Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
4t DEVELOPMENT SERVICES PERMIT #: ELR2004 -00216
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/19/2004
SITE ADDRESS: 12055 SW WHISTLER'S LP PARCEL: 2S103CC -14400
SUBDIVISION: WHISTLER ' S WALK NO. 2 ZONING: R -4.5
BLOCK: LOT: 091 JURISDICTION: TIG
Project Description: Limited energy - audio.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: X 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: • HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE HOMES QUADRANT SECURITY INC
4230 GALEWOOD ST., #100 PO BOX 14833
LAKE OSWEGO, OR 97035 PORTLAND, OR 97293
Phone: 503- 387 -7538 Phone: 234 -5558
Reg #: SUP 1211 JLE
LIC 96806
ELE 26- 565CLE
FEES Required Inspections
Description Date Amount
[ELPRMT] ELR Permit 7/19/2004 $75.00
[TAX] 8% State Surchart 7/19/2004 $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 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
07/15/2004 17:39 5032362322 QUADRANT SYSTEMS PAGE 01
Ellectrical Permit ola FOR OFFICE USE ONLY
t Rei ./ /, Blcctrical
�tt ' Dat ec ved 1 I O r 40 P No.:j ^� ac k 00
City of Tigard .� 6 2 1 Planning Approval Sign
�J g Q Date/By: : Permit No.:
13125 SSW Hall Blvd. ! AW- Plan Review Other
Tigard, Oregon 97223 p,,'BO
4171 Fax: li9V �j\S 0 A , Post - Review Card Us DateB P nd U s e :
Phone :
Internet; www.ci.tigard.ol.us tLOl 7FVr; I I C ontact Case No.: •
gv IA 1 Contact 's,: See Page 2 f
24 -hour Inspection Request: 503 -639 -4175 Name/Method: 1 c Supplemental Information.
4'. ,1 721" '! .if ICI 11l i Ya. F1 . C3ZES 01 - ` ,.-1 ( 7 1 57 - Eg , 7.y (' r t ;-�7y'r � s-" . .:'Y,- -'L 'f,,, - ttliK t ,, ; r
bt6G S�� _ i�.1a,f� :i. G.'.�II:Ivti• ���I:r - AL .�,��� \ i.�,,.r -(��!� , �dY Ir'+ �. l� f?� ll �' 4 f� 40.1 �dn .- 't. „ n ,/ 4 d"'''
1102 New construction M■ Demolition • Service over 225 amps- • Health-care facility
commercial ❑ Hazardous location
/■ Addition/alteration/re 4lacement .• Other ❑ Service over 320 amps - rating of p Building over 10,000 square feet,
1 :`1j1' 4!^ E.,11 '6r t 1,1ii,:.4,!I),VY - °'IIOn 1t0; !. :;.,,i. ;11 + ?rillTl? 1 & 2 family dwellings four or more residential units in
II I & 2- Fatnil dwellin: Ill! Commcrcial/Industria1 ❑ System over 600 volts nominal one structure
• Access° Buildin _ • 1-� ❑ Building over three stories ❑ Feeders, 400 amps or more
❑ Occupant load over 99 persons ID Manufactured structures or R.V park
1111 Master Builder I . Other: ID Egress/lighting plan p Other:
E �t� • I r l''' r l , 1}� f 1. 6'1.Mt ;j11' I i' t ++r r. , tr 0 ( (I-wt dint' 7 ,, i Submit sets of plans with any of the above.
raI L� I. d,a }da.,. ' �, y._ " _. s.� ... . �,rll l , P. w �ti (J' .� 1.. _ !
d dress: / O 5" SW C4.Jfl, s I / The about arc not s tic to tern • era construction service.
Job site a
• r �. ` -f I S L /// +. i: .= I' r 61 �1'I I I I ..� ti , _ 'lull✓ Il f,l J,ACIIlis].4 ,,k 1.!_,:i;' J54 ■
Suite #: Bid:. /A.t. #: Number of inspections per permit allowed
Pro 'ectName: Description I Qty Fee (es.) Total 1
New residential - single or multi- family per
Cross street/Directions to job site: dwelling nolL includes attached garage.
Service included:
1000 so. It. or less 145.15 4
Each additional 500 eq. ft. or portion thereof 33.40 1
Subdivision: Lot #: g _Limited energy, residential 75.00 2
Lim energy. non residential 75.00 2
Tax ma • /. arcel #: Each manufactured borne or modular dwelling
li ? i�'J if,V (:�l '...i. 1'0. . p 01,..II.A'10 ° , 11 . : `_.. -- _ , . . .. . .. .... tervice rind/Or feeder 90.90 2
c Services or feeders - Installation,
(!M #-F-e eite.er' u ' '0 alteration or relocation:
200 amps or less 80.30 2
201 amps to 400 amps _ 106.85 2
401 ernes to 600 amps 160.60 2
4`" C' ':• tJ (Si'i:i9!∎7311 "r'. ^ ".;11f °': ::."Fi'`°:lorS:�,l c` '. 601 amps to 1000 amps 240.60 2. • r
, Over 1000 amps or volts 454.65 2
ame: h a /vier 4e -€ Reconnect only 6645 2
Address: S ' ' Temporary services or feeders - installation,
alteration, or relocation:
200 amps or less 66.85 I
Phone: V ' - Ye?- - 7S Fax: 201 amps to 400 amps 100.30 2
°�1� ,It1 t)r l'I'', i �� 1 I,r ''air:. \;)i ir : +_,,I 401 to 600 amps 133.75 2
!t
I... , I .0 ? its i ,�C �_..1° ?, Branch circuits - new, alteration, or
Name: extension per panel:
Address: A Fee for branch circuits with purchase of
service or feeder fee, each branch circuit 6.65 2
Ci /State /Zi .: B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 46.85 _ 2
Phone: Each additional branch Circuit 6.65 2
E -mail: Mise.(service or titeder not included):
F - 1 , :'1'';,g.,':,.. - '' ::d ` ; ` ;, ` r ig f5).1:3;;a: \ {i:'i t ria a , Each pump or it illation circle 53.40 2
.... ,,.. :.,.. ... ,.......... � .. ........ _.. Each sign or outline lighting 53.40 _ 2
Job No: Signal circuit(() ora limited energy panel,
alteration, or extension 2
Business Name: OV , , , , ; , P . l • At Description:
Address: P.0, - L . 3 _
�, y�- , y d slti ' R 3 Each additional Inspection over the allowable hi any of the above:
Cit /State /Zi • •
• S Per inspection per hour (min. I hour) 62.50
Phone: S o 7 -Z - S . r S ' Fax: Sb 3'-Z b - 7 _ 2 . 2 - - Investigation fee:
CCB l.ic- #t ' 'C I i e- #: 2 s� f C. L-E °i -
.K'�.+�.. -..,, . ... � ...:., . , 4 .. 1 .� It.7il Cl»111 .2. F.C: .' I': �:+. =,i'l-
Supervising electrici : 1 I. - S ubtotal $ 7 V".
Si:.4 attirere.riled: v(4. - Plan Review(25%of Permit Fed $ _
Print Name: ?, ' WI . `I (e v HEEMPIIIMIN State Surcharge (8% of Permit pee) $ (o , CO
TOTAL PERMIT FEE $ i? ( , Gp
Authorized / G� Notice: This permit application expires if a permit is not obtained within
Signature: - ( • ) Date: r1 180 days after It has been accepted as complete.
"Fee methodology set. by Tri- County Building Industry Service Board.
u 1r f l.•1 ( , 1C(!4/11*! -
(Please print name)
i :\Dsts\Permit Forms \ElcPcrmitApp.doc 01 /03