Permit 4. _Am
CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR2004 -00071
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/22/04
SITE ADDRESS: 12345 SW WINTERVIEW DR PARCEL: 2S110BC -03700
SUBDIVISION: THORNWOOD ZONING: R -7
BLOCK: LOT: 008 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 #: SP.11 - 555821 IJLE
LIC 96806
ELE 26- 565CLE
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 3/22/04 $75.00 Elect'I Final
[TAX] 8% State Surcharl 3/22/04 $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 • e -s adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 throuc
i��
1 ued by ■'' / ARM
7 Permittee Signatu �p1 ' ;
tt
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
03/19/2004 12:20 5032362322 QUADRANT SYSTEMS PAGE 02 \
f - ‘).•
Electrical Permit , I 1 ', _ , ; on FOR 014101: USE ONLY"
--
Received �/ Electrical C
'I LT" Date/By: � 0 7 PermitNo.: GGpp G11D 7/
City of Tigard Planning App , al saga
Date/By: Permit No.;
13125 SW Hall Blvd. MAR 1 9 2004 Plan Review Other
Tigard, Oregon 97223 Date/By Permit No,:
Phone: 503- 639 -4171 Fase ISM 130181146R D Post- Review Land Use
'' . ''''ter; +� Dat Case No.:
Internet: www.ci.tigard.or;g� DI VISI O a1:' I Con Ju
' I Egi See Pa 2 for
24 -hour Inspection Request: 503 -639 -4175 "
Name/Method: ! ill - Information.
AV -i: k 1 +,may 1^ . , . 5:1. �. 17. r 4 C 1 t: fr - ... �,.,, � • �• :�il'l]( � nf' II'ju,r -ti 5�,,, 14�;;IS�7.41:I'�o�;'" t f � 21 Si: • �1 ` ' i 4:�1, J h iS : , . 1 �,! d , 7' � �li- '�'��� �r':� , i u'i�iSS
r New construction • Demolition • service over 225 amps- • Health -care facility
commercial ❑ Hazardous location
Addition/alteration/r r laccment 111 Other: ❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet,
' 4 § ;13,.,c2NaN Iiyo `i i:l.g &HLT:ME 1 ec 2 family dwellings four or more residential units in
ICI 1 & 2- Fam.il dwellin: ❑ CommerciaVIndustrial ❑ System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
,111V211' B 1 1. t • rli ❑Occupant load over 99 persons ❑ Manufactured structures or RV park
• Master Builder 1. Other: ❑ Egress/lighting plan ❑ other.
ile¢ Id e hTI ii ;40 i � C _! 17.ig ;,; : T? ; j; ;i_) Submit seta of plans with any of the above.
The above are not a .lieable to tem. ore construction service.
Job site address: it S t A i e v 4 - y' i ' " !.✓ y ' :' : ' + ' ^1;H Di a , ' : + . 7 : f r . 7:75 7 l t i l II ' !vi111 G l `',I FF ''a;1 ri ' 1.1:;:g
Suite #: B1d l ./A ■ t.#: Number of inspections per permit allowed
Pro'ect Name: T ie ,.. . , : •- Le -/ # Description Qty Vet (es.) Total
Cross street/Directions to job site: New residential- single or multi- family per 1
dwelling unit. Includes attached garage. ,
Service Included:
1000 sq. R. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 1
Limited energy, residential 75.00 2
Subdivision: Lot #: Limited enemy, non residential 75 -00 2
Tax ma • I / • arCel #: Each manufactured home or modular dwelling
i' a 1 l ?�Si'MS'E D Z5:A °L 1 n I'I'ri i� - vi �, f t 1 �I .------. r : ? service and/or feeder 90.90 2
1 ��""�� Servieeaorfeeders - installation,
• A
alteration or relocation:
200 amps or less 60.30 2
201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
-
pp� :jiiilT� ; rya`;1'�S�a2
'fii^!<<i:YjMEE - 1 ,li .it�; �� ::;i:'1: ,,.: ij:i: ?l` 601 am0aiti MCI amps 240.60 2
ai r •_ � � 1...- �..�_ + 1nL�..�.... ,,.w. �� � ,. _ :,, , Over 1000 amps or volts 454.65 2
Name: /n r' ' S- '1 & ' Reconnect only 66.85 2
Address: q L 0 1 s..PW , � /00 Temporary services or feeders - Installation,
alteration, or relocation:
Ci /State/Zi • : ( l Die/ / b i? , d 200 amps or less 66.85 1
Phone: Z5 - _ $ - ' 201 amiss to 400 amps 1 00.30 2
,,
K r r I i
r , :, F ' - a: ,_,.. 401 to 600 amps 133.75 2
II{{��' m atuyico.�s.i,'vA11!bat,,iii li'fll_(ii '� �t3�;;a_ Str(o�!'�{ai_ aiTg1'I�A�7,•::.�ti. -
yl�. 1� `; -�•s ' •, � ��(�- .�- �- �. ..: .. �!� I� Branch circuits. new, alteration, or
Name: A . (1/,7 „,,, 4- , e ' �,t! . extension per panel:
Address: C/ e /
- J Q ? A. Fee for branch circuits with purchase of
CJ y� d service or feeder fee, each branch circuit 6.65 2
Ci /State /Zi • : ov 1 ' 01 2 12 9 7 Z) B . Fee for branch circuits without purchase of
service or feeder foe, fist branch circuit 46.85 2
Phone: SG? 2. Pf/- S S" .' Fax: r0 -2? -- Z3 7-?� Bach additional branch circuit 6.65 ' 2
E -mail: Misc.(Servite or feeder not included):
`,_L ' v ,: -.;, i c �7 Each pump Ot iRl�ation circle 53.40 2
F�lI'' :,�1�fp f lj + tl i 411 `!•!7.. f'Ff7F1. /7• CI1ppCC iii i- f ;T r ? i ,4d
r �ip -.IIl I..', K,ltl. P.d. t. ..a. ..tJ•... \H,A°�fl..,._ -._n1. .JPx J'wll .L�• FBChsignoroutline!Oh'ne 53.40 2
Job No: si circuit(s) ore limited energy panel,
alteration, or extension 1/4 ..... Page 2) 2
Business Name: IMMITAMPEIMIEMIE
_ Description:
Address: _0 a , 0 / K g 3
Each additional ins • tenon over the allowable In an of tin above:
Cit /State /Zi r . 1 d CE Per inspection per hour (min. 1 hour) 62 50
Phone: SL - 2 ' -5"S Investigation fee:
/� other: _ ! }�
• i -1C. fP ° "4.. -- - __ 7' :T:j: - 1 ':�y �:: i�a; . .s`v.i_ -,{- �lh�r'r`,� F,/:;,f ;.:112'/
- Wy r.._ � i... u�a.). il.` �.` L !rS..... l..,l,,...�?4F.li..drlH L,..'I -..,. _1� ..�.� �1�:�.,.,,. 6
Supervising electrici. l Subtotal $ r S" aU
si' attire re • uircd: vh Flan Review125% of Pertnit Fcc) _ 5
State Surcharge (8% of Permit Fee) $ co- -
TOTAL PERMIT FEE $ OQ
Authorized Notice: This permit application expires if a permit is at obtained within
Signature: - Date: 180 days after it has been accepted as complete.
*Fee methodology set by Trl- County Building Industry Service Board.
(Please print name)
i:\Dsts \Permit Fonns \ElcPcrrnitApp•doc 01/03