAL -
ENER
RESTRICTED ENERGY
E DEVELOPMENT SERVICES PERMIT #: ELR2003 -00348
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 DATE ISSUED: 11/13/03
SITE ADDRESS: 12385 SW THORNWOOD DR PARCEL: 2S1106C -04700
SUBDIVISION: THORNWOOD ZONING: R -7
BLOCK: LOT: 018 JURISDICTION: TIG
Project Description: All encompassing low voltage
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:
DON MORISSETTE HOMES QUADRANT SYSTEMS
4230 GALEWOOD ST PO BOX 14833
STE 100 PORTLAND, OR 97293
LAKE OSWEGO, OR 97035
Phone: 503 - 387 -7538 Phone: 503- 387 -7538
Reg #: SP14- 5558211JLE
LIC 96806
ELE 26- 565CLE
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT]ELRPermit 11/13/03 $75.00 Elect'IFinal
[TAX] 8% State Surcharl 11/13/03 $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 :, •ted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 throuc
Issued / � J Permittee Signature ��� ;•� ��—�—
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
11/10/2003 14:39 5032362322 v QUADRANT SYSTEMS PAGE 02
p,� � FOR OFFICE USE ONLY
L' leetrelea Pel'YYIIL A Received t? !G „_ Electrical
AI Dat e/By: I f / d JJ J Permi No,: E L Pee!" 3 St
City O Tigaird ` • NOV 1 u Planning Approve Sign
Datc/8Y: Permit No.:
13125 SW Hail Blvd. .. Plan Review Other
Tigard, Oregon' 97223 CITY OF TI RD DatcI y: Permit No.:/ /?,�(i!0 Gb 562 -
Phone: 503 -639 -4171 . Fax: 503- 5a11111I IG D a Post- Review Land Use �^ � . 1 Date /13y: Case No.:
hiternet: vtnv<vci_tigard.or.us r t tiTt I Contact )71(1, CI See Page 2 for
—
24 -hour Inspection Request: 503 -639 -4175 -- Nalnc/Method: V Supplemental information.
:d .5 i ;; r:i-:w 1 ,ltl± ; r ;,O - .0 °.0 �I ,•q r� �U . n.._. e, �y5; I . h tar r y r:.-
r�b• .l, .tip f�li� ! 11:.i .. 'I pz+ Y�`. tl r '? ;,; t3;s t l N :.;,; s : i <! 'I '' Iw .� 1 ` t aMi li l? l? I r + '
J,ti:V, ,.,... !� " K% _.... � i,. ':I 111 ..,El ;:. 4�.. .?k� � � Y•: � t ; . ,.
New construction Q Demolition 0 Service over 225 amps - 0 Health -care Facility
commercial ❑ Hazardous location
• Addition/alteration/r • ■ ]acement l i t Other: 17I Service over 320 amps - rating of ❑ Building over 10,000 square il,el
I.i gyp. - {.. , _ ppi 1 rd � rpry E S q"it + ; •r y
-',;r ''. ; � '
.
r . rxif '. ?h,:il�F�. ' I_' �*� ��+�i���1 �„tjh ' �.r���t,lj�l�:•�'ip `�•' � '. 1 & 2 family dwellings four or more residential units in
1 & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories Q Feeders, 400 amps or more
n A ccesso. Building Multi -Family _i�-� ,� S Y � ['Occupant load over 99 persons ❑ Manufactured structures nr RV park
❑ Master Builder Other: ❑ Egress/lighting plan ❑ Other: _ —___,
iMIi D e s ks S 401 , 'j „r > r h O* Oy AIM - %. , �y�,iig Baboon sets of plans with any of the above.
4 i Y ``` The above are not ap licable to temporary construction service.
Job site address: I ; ?) ' 5 � - 11 -f / , 1,;i tin *:71(4Y^ ,.r�Y^ iiytyt'� I' q'p��' ;Icpr��n'�'y(/
/���I Z V �1
' fill 41Y.. I. I �, ' �SA`lrr ''N9�It�q�.44M1 Suite #: Bldg. /Apt. #: . _ - . Number of inspections per permit allowed -
Proj ect Name: _bz>f M 043.gc Q -t i .LC Description J. Qty Fee (ea.) I Total
Cross street/Directions told!) site: New resident In single attache fatuity per
dwelling unit. Includes attached garage.
1 c .. ( . Service included: . . •
1000 sq. R_ or less v 145.15 4
• - Each additional 500 sq. ft. or portion thereof v 3140 ' cr . 1 .
� � �I Limited energy, residential . I. ' 75.00 c 1 2
SUbdiVlsio �d ' -LR , J . Lot #: 1 i . limited energy, non residential 75;00 • 2
,Tax T)fl / flrcel #: ` Each manufactured home or m
c odular dwelling
il521 ' 1 4r k lag l 1 f Ol 0, . ; . 1 • . `tl'1s; y service and /or feeder 90,90 J
I Services or feeders • installation,
.4",C) .4",C) I - `a;r∎ -i I . (r1 . alteration or relocation:
� J
�� e u i .f c�t�;, I^rYt, d.a f 200 amps or Tess 80.30 2 `201 amps to 400 amps 106.85 2
401 amps to 600 amps 160 -60 2
E ijt�I Q 14 i.ilik„.i` � ^511 . `,� i'�sxu j;n M .AT id .iii! . u• i K _., 601 amDS to 000 240.60
r, �), '� i. , "r' � � � tlr : �If Ir N amps 2
Over 1000 amps or volts 454.65 2 -
Name: -iRl Gtr K_ciak , M (t n n _ Reconnect only 66.85 22
Address: Temporary services or feeder's - Installation,
- . alteration, or'relocatioti:
City /State/ZIpi_ . . , . ' 200 amps or less. I 66:85 . 1
Phone 46 9y me 1 e . Fax: 201 am.s to 400 am.s 100.30 • • 2
ar l lIS 41 it• i , v >r�'�. �r.1 .�r. {1 , , . qe ' Br n 600
,e amps 133,75 2
li
1 � �i �j.;{i'ifj�,''� 0 ,'�3fY+��� �` lfE',:�.���P�i�_i� x�.f +; ,Rranch,clrcults -new, alteration, or
Name: . , - extension per panel:. . .
______ A. Fee for branch circuits with purchas of
service or feeder fee, each branch circuit 6.65 2
V
City /State /Zip: B. Fee for branch circuits without purchase of '
service or feeder fcc, first bran h circuit 46.85 2
Phone: ' I Fax: F-achadditional branch 'circuit - 6,65 2
E- mail: Misc.(Scrvicc or feeder, not inbludcd):
�i+ ltkr l � f:` it 'f�%1c i •v: J. K T6 A I ° , `111 0 °1ra tc".,���'u`:t�l t�!i'i�ti�.i tL'S1u;ir ? F ch sign t in or oumutet circle
lighting 53.40 2
.Job No: Signal circuit(s) or a limited energy panel,
Business Namc: Q,Ko`.c S( pl.f-r(.• alteration, or extension • Page 2 2
Description:
Address: .80 -- I '4f1 33 - ,
C it lSt /Zi. :� -�1 � �� 9� ins. ellen . r our m hour Each additional Inspection over the allowable In any of the above: _ .
h �J _ T �
Q �-- Per il hour 1 h 62.50
Phone: Stoma - .l - Fax: - aS io a a--.. Investigation fee: _
CCBCCB A 1Iy �{%{��� r� he � L1 -
Lic- #: - , Y Olo Lie. #: 1 211 Other: fi r. he m 1 I .i r 1 1 t' I L I 1 r 1.1^ E1 ICI] T 1 A ( E1JL r�
Supervising electricL 1 ] / t'' rs., °�, :., a ? : E1 i ' r Subt t lr$ .iig5i4c'l 1 irrwt,' • a�
signature required: c1L't ,4 . Plan Review (25% of Permit Fee) $
Print Name: creel fli I Lie. #: (2/ ( I CA-- State Surbhar a 8% of Permit ) '
Authorized TOTAL. PERMIT FEE $ I.�J
Authorized Notice: This permit application expires if a permit is not obtained within -
Signature: t 1 �3 — — D I I ate_ I la P 180 days after it has been accepted as complete.
*Fee methodology sct.by Trl- County Building Industry Service Board.
. at, tab', L Re_ 4/Y■
- (Please print name)
i:\Dsts \Pcrrnit Fofms\ElerermitApp•doc 01/03 •